Pratique de l’Amygdalectomie et de l’Adénoïdectomie à Yaoundé

RESUME Introduction. L’amygdalectomie et/ou l’adenoidectomie sont des interventions courantes en Oto-Rhino-Laryngologie (ORL). Les indications et les modalites chirurgicales evoluent selon les contextes de pratique. Notre but etait de decrire la pratique de ces chirurgies dans notre contexte. Methode. Une etude descriptive et retrospective avait ete menee sur une periode de cinq ans dans les services d’ORL de trois hopitaux universitaires de Yaounde. Les dossiers des patients operes d’une amygdalectomie et/ou d’une adenoidectomie avaient ete inclus. Les donnees epidemio-cliniques, les indications operatoires, la technique chirurgicale et les complications ont ete collectees puis analysees. Resultat. Au total 385 dossiers ont ete retenus. L’âge moyen etait de 9 ans, avec des extremes a 9 mois et 60 ans. Le syndrome d’apnees obstructives du sommeil representait la premiere indication operatoire. On le retrouvait chez  48,51 % des sujets avant 5 ans. Au-dela de cet âge, les angines a repetition etaient la principale indication. L’adenoamygdalectomie etait le geste plus pratique. La dissection extra-capsulaire etait invariablement realisee aux instruments classiques ou au bistouri electrique. L’evolution a ete favorable dans 92,72 % des cas. L’hemorragie post operatoire immediate et la dysphagie ont ete retrouvees chez 4,85 % et 2,12 % des patients respectivement. Aucune association significative n’a ete etablie entre la technique de dissection et l’hemorragie postoperatoire. Conclusion. L’amygdalectomie et/ou l’adenoidectomie sont couramment pratiquees dans notre milieu. Le syndrome d’apnees obstructives du sommeil en est l’indication majeure. Les complications bien que rares pourraient etre reduites si les chirurgiens s’appropriaient les nouvelles techniques de cette chirurgie. ABSTRACT Introduction. Tonsillectomy and/or adenoidectomy are common surgical operations in ENT practice. Indications and surgical modalities change according to practice contexts. The goal of our study was to describe the practice of these surgeries in our context. Methods. A descriptive and record based study was conducted over a period of five years in the Ear Nose and Throat (ENT) units in three Yaounde university hospitals. Records of patients undergoing tonsillectomy and/or adenoidectomy were included. Epidemiological andclinical datas, surgical indications, surgical technique and complications were collected and analysed. Results. A total of 385 reports were included. The average age of patients was 9 years, with extremes at 9 months and 60 years. Obstructive Apnea Syndrome was the first surgical indication. It was found in 48.51% of subjects before 5 years. After this age, repetitive angina was the main indication. Adenomygdalectomy was the most common gesture. The extra-capsular dissection was invariably performed on classical instruments or with electric bistouri. The outcome was favourable in 92.72% of cases. Immediate postoperative hemorrhage and dysphagia were recorded in 4.85% and 2.12% of patients, respectively. No statistically significant association was established between the dissection technique and the postoperative hemorrhage. Conclusion. Tonsillectomy and/or adenoidectomy are commonly practiced in our environment. Obstructive sleep apnea syndrome is the main indication. Although complications are rare, they could be reduced if surgeons update themselves about new approaches concerning of this surgery.