Non-Traumatic Chronic Nasosinusitis Disorders: Clinical and Computed Tomodensitometric Aspects in Cotonou in Benin, West Africa

Introduction: Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and Method: It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016;on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. Results: Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. Conclusion: chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.

Sonographic Measurement of the Optic Nerve Sheath Diameter (ONSD) and Eyeball Transversal Diameter (ETD) in Benin Healthy African Adults

Background: Measuring optic nerve sheath diameter (ONSD), a relatively re-cent technique, allows an indirect and non-invasive diagnosis of intracranial hypertension. The ONSD ratio to eyeball transverse diameter (ETD) increases this reliability of the technique. The objective of this study was to determine the normal ONSD and its ratio with ETD in black African adults in Benin. Methods: A descriptive cross-sectional study was conducted between May 2019 and August 2019. Ultrasound ONSD and ONSD/ETD ratio were meas-ured in 210 healthy adults received in the medical imaging department of the Borgou and Alibori University Hospital Center in Benin. The ONSD corre-sponded to the average of 12 measurements (03 horizontal and 03 vertical for each eye) taken 3 mm behind the papilla. The transverse ETD corresponded to the average of 03 measurements. Results: The mean ONSD was 4.20 ± 0.28 mm (95% CI = [4.17;4.24] mm and 95th percentile = 4.70 mm). The mean ETD was 24.25 ± 1.10 mm. The ONSD/ETD ratio was 0.17 ± 0.01 (95% CI = [0.17;0.17] and 95th percentile = 0.19). There was no difference between ver-tical and horizontal ONSD and between right and left ONSD. The ONSD and the ONSD/ETD ratio were not correlated with any of the socio-demographic and anthropometric characteristics studied (sex, age, ethnicity, weight, height, body mass index, head circumference and waist circumference). The ONSD was associated with ETD (p < 0.001 and r = 0.55). Conclusion: An ONSD and an ONSD/ETD ratio respectively greater than 4.70 mm and 0.19 should sus-pect intracranial hypertension. The ONSD/ETD ratio may be a better indicator of HICT because of its small variation.

Magnetic Resonance Imaging of Central Nervous System Lesions in HIV/AIDS: About 35 Cases in Libreville (Gabon)

Background: Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Results: Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusion: MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.

Anatomic Variants of Sphenoid Sinuses and Adjacent Structures: A Study of 225 Skull CT Scans at CNHU-HKM in Benin, West Africa

Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.