Cellulites Cervico-Faciales D’origine Dentaire au CHU Sylvanus Olympio de Lome Au Togo

Objective: to describe the epidemiological, clinical, therapeutic and progressive aspects of head and neck cellulitis of dental origin at Sylvanus Olympio University Hospital (SO), Lome. Material and method: This was a descriptive cross-sectional study carried out over a period of seven years, concerning 373 medical files collected in the Department of Oto-RhinoLaryngology and Head and Neck Surgery of the Sylvanus Olympio University Hospital in Lome, with clinical and paraclinical information on head and neck cellulitis of dental origin. Results: The mean age of our patients was 38.5 ± 15.2 years. The average consultation time was 11 days. The most common reasons were painful swelling (94.1%) and toothache (90.6%). Selfmedication based on NSAIDs / analgesics was found in 33.0% of cases. Clinically, swelling wassub-mandibular in 60.1% of cases and associated with tooth decay in 74.8% of cases. The decayed teeth were predominantly lower molars in 81.9% of cases. The cytobacteriological examination of the specimens was carried out in 189 patients and 97 samples were positive and isolating the streptococcus in 32 cases. Panoramic X-ray revealed granuloma in 51.0% of cases, followed by apical cyst in 35.5% of cases. The medical treatment was made of a bi-antibiotherapy rehabilitated secondarily on the basis of antibiogram. Surgical drainage with delayed tooth extraction was performed in 86.1% of cases. The evolution was favorable for the majority of patients with 6.9% of deaths. Conclusion: Head and neck cellulitis of dental origin remains valid. The diagnosis must be early, the management is multidisciplinary but an emphasis must be placed on prevention. Objectif : decrire les aspects epidemiologiques, cliniques, therapeutiques, et evolutifs des cellulites cervico-faciales d’origine dentaire au CHU Sylvanus Olympio (SO) de Lome. Patients et methodes : Il s’est agi d’une etude transversale descriptive realisee sur une periode de sept ans, a propos de 373 dossiers medicaux colliges dans le service d’Oto-RhinoLaryngologie et de Chirurgie Cervico-Maxillo-Faciale du CHU SO de Lome, comportant des informations cliniques et paracliniques faisant cas de cellulites cervico-faciales d’origine dentaire. Resultats : L’âge moyen de nos patients etait de 38,5 ans ± 15,2. Le delai moyen de consultation etait de 11 jours. Les motifs les plus frequents etaient la tumefaction douloureuse (94,1%) et l’odontalgie (90,6%). Une automedication a base AINS/antalgiques a ete retrouvee dans 33,0% des cas. Cliniquement, la tumefaction etait submandibulaire dans 60,1% des cas et associee a la carie dentaire dans 74,8% des cas. Les dents cariees etaient majoritairement les molaires inferieures dans 81,9% des cas. L’examen cytobacteriologie des prelevements a ete realise chez 189 patients et 97 prelevements se sont reveles positifs et isolant le streptocoque dans 32 cas. La radiographie panoramique a permis de noter un granulome dans 51,0% des cas, suivi du kyste apical dans 35,5% des cas. Le traitement medical etait fait d’une bi-antibiotherapie readaptee secondairement sur la base d’antibiogramme. Un drainage chirurgical avec extraction dentaire differee a ete effectue dans 86,1% des cas. L’evolution etait favorable chez la majorite des patients avec 6,9% de deces. Conclusion : Les cellulites cervico-faciales d’origine dentaire restent d’actualite. Le diagnostic doit etre precoce, la prise en charge est pluridisciplinaire mais un accent doit etre mis sur la prevention.