Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the st...Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.展开更多
Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Mult...Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Multiple risk factors are known. The data from our environment concerning this condition are few. Thus, in order to contribute to the study of this complication in our environment, we proposed to carry out this study, whose objective was to determine the predictive factors for the occurrence of pharyngo-cutaneous fistula or pharyngostoma after total laryngectomy and total pharyngo-laryngectomy in Yaounde and Douala. Patients and Methods: This was a retrospective, cross-sectional, descriptive study conducted in the 5 Ear-Nose-Throat (ENT) department of hospital in the city of Yaounde and Douala. The study took place between January 2009 and December 2020. All patients who underwent total laryngectomy or total pharyngo-laryngectomy with a follow-up of at least one month were included in the study. Incomplete records were excluded, as well as those of patients who died before one month of postoperative follow-up. Results: We selected 48 cases of total laryngectomies (TL) and total pharyngo-laryngectomies (TPL), and identified 37 cases of pharyngostoma. 45 men (93.8%) and 3 women (6.3%). The mean age was 56.4 years with extremes ranging from 37 to 86 years. Smoking and alcoholism were noted in 75% and 79.2% of our patients respectively. A tracheotomy before TL and TPL was found in 41.7%. 100% of the tumours found were T3 or T4. The surgery was in 34 cases (70.8%) TL and in 14 cases (29.2%) TPL. Pharyngostomas were observed in 37 cases among 48 patients operated on, i.e. a frequency of 77.1%. The average delay of appearance was 7 to 14 days. We had spontaneous healing with pressure dressing and nasogastric tube feeding in 35 patients (77.8%) and two patients benefited from pectoralis major flap treatment;the healing time was 21 to 30 days. We did not find any correlation between gender, age, tumour site of origin and locoregional extension and the occurrence of pharyngostoma. Preoperative tracheotomy and radiotherapy were not significant risk factors for the occurrence of pharyngostoma. However, preoperative anaemia (p = 0.02), LTP (p = 0.02), early complications (p 0.001) and lack of continuous saliva aspiration postoperatively (p = 0.03) were statistically significant predictors of pharyngostoma in univariate analysis. Conclusion: Pharyngostoma is the most common postoperative complication after TL and TPL. In our setting, the main associated risk factors identified were: preoperative anaemia, LTP, early complications and failure to continuously aspirate saliva postoperatively.展开更多
文摘Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.
文摘Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Multiple risk factors are known. The data from our environment concerning this condition are few. Thus, in order to contribute to the study of this complication in our environment, we proposed to carry out this study, whose objective was to determine the predictive factors for the occurrence of pharyngo-cutaneous fistula or pharyngostoma after total laryngectomy and total pharyngo-laryngectomy in Yaounde and Douala. Patients and Methods: This was a retrospective, cross-sectional, descriptive study conducted in the 5 Ear-Nose-Throat (ENT) department of hospital in the city of Yaounde and Douala. The study took place between January 2009 and December 2020. All patients who underwent total laryngectomy or total pharyngo-laryngectomy with a follow-up of at least one month were included in the study. Incomplete records were excluded, as well as those of patients who died before one month of postoperative follow-up. Results: We selected 48 cases of total laryngectomies (TL) and total pharyngo-laryngectomies (TPL), and identified 37 cases of pharyngostoma. 45 men (93.8%) and 3 women (6.3%). The mean age was 56.4 years with extremes ranging from 37 to 86 years. Smoking and alcoholism were noted in 75% and 79.2% of our patients respectively. A tracheotomy before TL and TPL was found in 41.7%. 100% of the tumours found were T3 or T4. The surgery was in 34 cases (70.8%) TL and in 14 cases (29.2%) TPL. Pharyngostomas were observed in 37 cases among 48 patients operated on, i.e. a frequency of 77.1%. The average delay of appearance was 7 to 14 days. We had spontaneous healing with pressure dressing and nasogastric tube feeding in 35 patients (77.8%) and two patients benefited from pectoralis major flap treatment;the healing time was 21 to 30 days. We did not find any correlation between gender, age, tumour site of origin and locoregional extension and the occurrence of pharyngostoma. Preoperative tracheotomy and radiotherapy were not significant risk factors for the occurrence of pharyngostoma. However, preoperative anaemia (p = 0.02), LTP (p = 0.02), early complications (p 0.001) and lack of continuous saliva aspiration postoperatively (p = 0.03) were statistically significant predictors of pharyngostoma in univariate analysis. Conclusion: Pharyngostoma is the most common postoperative complication after TL and TPL. In our setting, the main associated risk factors identified were: preoperative anaemia, LTP, early complications and failure to continuously aspirate saliva postoperatively.
