[Oto-rhino-laryngological and cervico-maxillofacial pathologies among hospitalized older patients: epidemiological, diagnostical and therapeutical aspects in Lomé, Togo].

Medecine tropicale et sante internationale Pub Date : 2023-08-21 eCollection Date: 2023-09-30 DOI:10.48327/mtsi.v3i3.2023.336
Winga Foma, Palakina Pagninsi Agoda, Débora Koulete, Essobiziou Amana, Gérémie Ananidjin, Solim Uziel Roselin Boko, Essobozou Plaodezina Pegbessou, Bathokédéou Amana, Essohanam Boko
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Abstract

Introduction: In developing countries, 10% of the population is over 60 years old and this proportion is increasing rapidly. The general objective of this study was to describe the profile and management of the elderly subject aged 60 and over, hospitalized in the ENT (Ear, Nose and Throat) and Head/Neck surgery department of the Sylvanus Olympio University Hospital in Lomé, from 2012 to 2021.

Method: Retrospective descriptive study. After reviewing the files, selection of patients aged 60 and over, regardless of sex, and hospitalized for an ENT pathology from January 2012 to December 2021. Not included in our study were files of elderly subjects hospitalized but whose age was imprecise, or empty or very incomplete files.

Results: A total of 296 cases were included, representing 6.7% of the department's activities. The mean age of the patients was 72 ± 7.3 years with extremes of 60 and 95 years. The age group 6069 years represented 59.5%. The sex ratio M/F was 0.92. Infectious/inflammatory lesions were found in 138 patients (46.6%) including 38.9% of acute cellulitis of dental origin, and tumors were found in 135 patients (45.6%). Tumors were malignant in 59 patients (43.7%) and benign in 76 patients (56.3%). Thyroid was the site of 46 (60.5%) benign lesions and larynx of 29 (49.2%) malignant lesions. Poor oral hygiene, use of non-steroidal anti-inflammatory drugs, diabetes and the combination of smoking and alcohol were the factors favoring the occurrence of acute cellulitis of dental origin in 89.6%, 80.9%, 20.0% and 2.6% of cases respectively (p<0.001). The combination of smoking and alcohol was a factor favoring the occurrence of malignancy in 39% (p<0.001). Surgical treatment was performed in 234 patients (79.1%). With a case lethality rate of 21%, acute cellulitis of dental origin was the leading cause of death (p<0.001).

Conclusion: The most frequent pathologies of the ENT sphere in the elderly in our tropical context were infectious and tumoral, largely dominated by acute cellulitis of dental origin, thyroid adenoma and squamous cell carcinoma of the larynx. Despite the tendency to balance infectious and tumoral pathologies, the proportion of acute cellulitis of dental origin remains twice as high as that of malignant tumors. It contrasts with data from other sub-Saharan series where tumoral pathology remains predominant in the elderly. It is important to provide dental care assistance to the elderly and to advocate for the development of geriatrics and access to universal health coverage for the elderly in Togo.

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[多哥洛美住院老年病人的口鼻喉科和颈颌面部病变:流行病学、诊断和治疗方面]。
导言:在发展中国家,60 岁以上的老年人占总人口的 10%,而且这一比例还在迅速上升。本研究的总体目标是描述2012年至2021年在洛美西尔瓦努斯-奥林匹奥大学医院耳鼻喉科和头颈外科住院的60岁及以上老年人的概况和管理情况:回顾性描述研究。在查阅档案后,选择了2012年1月至2021年12月期间因耳鼻喉科病理住院的60岁及以上患者,不分性别。住院但年龄不精确的老年患者档案、空档案或档案不完整的患者不在研究范围内:共纳入 296 个病例,占该科室活动的 6.7%。患者的平均年龄为 72 ± 7.3 岁,极端年龄为 60 岁和 95 岁。60-69 岁年龄组占 59.5%。男女性别比为 0.92。138名患者(46.6%)发现了感染/炎症病变,包括38.9%的牙源性急性蜂窝织炎,135名患者(45.6%)发现了肿瘤。59名患者(43.7%)的肿瘤为恶性,76名患者(56.3%)的肿瘤为良性。46例(60.5%)良性病变发生在甲状腺,29例(49.2%)恶性病变发生在喉部。口腔卫生不良、使用非甾体类抗炎药、糖尿病以及烟酒并用是导致牙源性急性蜂窝织炎的有利因素,分别占 89.6%、80.9%、20.0% 和 2.6%(p 结论:在热带地区,老年人耳鼻喉科最常见的疾病是感染性和肿瘤性疾病,主要是牙源性急性蜂窝织炎、甲状腺腺瘤和喉鳞状细胞癌。尽管感染性和肿瘤性病变趋于平衡,但牙源性急性蜂窝织炎的比例仍然是恶性肿瘤的两倍。这与其他撒哈拉以南地区的数据形成了鲜明对比,在这些地区,肿瘤性病变在老年人中仍占主导地位。为老年人提供牙科护理援助,并倡导发展老年医学和为多哥老年人提供全民医保是非常重要的。
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