Context and Objective: Cellulitis is potentially serious polymicrobial infections that can be life-threatening for the patient. They are clearly increasing in our service. It is with the aim of determining the hospita...Context and Objective: Cellulitis is potentially serious polymicrobial infections that can be life-threatening for the patient. They are clearly increasing in our service. It is with the aim of determining the hospital frequency of cellulitis of dental origin epidemiological profile, describing the clinical types, the therapeutic modalities and evaluating the results obtained. Subjects and Methods: This is a retrospective descriptive study on the files of 431 hospitalized patients, between January 2010 and December 2018 in the department of stomatology and maxillofacial surgery of the University Hospital of Brazzaville (Congo). The studied parameters: The frequency, the age, the gender, the origin, the consultation average time, the contributing factors, the entrance gate, the seat, the paraclinical assessment, the therapeutic modalities and the evolution. Results: Cervico-facial cellulitis accounted for 32.8% of hospitalizations. The average age was 32.8 ± 1.98 years, ranges from 3 to 93 years. The predominance was male with 241 cases, or 55.9%. 64.73% of patients came from CHUB emergencies. The mandibular seat was dominant with 77.72% of cases. The average consultation time was 6 days. As a contributing factor, we found the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). Tooth decay was the most common etiology 92.5%. Antibiotic therapy and surgery had a good evolution in 96.8% of cases. The mortality rate was 3.3%. Conclusion: odontogenic cervicofacial cellulitis remains common in daily practice. Patient care should focus on the preventive component integrating patient awareness of oral health.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Cervico-isthmic pregnancy is rare, and serious bec...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. </span><b><span style="font-family:Verdana;">Observation:</span></b><span style="font-family:Verdana;"> We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. </span><a name="_Hlk80358912"></a><span style="font-family:Verdana;">The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span>展开更多
Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, pe...Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, peculiarity and etiological factor of wound. There were 28 cases of island pectoralis major island myocutanuous flaps, 34 cases of latissimus dorsi island myocutaneous flaps, 19 cases of trapizius island myocutaneous flaps and 17 cases of rectus abdominis island myocutaneous flaps in this report. Results: All 98 patients with challenging wound on cervico-thoracic region were successfully treated with this method without complications, and obtained functional and cosmetic effectiveness. Conclusion:Challenging wounds in cervico-nuchal region can be repaired with pertoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap and trapizius island myocutaneous flap, while challenging wounds in thoracic region can be repaired with latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. Satisfactory functional and cosmetic results can be obtained.展开更多
This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat...This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.展开更多
Objectives: Evaluation of diagnostic performance of rapid testing of cervico-vaginal fluid (CVF) for fetal fibronectin (FFN) and placental α-microglobulin 1 (PAMG-1) as screening of women presented by threatened pret...Objectives: Evaluation of diagnostic performance of rapid testing of cervico-vaginal fluid (CVF) for fetal fibronectin (FFN) and placental α-microglobulin 1 (PAMG-1) as screening of women presented by threatened preterm labor (TPTL) with intact membranes for duration till getting spontaneous labor (SL). Patients & Methods: 37 women presenting with TPTL underwent CVF samplings before digital examination and then underwent transvaginal ultrasonography for estimation of cervical length (CL). All women received fluid and anxiolytic therapy and if uterine contractions persisted, all had received tocolytic therapy with oral nifedipine or intravenous magnesium sulphate according to requirements. Incidence of SL within Results: Incidence of SL was 13.5%, 35.2% and 51.3% within 48-hr, 2 - 7 and 7 - 14 days, respectively. Duration till labor after sampling was positively correlated with CL, while was negatively correlated with positive FFN and PAMG-1 tests. Positive FFN test had high specificity, while positive PAMG-1 test had high sensitivity for labor within 7 days. Regression analysis defined short CL and positive PAMG-1 test as significant predictors for short duration till SL. ROC curve analysis defined short cervix and positive PAMG-1 test as significant predictors for labor within 48-hr and within 2 - 7 days respectively and combined negative PAMG-1 test and CL of 20 - 25 mm were significant predictors for labor within 7 - 14 days. Conclusion: PAMG-1 test had high specificity, if positive, for predicting SL and high NPP, if negative, for excluding labor within 7 days, so it can be used as rapid adjuvant to clinical evaluation to help management decision-making. Moreover, PAMG-1 test is recommended screening test for being easy-to-use bedside test, provides rapid results, can be used after vaginal exam and coitus and does not require a speculum examination or specialized equipment to analyze results.展开更多
