Biomedical subjects
Publications and source records attributed to R Diouf.
African authors, other than senegalese, have not paid enough attention to lethal granuloma, a terrible disease. This series is about a series collected between 1975 and 1990. It is particularly high compared to other series in the world. If diagnosis is easy for the clinician, much care must surround the pathological answer. Those diagnosis problems and difficulties of treatment (represented by 11 deaths) are studied.
The observation of an exceptional laryngeal localization of an adenoid cystic carcinoma allows authors to review diagnostic, therapeutic and increasing problems of this glandular carcinoma. The reported case constitutes a histologic surprise. An economical removal has allowed to obtain a long remission without recurrence, nor metastasis; this never put back the principle of the broad surgery to institute when faced this type of cancer, but just emphasize the interest of an early treatment.
Cervico-facial carcinology is currently one of the major concerns of oto-rhino-laryngologists. The authors have chosen laryngeal cancers to determine the limits of the practice of such cervico-facial carcinology in the topics. Over a 10-year period, 61 patients with a suspected malignant laryngeal disease were examined at the E.N.T. Clinic of the University Hospital in Dakar. Histological confirmation was found in only 38 patients, and a curative treatment was undertaken with 27 patients. No significant differentiation could be found from the results as far as sex, age and histology were concerned. On the other hand, the TNM breakdown of our 36 carcinomas revealed that in 78% of the cases large tumours (T3, T4) were involved. In the vast majority of these cases (18/27), treatment was purely surgical, with a total laryngectomy in 90% of the cases. Pharyngostomas accounted for the majority of the early postoperative complications (6/14). Over 10 years of practice, 70% of our patients have died or have been lost from sight. These poor results are due to numerous factors, including late consultation, the lack of specialists and the insufficiency of technical facilities. To improve results, the authors recommended the setting-up of proper cancer institutes.
Patient, with cleft lip do not go unnoticed because the malformation is obvious. But in our countries it's not rare to receive some teenagers and even adults with cleft lip: among the patients of our series 20% were more than 14 years old. Cleft lip was unilateral in 92.5% of the cases. All these patients were operated on by a same E.N.T. specialist's team using a same method: the modified rotation--advancement of MILLARD Results were judged good in 85% of the cases. Minimum fare of malformation must begin at birth by many specialist.
At the present time, cervico-facial oncology is one of the great themes of oto-rhino-laryngologists. Cancer of the larynx has been chosen by the authors to demonstrate the limits in the practice of cervico-facial oncology in the tropics. Over a period of 10 years, 61 patients with suspected malignant larynx afflictions were examined at Dakar U.H.C.O.R.L. clinic. Histological confirmation concerned 38 patients, and 27 underwent treatment aimed at curing them. As far as results are concerned, there seem to be no particularities connected with sex, age or histology. TNM distribution within the 36 carcinomas, however, shows 78% of these cases to be large volume tumours (T3-T4). In the great majority of cases (18/27) treatment undertaken was purely surgical, represented by complete laryngectomy in 90% of the cases. Early, post-operational complications were dominated by pharyngostomy (6/14). After 10 years practice, 70% of these patients have died or have ceased to consult. The bad results are due to a number of factors including delay in consultation, too few specialists, too little equipment.... To remedy this, the authors suggest the creation of real cancer institutes.
The authors report on their initial observation of a Shamblin Type I carotid body chemodectoma. Surgical exeresis was complete and relatively easy even though the diagnosis has been carried out in the open air. They take the opportunity to discuss diagnostic, therapeutic, evolutional and nosological problems connected with this rare neoplasm.
Retrospective study of 27 cases of laryngeal papillomatosis confirmed the continued existence of this illness in this area. Despite much therapy applied over the years, it remains characterized by: delayed consultation, usually requiring urgent tracheotomy, multiple recidivism, poor functional results, at least from a vocal point of view. As a long spell in hospital is often necessary, it constitutes e real public health problem.
Ethmoido-frontal osteomas, slowly-evolving, benign, bone tumours, are being studied anew, especially from a surgical point of view. Asymptomatic for a long period, they can be detected from bone tumour and ophthalmological manifestations (60% of the cases). An X-ray renders the diagnostic almost certain. ORL access is satisfactory in the great majority of cases, and controlled milling of the osteoma, according to BOURDIAL (1972) is the best means of removal. For the 9 cases observed, post operational follow-up was always straightforward.