Clinical and Therapeutic Characteristics of Acute Maxillary Rhinosinusitis in a Hospital of Cotonou

Introduction: Acute maxillary rhinosinusitis (AMRS) is one of the most common ear, nose and throat infections. The aim of this study was to contribute to the improvement of the management of the condition in sub-Saharan Africa. Material and Method: This was a cross-sectional, descriptive study that ran from January 1, 2017 to December 31, 2021 in the ENT-HNS department of the “Centre Hospitalier et Universitaire de Zone de Suru-Léré” (CHUZ SL) in Cotonou, Benin. It involved all patients who consulted during the study period and in whom the diagnosis of acute maxillary rhinosinusitis was made. Results: A total of 405 cases were identified. The mean age was 34.26 ± 15.26 years with extremes of 9 and 63 years. The predominance was female with a sex ratio of 0.61. Acute maxillary rhinosinusitis was bilateral in 371 cases (91.60%). The main symptoms were facial pain in 346 cases (85.43%), mucopurulent rhinorrhea: 315 cases (77.78%), headache: 283 cases (69.88%), and nasal obstruction: 244 cases (60.25%). The most frequent physical signs were pain on pressure of the maxillary sinus points in 405 cases or 100%, purulent secretions at the middle meatus: 11.35%, hyperemia of the nasal mucosa: 53.58%, hypertrophy of the middle turbinate: 41.48% and discharge of pus on the posterior pharyngeal wall: 36.79%. Amoxicillin + clavulanic acid was the main antibiotic prescribed. Vasoconstrictors were used in 228 cases 56.30%. The evolution was favorable in all cases. Conclusion: The diagnosis of acute maxillary rhinosinusitis is clinical. Treatment with antibiotic gives good results.

A Rare Tumor of the Scalp: Papilliferous Cystadenoma

Introduction: Papilliferous cystadenoma is a rare adnexal tumor of early childhood. Case Report: We report a case of papilliferous cystadenoma of the scalp in a 22-year-old adult with no previous history of the disease. She had been presenting with a slowly progressing scalp mass for about 10 years. The mass was mildly pruritic and painless, but the patient reported several painful episodes treated with local herbal applications and unspecified antibiotics. On inspection, the lesion was raised, granular, sessile and vegetated, greyish in color, with an irregular surface, nippled and hemispherical in shape. On palpation, the lesion was painless, fleshy and surrounded by crusts that were easily removed by applying a saline-moistened compress. The patient underwent excision with at least 4-mm margins. Pathological examination of the operative specimen revealed a papilliferous syringocystadenoma. There was no tumor recurrence after three years. Conclusion: Papilliferous cystadenoma is a rare benign tumor of the scalp requiring clinical analysis and surgical excision to confirm its histological nature. Post-operative follow-up is necessary due to frequent recurrences.

Diffuse Cervico-Facial Cellulitis: Epidemiological, Diagnostic and Therapeutic Aspects at the Teaching Hospital CNHU HKM of Cotonou

Purpose of the work: to study the epidemiological, clinical and therapeutic aspects of diffuse cervico-facial cellulitis collected within the ENT-CCF surgery department of the CNHU of Cotonou. Materials and method: the study was a descriptive retrospective carried out from January 1st, 2018 to December 31st, 2020. It concerned new cases of diffuse cervico-facial cellulitis identified during the period. Results: in 3 years, 55 cases of diffuse cervico-facial cellulitis were identified out of 1101 hospitalized patients. The frequency was 4.99%. Per year, 18 cases of cervico-facial cellulitis are recorded. The mean age of the patients was 41.3 years with extremes of 15 years and 85 years. A clear male predominance was noted with a sex ratio of 1.29. Painful cervico-facial swelling was the most common reason for medical consultation (47 patients or 85.5% of cases). Thirty patients (54.5%) showed a deterioration in general condition. Several clinical forms of diffuse cervico-facial cellulitis have been described, in particular the gangrenous form, the suppurative, necrotizing form and LUDWIG’s angina. The portal of entry was dental in 50 patients (91% of cases), favored by poor oral hygiene and self-medication with non-steroidal anti-inflammatory drugs (NSAIDs). The medico-surgical treatment implemented was favorable for 47 patients (85.5%). Conclusion: Diffuse cervico-facial cellulitis remains a frequent medical-surgical emergency in the CCF ENT department at the Teaching Hospital of Cotonou. Mainly of odontogenic origin, it is encountered in different clinical forms.

