Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of con...Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.展开更多
Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our cont...Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.展开更多
Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of ...Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.展开更多
Objective: We conducted a study to describe the problem of maxillofacial trauma in rural Africa. Background: the maxillofacial region is very much affected by trauma. These traumas, which are mainly related to public ...Objective: We conducted a study to describe the problem of maxillofacial trauma in rural Africa. Background: the maxillofacial region is very much affected by trauma. These traumas, which are mainly related to public roads, are responsible for considerable mortality. In Africa, they mainly concern young men. Method: This was a monocentric, retrospective and descriptive study over 02 years from January 2019 to December 2021 in the surgical and stomatology departments of the Regional Hospital of Dapaong in Togo. All patients who received treatment for maxillofacial trauma in the said departments during the study period were included. Results: 208 cases of trauma were reported with an annual incidence of 104 cases. The average age was 31.4 years and the age groups most represented were 20 to 29 years (34.13%). Road traffic accidents were the main circumstance (70.14%) and involved mainly blue-collar workers (25.48%). Only standard X-rays were used to assess the injuries. Bone lesions concerned 92.79% of the patients with a predominance of mandibular fractures (34.60%). The main mode of management in the centre was orthopaedic treatment. Conclusion: Maxillofacial trauma is common in Togo. It involves young men and is essentially related to road accidents.展开更多
Oral cavity cancers are part of head and neck cancers. They have become frequent in the world in general and Senegal in particular. This study evaluates microsatellite instability tumors in oral cavity cancers in Sene...Oral cavity cancers are part of head and neck cancers. They have become frequent in the world in general and Senegal in particular. This study evaluates microsatellite instability tumors in oral cavity cancers in Senegal. Forty cancerous tissues, 20 healthy tissues, and 12 blood tissues were included in this study. These tissues were collected from each patient during the biopsy after obtaining consent. DNA extraction, Polymerase Chain Reaction (PCR) and sequencing were carried out to obtain sequences. Mutation surveyor, Bioedit and Dnasp software were used to perform our analyses. High instability was found in 57.5% of patients with cancer. Moreover, 90% of the patients had the same motif on healthy and cancerous tissue. Furthermore, 26.12%, 20.72%, and 11.71% polymorphic sites were found in cancerous, healthy and blood tissue respectively. Thus, a similarity between cancerous and healthy tissues seems to exist. This implies that instability of the Bat 26 microsatellite could occur early in the occurrence of oral cavity cancers.展开更多
Introduction: Ocular melanoma develops at the expense of eyes’ melanocytes which give to the eyes their color. It is the first primitive intraocular tumor in the White race. It is rare, as that of the skin in black p...Introduction: Ocular melanoma develops at the expense of eyes’ melanocytes which give to the eyes their color. It is the first primitive intraocular tumor in the White race. It is rare, as that of the skin in black people. The bilateral cases are exceptional even in the white race, estimated at 0.2%. We present the case of bilateral ocular melanoma with bad prognosis in a black patient. Patient and observation: A 56-year-old black male patient, who had benefited 4 years earlier from an enucleation of the right eye for ocular melanoma, and admitted for bilateral exophthalmos which evolved for three months in a context of bilateral blindness. The cerebral Scanning had allowed to objectify a bilateral lateral-conical mass which evoked an inflammatory pseudo tumor. The failure of the medical treatment led to the exeresis of a conical, juxta-orbital and mid-muscular blackish mass, to the later apex respecting the surrounding structures. The histological examination ends again in a melanoma. No additional therapy was undertaken. The evolution 2 years later was marked by a local recurrence, multiple hepatic metastases and patient death. Conclusion: Bilateral ocular melanoma is exceptional in Black people. The etiologic factors as well as bilateralism mechanisms are still hypothetic. Its most effective treatment is local and the prognosis, bad in case of metastases due to the absence of an effective chemotherapy.展开更多
文摘Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.
文摘Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.
文摘Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.
文摘Objective: We conducted a study to describe the problem of maxillofacial trauma in rural Africa. Background: the maxillofacial region is very much affected by trauma. These traumas, which are mainly related to public roads, are responsible for considerable mortality. In Africa, they mainly concern young men. Method: This was a monocentric, retrospective and descriptive study over 02 years from January 2019 to December 2021 in the surgical and stomatology departments of the Regional Hospital of Dapaong in Togo. All patients who received treatment for maxillofacial trauma in the said departments during the study period were included. Results: 208 cases of trauma were reported with an annual incidence of 104 cases. The average age was 31.4 years and the age groups most represented were 20 to 29 years (34.13%). Road traffic accidents were the main circumstance (70.14%) and involved mainly blue-collar workers (25.48%). Only standard X-rays were used to assess the injuries. Bone lesions concerned 92.79% of the patients with a predominance of mandibular fractures (34.60%). The main mode of management in the centre was orthopaedic treatment. Conclusion: Maxillofacial trauma is common in Togo. It involves young men and is essentially related to road accidents.
文摘Oral cavity cancers are part of head and neck cancers. They have become frequent in the world in general and Senegal in particular. This study evaluates microsatellite instability tumors in oral cavity cancers in Senegal. Forty cancerous tissues, 20 healthy tissues, and 12 blood tissues were included in this study. These tissues were collected from each patient during the biopsy after obtaining consent. DNA extraction, Polymerase Chain Reaction (PCR) and sequencing were carried out to obtain sequences. Mutation surveyor, Bioedit and Dnasp software were used to perform our analyses. High instability was found in 57.5% of patients with cancer. Moreover, 90% of the patients had the same motif on healthy and cancerous tissue. Furthermore, 26.12%, 20.72%, and 11.71% polymorphic sites were found in cancerous, healthy and blood tissue respectively. Thus, a similarity between cancerous and healthy tissues seems to exist. This implies that instability of the Bat 26 microsatellite could occur early in the occurrence of oral cavity cancers.
文摘Introduction: Ocular melanoma develops at the expense of eyes’ melanocytes which give to the eyes their color. It is the first primitive intraocular tumor in the White race. It is rare, as that of the skin in black people. The bilateral cases are exceptional even in the white race, estimated at 0.2%. We present the case of bilateral ocular melanoma with bad prognosis in a black patient. Patient and observation: A 56-year-old black male patient, who had benefited 4 years earlier from an enucleation of the right eye for ocular melanoma, and admitted for bilateral exophthalmos which evolved for three months in a context of bilateral blindness. The cerebral Scanning had allowed to objectify a bilateral lateral-conical mass which evoked an inflammatory pseudo tumor. The failure of the medical treatment led to the exeresis of a conical, juxta-orbital and mid-muscular blackish mass, to the later apex respecting the surrounding structures. The histological examination ends again in a melanoma. No additional therapy was undertaken. The evolution 2 years later was marked by a local recurrence, multiple hepatic metastases and patient death. Conclusion: Bilateral ocular melanoma is exceptional in Black people. The etiologic factors as well as bilateralism mechanisms are still hypothetic. Its most effective treatment is local and the prognosis, bad in case of metastases due to the absence of an effective chemotherapy.