<strong>Introduction:</strong> Complete cervico-urethral transection is a vesicovaginal fistula characterized by total disinsertion of the urethra from the bladder. It is a fistula of the cervico-urethral ...<strong>Introduction:</strong> Complete cervico-urethral transection is a vesicovaginal fistula characterized by total disinsertion of the urethra from the bladder. It is a fistula of the cervico-urethral intersection threatening the mechanism of continence. The aim of this study was to describe the epidemiological and therapeutic aspects of this type of fistula. <strong>Patients and Methods:</strong> This was a descriptive retrospective study on patients who have had surgery for cervico-urethral transection from June 01, 2012 to June 01, 2015. <strong>Results:</strong> Cervico-urethral transections (n = 76) accounted for 33.77% of all urogenital fistulas admitted to our department of surgery during the study period. The average age was 25.02 ± 8, 6 years. Married patients accounted for 85.58%, 72.36% had not received any classical education. Fistulas less than one year old made up 56.58% of cases, associated lesions were perineal tears 25.0%, vaginal sclerosis, 21.05%, vaginal straps, 13.15%, rectovaginal fistula, 2.63% and the shortness of the urethra less than 2.5 cm in 42.10% of cases. All surgeries were performed vaginally with a 98.68% fistula closure rate and an average of 1.68 surgeries per patient. After closure of the fistula, 10.67% of patients presented a residual urinary incontinence. <strong>Conclusion:</strong> Complete cervico-urethral transection is a frequent vesicovaginal fistula. She sometimes exposes to urinary incontinence after closing the fistula. The results of his surgery are often good at the cost of multiple intervention.展开更多
Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis ...Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis at the Regional Teaching Hospital (RTH) of Ouahigouya, in order to guide practitioners in the development of effective probabilistic antibiotic therapy protocols. Subjects and Methods: This was a transversal descriptive study with prospective data collection from July 1 to December 31, 2021 at the RTH of Ouahigouya. All cases of suppurative cervicofacial cellulitis that had been the subject of pyoculture were retained. Results: A total of 63 patients were chosen including 41 men, with 40.91 years as the average age and the sex ratio was 1.86. In 90.48% of cases, the front door was dental. All patients took antibiotics before their admission. Pus culture was positive in 34/63 subjects (53.97%) and showed monomicrobial infection. The isolates were Gram-negative bacilli for 20.59% and Gram-positive cocci for 79.41%. These isolates were all resistant to certain beta-lactams (such as amoxicillin, amoxicillin + clavulanic acid). However, some isolates were susceptible to cefoxitin, ceftazidime and ceftriaxone. All isolates were sensitive to amikacin for aminoglycosides. As for macrolides, erythromycin had excellent activity (100%) against Gram-positive cocci. Indeed, some isolates were susceptible and others resistant to ciprofloxacin for quinolones. Conclusion: Bacteriological profile and antimicrobial susceptibility knowledge of cervicofacial cellulitis may propose an effective probabilistic antibiotic therapy protocol.展开更多
We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi followin...We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi following FESS. CT scan evaluation of aero-digestive tract in the immediate post-operative period was done to ascertain the cause pertaining to any surgical trauma or anaesthesia related complications. Such a case previously unreported has been included in this study. A simple close monitoring after establishing the cause is usually sufficient in management of such related or unrelated complications during FESS which in our case was likely to be anaesthesia related. Published data of such a complication assists in building up a good and effective medical audit based on ethical practice. This paper stresses the importance of immediate CT scan of aero-digestive tract in evaluating the cause.展开更多
Introduction: Cervicofacial cellulitis is a medical and surgical emergency, it is an extensive infection of the aponeurotic spaces of the face and neck. Although frequent in black Africa rather than in developed count...Introduction: Cervicofacial cellulitis is a medical and surgical emergency, it is an extensive infection of the aponeurotic spaces of the face and neck. Although frequent in black Africa rather than in developed countries, they remain associated with a poor prognosis and few studies have been done on this subject. Their management must be early, probabilistic and then adapted to the bacteriological results of the pus taken. As Senegal is one of the many sub-Saharan African countries without recent data on cervicofacial cellulitis, we felt it was important to review the situation. The aim of our study was to describe the epidemiological and clinical aspects of cervicofacial cellulitis in the ENT department of Lamine Sine DIOP of the Fann National University Hospital of Dakar. Materials and Method: This was a retrospective study conducted over 5 years from January 2017 to December 2021 in the ENT-CCF LAMINE SINE DIOP Department of the CHNU FANN in Dakar. Our data sources were hospitalization registers and medical records of patients hospitalized for cervicofacial cellulitis. Our data were analyzed using the spss 12 for windows software. Results: During this 5-year period, we collected 297 cases of cervicofacial cellulitis, i.e. 19% of the hospitalizations. The average age was 35 years with a sex ratio of 2.23. The notion of taking NSAIDs was found in 90.57% of the cases, the immunocompromised background was present in 18 patients, i.e. 6.06% of the cases. The site of the swelling was sub-mento-maxillary in 49% of the cases and anterior cervical in 5% of cases. The portal of entry was dental in 189 patients, i.e. 64% of cases, and unknown in 3%. 