Prevalence of Noise-Induced Hearing Loss Related to the Mills in the Markets of the Municipality of Parakou in 2021

Introduction: Noise is the second leading cause of hearing loss in adults after presbycusis. The objective of this work was to study hearing loss induced by the noise of mills in the markets of Parakou. Methods: This was a descriptive and analytical cross-sectional study, conducted from February 3 to June 3, 2021 in the markets of Parakou. It concerned millers and sellers located within a 5 meter radius around the mills and among whom pure-tone audiometry was performed to detect a hearing loss. Subjects with no particular medical health history, under 55 years of age and having been working in these markets since more than 12 months, were included. Results: In this study, 103 subjects were selected, including 43 millers and 61 sellers. Their average age was 29 ± 13 years. The sex ratio was 0.49. The average length of service in the profession was 8 years with the extremes of 3 months and 47 years. They were exposed to noise on average 10 hours per day and 6 days a week. The average duration of weekly noise exposure was 23 h 28 min ± 13 h 32 min with the extremes of 5 h 00 min and 52 h 30 min. The average level of noise exposure was 90 dB with the extremes of 72 and 110 dB. 24 subjects reported symptoms related to noise such as headache, tinnitus, and hearing loss, with respective proportions of 22.33%, 20.39% and 06.80%. The prevalence of noise-related hearing loss was 26.21% (n = 27/103). Subjects with a notch at 4000 Hz and normal Average Hearing Loss (AHL) (20.39%) had a seven-time greater risk of developing noise-induced hearing loss (OR = 6.58;95% CI [2.54 - 18.8], p Conclusion: Hearing loss related to the noise of mills affected both millers and sellers near the mills in markets, hence the importance of regulating mills.

Place of Partial Arytenoidectomy in the Management of Bilateral Vocal Cord Immobilitis

Surgical management of laryngeal paralysis varies depending on whether the vocal cords are in abduction, adduction or paramedian position. Various surgical techniques have been described including partial arytenoidectomy which is reported to give good surgical results that are stable over time. The objective of the study was to analyze the surgical therapeutic elements of bilateral paralysis, especially to assess partial arytenoidectomy, one of the most performed techniques. This was a descriptive retrospective study of cases of bilateral immobility admitted between January 1st 2008 and March 31st 2018 and treated surgically. Socio-demographic and therapeutic data were collected. The survey involved 46 patients, with an equal number of male and female (23) with 50% of male patients and 23 patients were female, or a sex ratio of 1. The average age of the patients was 56 ± 17 years ranging between 14 and 89 years. Posterior partial arytenoidectomy was the most widely performed surgical technique (26 patients or 56.5%), followed by cordopexia or lateral-fixing of a vocal cord (19.6%) and posterior cordectomy (17.4%). Patients who received a partial arytenoidectomy and cordopexia had their vocal cords either in adduction or in the paramedian position. Those who received a posterior cordectomy had their vocal cords in adduction. 18 patients (39.13%) were taken to the operating theatre in less than 6 hours, 28 (60.9%) had no post-operative complications, and 9 patients received a surgical enlargement resumption. In post-operative follow-up, 11 patients suffered pulmonary aspiration corrected after speech therapy;26 patients (56.5%) did not. Partial arytenoidectomy remains the most performed surgical procedure in the management of closed bilateral laryngeal paralysis at the Mont-Godinne University Hospital. It allows a reliable and durable breathing function over time with less impact on the voice.

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.

Characteristics of Ent Foreign Bodies in a Hospital at Cotonou, Benin

Introduction: Foreign bodies (FB) can constitute a life-threatening emergency by their nature or their location. The objective of this study was to describe the socio-demographic, diagnostic and therapeutic characteristics of FB in the ENT department of CHUZ-Suru Léré in Cotonou. Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection spanning a period of ten (10) years from January 1st, 2013 to December 31st, 2022. Patients of all ages seen in consultations in the ENT and CCF department of the CHUZ-Suru Léré during the study period and meeting the inclusion criteria were taken into account. Results: During the study period, 1810 cases of FB were collected among the 13,947 consultations, i.e. a hospital frequency of 12.98%. The age of the patients varied from 19 days to 94 years with a predominance of children under 10 years (60.2%). The sex ratio (male/female) was 1.13. The duration between the onset of FB and the medical consultation was greater than 72 hours in 88.49% of cases. The circumstances of occurrence of FB were unknown in 86.34% of cases. The external acoustic meatus was the most common location (90.22%). The nature of FB was inorganic in 86.80% of cases dominated by earwax plugs (77.90%), and organic FB in 7.96% of cases dominated by cotton (3.98%). All FB were extracted by the route of introduction except one case. The extraction was performed most often in the consultation chair (97.07% of cases). The evolution was generally favorable (99.94%). Conclusion: ENT foreign bodies are a frequent reason for consultation and mainly affect male children. They are usually inorganic. Evolution is generally favorable after extraction. Prevention remains the best solution.

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.

Impact and Factors Associated with Presbycusis among 50 Years Old People of Parakou and Over in 2021

Introduction: Presbycusis or age-related hearing loss is a condition of in-sidious onset with significant socio-professional repercussions. The objec-tive of this study was to determine the impact and factors associated with presbycusis among 50 years aged people or older in Parakou commune during 2021. Methods: This was a cross-sectional, descriptive, analytical study with prospective data collection. The study has involved 541 50 years aged people or older, from February to May 2021. For each of them, a questionnaire was completed, otoscopy and tone audiometry performed. The ERSA questionnaire and the logistic regression model were used to determine the impact and factors associated with presbycusis. Results: The mean age was 59.48 ± 9.80 years and the sex ratio was 1.23. The prevalence of presbycusis was 50.28%. Age ≥ 80 years (p = 0.002), male sex (p = 0.016), low educational level (p = 0.001), family history of age-related hearing loss (p = 0.018) and presence of hearing loss (p = 0.001) were significantly associated with presbycusis in multivariate analysis. Of the life domains studied, personal life (mean score = 32.9 ± 10.52) was the most affected. Similarly, communication in a noisy environment (mean score = 4.39 ± 2.39) was the most affected aspect of personal life. Conclusion: Presbycusis leads to an impairment of personal life. A good knowledge of the associated factors and an early management could contribute to the improvement of the hearing health of the elderly.

Noise Exposure and Otological Morbidity in Military Musicians in Cotonou

Introduction: Military musicians are subjected to a double risk of noise related to the use of combat weapons and then to the use of musical instruments. The objective of this study was to assess the otological damage of military music professionals in Cotonou. Methods: This was an analytical cross-sectional study carried out from July 15 to November 15, 2019. It focused on soldiers from the Music Squadron and the first Motorized Intervention Battalion of Camp Guézo in Cotonou. Results: 110 soldiers were included. The mean age was 34.3 ± 6.2 years. The sex ratio was 17.3. The instruments used were wind (74.5%), percussion (23.6%) and string (1.8%). The average length of service in the Music Squadron was 11.5 ± 6.7 years with extremes of 1 year and 25 years. They practiced military music for an average of 4.58 hours per day for 4 days per week. The mean sonometric measurement during training ranged from 89.1 dB (A) to 116.4 dB (A). Hearing loss was predominant in the military musicians group and was mild degree bilaterally (p = 0.002) and perceptual type (p = 0.007). Conclusion: Military musicians are exposed to high noise levels, putting them at risk of developing hearing problems that may limit their performance. The main otological morbidity found was hearing loss associated with a few cases of tinnitus and headache.

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.