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40 cases of cysts and fistulas of the thyroglossal tract duct offer to the authors occasion to review the rare problems of diagnosis raised by this pediatric pathology. They compare the results of surgery obtained by the classic technic of Sistrunck (1920) versus the Schlange's operation (1893) which remove the cyst with the hyoid bone's body only. The average of age is 17 years. A location of a thyroglossal cyst in the submandibular area was noted during operation. Sistrunck's operation was performed in 21 cases (52.5%) and the Schlange's one in 14 cases (35%) without recurrence. 4 cases (10%) recurrences were noted, all after simple cystectomy. Removal of the hyoid bone's body appear to us as the key of success in the surgery of thyroglossal anomalies.

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It is a prospective study of 1048 newborns incurring the risk of deafness in three hospitals in Dakar from March 14th to January 4th 1989. It comes out of this analysis that the most important causes of suspect cases are neonatal jaundices, congenital malformations, premature birth. The most frequent reactions are noticed in the members of a bilateral way, unlike the general assumption that reactions are noticed in the head. Out of a final population of 846 newborn, 839 were "normal", 7 were "suspect" (less than 1%). This evaluation would be higher for, among the 202 people we ultimately lost sight of (about 19.3%) were "suspect" without any associated pathology). Finally, the authors are then given the opportunity to draw the attention of the public authorities, the medical staff and the populations, on the importance of detecting early the infant's deafness.

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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.

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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.

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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.

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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.

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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.

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The authors document a public education establishment for deaf-and-dumb children which uses the verbo-tonal method of Yugoslav Professor PETAR GUBERINA. They describe the educational activities, and draw a positive and encouraging picture of results obtained from its 8 years of operation, in spite of many difficulties.

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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.

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Surgical treatment of cervical metastases from head and neck cancer involves different techniques as a function of indication. An anatomical structure of major importance during this surgery is the spinal accessory nerve, and 106 dissections were performed to examine relations of this nerve with cervical plexus, jugular vein, sterno-cleido-mastoid muscle and mastoid tip. Interesting conclusions were drawn with regard to technical procedures of value to surgeons involved in cervicofacial cancerology.

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The term mucocele designates a cyst developing from a sinus mucosa, generally the frontal and/or ethmoidal sinuses. They present clinically as a benign tumor, and their diagnosis and treatment is usually simple. Maxillary sinus localizations are exceptional, however, and raise numerous problems in daily practice. Three cases of maxillary sinus mucoceles are reported.

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Cancer is the most frequently observed tumor of the larynx, benign laryngeal tumors being as rare as they are varied. A case is reported of lipoma of larynx revealed by a respiratory distress syndrome.

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Cystic hygroma is a benign dysembryoplasia of the lymphatic system of mainly cervical expression. Clinical findings of a stereotyped nature were found in 4 cases of this particular aspect of infantile surgical affections. On operation there was an obvious relation with the internal jugular vein, and an entire segment had to be removed in 2 cases. These data confirm conventional pathogenic theories.

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