4 deaths were recorded, i.e. 1.35% of patients hospitalized for cervicofacial cellulitis, and 1 case of mediastinitis with polyseritis was transferred to the Department of Thoracic and Cardiovascular Surgery, which had a favourable outcome. Conclusion: Cervicofacial cellulitis is a fairly common infection with a poor prognosis in developing countries. They affect a relatively young and healthy segment of the population. At the National University Hospital of Fann in Dakar, they are increasingly frequent and linked to the use of non-steroidal anti-inflammatory drugs.展开更多
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: th...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 1<sup>st</sup>, 2018 to December 31<sup>st</sup>, 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.展开更多
PURPOSE: To evaluate the results of facial-cervico-pectoral rotation flap (FRF) and temporalis myofascial flap (TMF) in the repair of large soft tissue defect in oral and maxillofacial regions. METHODS: Six patients w...PURPOSE: To evaluate the results of facial-cervico-pectoral rotation flap (FRF) and temporalis myofascial flap (TMF) in the repair of large soft tissue defect in oral and maxillofacial regions. METHODS: Six patients with malignant orbital tumors and/or maxillofacial tumors invading the orbital regions were treated with extensive resection. The major midfacial soft tissue defects were repaired by temporalis myofascial flap and facial-cervico-pectoral rotation flap. RESULTS: All flaps were successfully transferred; the result of facial aesthetics was satisfactory in all patients. Follow-up periods varied from 9 to 20 months (mean follow up period: 13.2 months) and all of the patients were alive during the follow-up period with one recurrence. CONCLUSIONS: The TMF and the FRF are easy to harvest, have low donor site morbidity, and are compatible with the principles of oncologic resection. It is the method of choice for repairing major orbito-maxillofacial skin defects following resection of the tumors.展开更多
The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction...The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction,medial to the uterine vessels.This narrated video demonstrated the step-by-step laparoscopic cervico-isthmic cerclage technique using a handheld Berci fascial closure needle to accurately place the suture,medial to the uterine vasculature.展开更多
文摘Context and Objective: Cellulitis is potentially serious polymicrobial infections that can be life-threatening for the patient. They are clearly increasing in our service. It is with the aim of determining the hospital frequency of cellulitis of dental origin epidemiological profile, describing the clinical types, the therapeutic modalities and evaluating the results obtained. Subjects and Methods: This is a retrospective descriptive study on the files of 431 hospitalized patients, between January 2010 and December 2018 in the department of stomatology and maxillofacial surgery of the University Hospital of Brazzaville (Congo). The studied parameters: The frequency, the age, the gender, the origin, the consultation average time, the contributing factors, the entrance gate, the seat, the paraclinical assessment, the therapeutic modalities and the evolution. Results: Cervico-facial cellulitis accounted for 32.8% of hospitalizations. The average age was 32.8 ± 1.98 years, ranges from 3 to 93 years. The predominance was male with 241 cases, or 55.9%. 64.73% of patients came from CHUB emergencies. The mandibular seat was dominant with 77.72% of cases. The average consultation time was 6 days. As a contributing factor, we found the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). Tooth decay was the most common etiology 92.5%. Antibiotic therapy and surgery had a good evolution in 96.8% of cases. The mortality rate was 3.3%. Conclusion: odontogenic cervicofacial cellulitis remains common in daily practice. Patient care should focus on the preventive component integrating patient awareness of oral health.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. </span><b><span style="font-family:Verdana;">Observation:</span></b><span style="font-family:Verdana;"> We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. </span><a name="_Hlk80358912"></a><span style="font-family:Verdana;">The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span>
文摘Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, peculiarity and etiological factor of wound. There were 28 cases of island pectoralis major island myocutanuous flaps, 34 cases of latissimus dorsi island myocutaneous flaps, 19 cases of trapizius island myocutaneous flaps and 17 cases of rectus abdominis island myocutaneous flaps in this report. Results: All 98 patients with challenging wound on cervico-thoracic region were successfully treated with this method without complications, and obtained functional and cosmetic effectiveness. Conclusion:Challenging wounds in cervico-nuchal region can be repaired with pertoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap and trapizius island myocutaneous flap, while challenging wounds in thoracic region can be repaired with latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. Satisfactory functional and cosmetic results can be obtained.
