Objectives: Our work was aimed at exposing the methods of extraction of a foreign body enclosed in the cervical esophagus and specifying the place of cervicotomy in its management. Observation: We report the case of a 76-year-old patient admitted to the ENT emergency department for sudden onset dysphagia following the ingestion of a foreign body of dental prosthesis type (two teeth). The face and profile cervicothoracic radiography revealed a thickening of the oesophageal lumen associated with a prevertebral hyperclarity at the height of the C8 and D1 vertebrae. After two endoscopic extraction attempts to the rigid tube we performed a cervicothoracic CT that showed the dental prosthesis at the height of C8-D1 associated with a peripheral hyperclarity and a left pneumothorax. The hemoglobin level was 14 g/dl, the prothrombin rate was 84%, the activated partial thromboplastin time was 35 seconds. The cervicotomy allowed us to note a perforation of the esophagus at the height of C8-D1. We made an oesophagofissure that allowed us to extract the prosthesis. The reconstruction of the oesophageal lesion was done in two planes. Conclusion: Denture type foreign bodies carry a risk of perforation, especially when endoscopic extraction is difficult. This risk is all the more important when the extraction time is long, when there is a pre-existing oesophageal pathology and by forced extraction maneuvers. Standard surgery is the best way to prevent perforation and septic complications.
Background: Retraction pockets represent a form of chronic otitis considered to be a precholesteatomatous stage. This study aims to study the diagnostic and therapeutic aspects of tympanic retraction pockets in the ENT department of the University Hospital Center "Gabriel Touré". Patients and Method: This was a prospective longitudinal study extended over 15 months; from February 1, 2020 to May 31, 2021 from the files of patients received as an outpatient in the ENT and Cervicofacial Surgery department of the CHU Gabriel Touré in Bamako. Were included any patient seen in an outpatient department at the otorhinolaryngology and head and neck surgery department of the CHU Gabriel Touré in Bamako with a pocket of tympanic retraction and who had consented to the study. Data collection was done using a previously established survey form. Data were entered in Word 2016 and analyzed using SPSS software. Results: The prevalence of retraction pockets was estimated at 1.2% of all consultations. The most represented age group was that of (25-39 years), i.e. 25.0%. The average age was 44.91 ± 20.05 years. The extremes of ages were 10 years and 81 years. The female sex was the most represented, at 63.9% with a sex ratio ꞊ 0.6. A history of otitis was present in half of the cases. Tinnitus was the main reason for consultation (50% of cases) followed by hearing loss (25%). The otoendoscopic examination had noted a predominance of lesions on the left (52%) and an attical seat in 30.6% of cases. The pockets were controllable and self-cleaning in all cases, and peelable in 75% of cases (stage I of the weevil classification) and nonpeelable and controllable in 25% of the cases (stage II of weevil). Conductive hearing loss was found in 8.3% of cases, mixed hearing loss in 5.6% of cases and sensorineural hearing loss in 2.8% of cases. CT of the rock was performed in two patients, and showed erosion of the attic wall associated with tissue hypodensity in the attic. Medical treatment based on systemic corticosteroids and nasal decongestant was initiated in all our patients associated with quarterly monitoring for stages I of charachon, i.e. 75% of the workforce. The placement of a tympanostomy tube was performed in 8 patients classified (stage II of charachon) ie (2, 88%). Antroatticotomy associated with reinforcement tympanoplasty was performed in a patient (0,36%).
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