TITLE:
Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako
AUTHORS:
Kassim Diarra, Oumou Coulibaly, Yaya Dembele, Nfaly Konaté, Sidibe Youssouf, Saydi Ag Mohamed, Harouna Sanogo, Abraham Diarra, Ibrahim Fofana, Moussa Bourama Keita, Youssouf Traore, Fatogoma Issa Koné, Boubacary Guindo, Siaka Soumaoro, Doumbia Kadidiatou Singare, Mohamed Amadou Keita
KEYWORDS:
Cholesteatoma, CT, TTO, TTF
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.13 No.4,
July
31,
2024
ABSTRACT: In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify any cases of scar stenosis of meatoplasty. Hearing was improved or preserved in 91.17% of cases and 3 cases of worsening hypoacusis.