文摘This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.
文摘Objectives: Evaluation of diagnostic performance of rapid testing of cervico-vaginal fluid (CVF) for fetal fibronectin (FFN) and placental α-microglobulin 1 (PAMG-1) as screening of women presented by threatened preterm labor (TPTL) with intact membranes for duration till getting spontaneous labor (SL). Patients & Methods: 37 women presenting with TPTL underwent CVF samplings before digital examination and then underwent transvaginal ultrasonography for estimation of cervical length (CL). All women received fluid and anxiolytic therapy and if uterine contractions persisted, all had received tocolytic therapy with oral nifedipine or intravenous magnesium sulphate according to requirements. Incidence of SL within Results: Incidence of SL was 13.5%, 35.2% and 51.3% within 48-hr, 2 - 7 and 7 - 14 days, respectively. Duration till labor after sampling was positively correlated with CL, while was negatively correlated with positive FFN and PAMG-1 tests. Positive FFN test had high specificity, while positive PAMG-1 test had high sensitivity for labor within 7 days. Regression analysis defined short CL and positive PAMG-1 test as significant predictors for short duration till SL. ROC curve analysis defined short cervix and positive PAMG-1 test as significant predictors for labor within 48-hr and within 2 - 7 days respectively and combined negative PAMG-1 test and CL of 20 - 25 mm were significant predictors for labor within 7 - 14 days. Conclusion: PAMG-1 test had high specificity, if positive, for predicting SL and high NPP, if negative, for excluding labor within 7 days, so it can be used as rapid adjuvant to clinical evaluation to help management decision-making. Moreover, PAMG-1 test is recommended screening test for being easy-to-use bedside test, provides rapid results, can be used after vaginal exam and coitus and does not require a speculum examination or specialized equipment to analyze results.
文摘<strong>Introduction:</strong> Complete cervico-urethral transection is a vesicovaginal fistula characterized by total disinsertion of the urethra from the bladder. It is a fistula of the cervico-urethral intersection threatening the mechanism of continence. The aim of this study was to describe the epidemiological and therapeutic aspects of this type of fistula. <strong>Patients and Methods:</strong> This was a descriptive retrospective study on patients who have had surgery for cervico-urethral transection from June 01, 2012 to June 01, 2015. <strong>Results:</strong> Cervico-urethral transections (n = 76) accounted for 33.77% of all urogenital fistulas admitted to our department of surgery during the study period. The average age was 25.02 ± 8, 6 years. Married patients accounted for 85.58%, 72.36% had not received any classical education. Fistulas less than one year old made up 56.58% of cases, associated lesions were perineal tears 25.0%, vaginal sclerosis, 21.05%, vaginal straps, 13.15%, rectovaginal fistula, 2.63% and the shortness of the urethra less than 2.5 cm in 42.10% of cases. All surgeries were performed vaginally with a 98.68% fistula closure rate and an average of 1.68 surgeries per patient. After closure of the fistula, 10.67% of patients presented a residual urinary incontinence. <strong>Conclusion:</strong> Complete cervico-urethral transection is a frequent vesicovaginal fistula. She sometimes exposes to urinary incontinence after closing the fistula. The results of his surgery are often good at the cost of multiple intervention.
文摘Context and Objective: Cervicofacial cellulitis is a lethal infection without treatment. The aim of this study is to establish the bacteriological and antimicrobial susceptibility profile of cervico-facial cellulitis at the Regional Teaching Hospital (RTH) of Ouahigouya, in order to guide practitioners in the development of effective probabilistic antibiotic therapy protocols. Subjects and Methods: This was a transversal descriptive study with prospective data collection from July 1 to December 31, 2021 at the RTH of Ouahigouya. All cases of suppurative cervicofacial cellulitis that had been the subject of pyoculture were retained. Results: A total of 63 patients were chosen including 41 men, with 40.91 years as the average age and the sex ratio was 1.86. In 90.48% of cases, the front door was dental. All patients took antibiotics before their admission. Pus culture was positive in 34/63 subjects (53.97%) and showed monomicrobial infection. The isolates were Gram-negative bacilli for 20.59% and Gram-positive cocci for 79.41%. These isolates were all resistant to certain beta-lactams (such as amoxicillin, amoxicillin + clavulanic acid). However, some isolates were susceptible to cefoxitin, ceftazidime and ceftriaxone. All isolates were sensitive to amikacin for aminoglycosides. As for macrolides, erythromycin had excellent activity (100%) against Gram-positive cocci. Indeed, some isolates were susceptible and others resistant to ciprofloxacin for quinolones. Conclusion: Bacteriological profile and antimicrobial susceptibility knowledge of cervicofacial cellulitis may propose an effective probabilistic antibiotic therapy protocol.