An Unusual Cervical Penetrating Wound Extended to the Right Pleural Dome

The solution of continuity of the tissues of the neck with rupture of the platysma muscle is called a cervical penetrating wound. The authors report a case of an unusual penetrating neck wound extended to the pleural dome by stabbing a psychiatric patient. They describe the diagnostic circumstances, the therapeutic approach and discuss data from the literature. It was a 26-year-old young woman, who was received in ENT for a penetrating neck wound with a stab wound following a suicide attempt. The diagnosis of a penetrating stab wound to the neck extending to the right pleural dome was retained. The exploratory cervicotomy with the extraction of the foreign body found a knife blade penetrating the anterior base of the right side of the neck to the right pleural dome, sparing the noble vasculo-nervous and aero-digestive organs of the neck. The postoperative course was simple and the evolution was favourable. This unusual penetrating wound of the neck is spectacular and remarkable for the absence of involvement of noble organs despite the involvement of the pleural dome. However, it remains a concern in psychiatric patients and requires multidisciplinary management and systemic management in order to avoid recurrence.

Risk Factors for Acute Otitis Media in Children Aged 0 to 5 Years in Parakou

Introduction: Acute otitis media (AOM) is one of the most common ENT childhood diseases. Objective: To identify risk factors for AOM in children aged 0 to 5 years. Methods: This research work was a cross-sectional, descriptive and analytical study. It focused on 2040 children aged 0 to 5 years from both sexes, who were healthy or sick, and living in the Local government of Parakou for at least one year. Those children were randomly selected in all three districts of Parakou. Results: Frequency of AOM was 2.8% and their prevalence was estimated at 16.3%. The identified risk factors were persistent or chronic cases of rhinitis, exposure to charcoal and wood smoke, low socioeconomic status, personal history of AOM, AOM history among the siblings, and children’s poor nutritional status. No relationship could be established between AOM occurrence and factors like sex, passive smoking, attendance of a day-care centre or stay in nursery, prematurity, exclusive breastfeeding and large number of siblings. Conclusion: The identification of those risk factors will help put in place appropriate measures to reduce AOM prevalence in Parakou.

Tracheotomy in ENT at CNHU HKM of Cotonou

Background: known since more than 5000 years, tracheotomy is indicated in severe obstructions of the upper airways or in improvement of ventilation in cases of problematic tracheal intubation. Its usefulness and efficiency are certain, but it needs regular assessments. Aim: to determine the frequency of tracheotomies in ENT at CNHU of Cotonou, identify the indications, surgical technics and the postoperative course. Materials and methods: the study was retrospective, based on files of patients who have had tracheotomies for ten years since 2010. Results: in 10 years, 105 tracheotomies were performed for 99 patients, average 10 to 11 per year. Patients were male in 61.9%. Extreme of age where 09 months and 80 years old. Children under15 were concerned in 41.9%, while patients from 45 to 64 years old in 33.3%. Emergency tracheotomy represented 76%. Causes were tumors in 62.8%. Laryngeal papillomatosis was the predominant tumor in children;28 cases or 26.67%. In adults, larynx cancer represented 20%. Skin incisions were horizontal in 94.3%. Tracheal opening was “H-shaped” in 92.4%. Complications occurred in 28.6%. They included granuloma (13.3%) and oeso-tracheal fistula (1.9%). Decanulation was possible in 87.6%, but it was more difficult in children. Conclusion: tracheotomy was an act of rescue in our practice.

ENT Pathologies Screening in Woodworkers in Parakou,Benin

Wood dust may induce health risks on exposed timber or wood workers, one of which is ENT disorders. This article aimed to detect ENT pathologies found among woodworkers in Parakou. It was a cross-sectional descriptive study carried out from 1st March to 31st May, 2012 in Parakou, North-Benin. It involved 703 carpenters and sawyers operating in timber workshops in Parakou, regardless of age and sex. The mean age of the wood-workers was 26.14 ± 7.77 years. Their seniority in the timber profession was on average 4.9 ± 2.64 years. All of them were males. It had been noticed that 81.6% of them did not comply with any safety measure for their protection. ENT pathology had been diagnosed in 60.3% of the timber workers. Rhinitises came first and affected 43.1% of the workers, followed by pharyngitises (14.1%). The histological nature of the only case of tumor observed in Parakou could not have been specified, as the patient refused to undergo anatomopathological examination. Measures should be taken to get Parakou timber workers to protect themselves.