文摘We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi following FESS. CT scan evaluation of aero-digestive tract in the immediate post-operative period was done to ascertain the cause pertaining to any surgical trauma or anaesthesia related complications. Such a case previously unreported has been included in this study. A simple close monitoring after establishing the cause is usually sufficient in management of such related or unrelated complications during FESS which in our case was likely to be anaesthesia related. Published data of such a complication assists in building up a good and effective medical audit based on ethical practice. This paper stresses the importance of immediate CT scan of aero-digestive tract in evaluating the cause.
文摘Introduction: Cervicofacial cellulitis is a medical and surgical emergency, it is an extensive infection of the aponeurotic spaces of the face and neck. Although frequent in black Africa rather than in developed countries, they remain associated with a poor prognosis and few studies have been done on this subject. Their management must be early, probabilistic and then adapted to the bacteriological results of the pus taken. As Senegal is one of the many sub-Saharan African countries without recent data on cervicofacial cellulitis, we felt it was important to review the situation. The aim of our study was to describe the epidemiological and clinical aspects of cervicofacial cellulitis in the ENT department of Lamine Sine DIOP of the Fann National University Hospital of Dakar. Materials and Method: This was a retrospective study conducted over 5 years from January 2017 to December 2021 in the ENT-CCF LAMINE SINE DIOP Department of the CHNU FANN in Dakar. Our data sources were hospitalization registers and medical records of patients hospitalized for cervicofacial cellulitis. Our data were analyzed using the spss 12 for windows software. Results: During this 5-year period, we collected 297 cases of cervicofacial cellulitis, i.e. 19% of the hospitalizations. The average age was 35 years with a sex ratio of 2.23. The notion of taking NSAIDs was found in 90.57% of the cases, the immunocompromised background was present in 18 patients, i.e. 6.06% of the cases. The site of the swelling was sub-mento-maxillary in 49% of the cases and anterior cervical in 5% of cases. The portal of entry was dental in 189 patients, i.e. 64% of cases, and unknown in 3%. 4 deaths were recorded, i.e. 1.35% of patients hospitalized for cervicofacial cellulitis, and 1 case of mediastinitis with polyseritis was transferred to the Department of Thoracic and Cardiovascular Surgery, which had a favourable outcome. Conclusion: Cervicofacial cellulitis is a fairly common infection with a poor prognosis in developing countries. They affect a relatively young and healthy segment of the population. At the National University Hospital of Fann in Dakar, they are increasingly frequent and linked to the use of non-steroidal anti-inflammatory drugs.
文摘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 1<sup>st</sup>, 2018 to December 31<sup>st</sup>, 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.
文摘PURPOSE: To evaluate the results of facial-cervico-pectoral rotation flap (FRF) and temporalis myofascial flap (TMF) in the repair of large soft tissue defect in oral and maxillofacial regions. METHODS: Six patients with malignant orbital tumors and/or maxillofacial tumors invading the orbital regions were treated with extensive resection. The major midfacial soft tissue defects were repaired by temporalis myofascial flap and facial-cervico-pectoral rotation flap. RESULTS: All flaps were successfully transferred; the result of facial aesthetics was satisfactory in all patients. Follow-up periods varied from 9 to 20 months (mean follow up period: 13.2 months) and all of the patients were alive during the follow-up period with one recurrence. CONCLUSIONS: The TMF and the FRF are easy to harvest, have low donor site morbidity, and are compatible with the principles of oncologic resection. It is the method of choice for repairing major orbito-maxillofacial skin defects following resection of the tumors.
文摘The laparoscopic abdominal cerclage is an established approach in the management of selected cases of cervical insufficiency.The main challenge is to safely insert the cerclage at the level of cervico-isthmic junction,medial to the uterine vessels.This narrated video demonstrated the step-by-step laparoscopic cervico-isthmic cerclage technique using a handheld Berci fascial closure needle to accurately place the suture,medial to the uterine vasculature.
