[Condylar remodelling after temporomandibular joint reconstruction with fibula free flap].

Aim: Mandibular reconstructions with fibula free flap are commonly used in maxillo-facial surgery; termino-lateral mandibulectomy with reconstruction of the ramus and condylar unit is seldom used. Consequences on the temporomandibular joint remain unclear, and the type of reconstruction is still subject to controversy.

Methods: Six patients were followed after terminal mandibulectomy, reconstructed with fibular free flap.

[Condylar positioning during mandibular orthognatic surgery].

Sagittal split osteotomy of the mandible is the most frequently used method in orthognatic surgery. Osteosynthesis was performed with wires in the 1970s. The instability of fixation allowed condyle movements and there was no problem of condylar positioning.

[Split temporalis muscle flap vascularized by the superficial temporal pedicle].

Introduction: The temporalis muscle has been used for more than a century for facial reconstruction. But this flap cannot fill defects beyond the midline. Splitting the temporalis muscle in the plane of the tendon insertion allows lengthening the flap and crossing the midline.

Lengthening temporalis myoplasty and brain plasticity: a functional magnetic resonance imaging study.

Background: Lengthening temporalis myoplasty (LTM) is a technique developed since ten years for facial paralysis. A spontaneous smile is acquired after this surgery explains by brain plasticity and the aim of the study is to confirm this plasticity by functional magnetic resonance imaging.

Materials And Methods: A functional magnetic resonance imaging (fMRI) was performed at various time points in ten patients who were operated on LTM during one year.

[Inferior alveolar nerve block with ropivacaine: effect on nausea and vomiting after mandibular osteotomy].

Introduction: Our objective was to evaluate the contribution of bilateral inferior alveolar nerve block (BIANB) in patients before mandibular sagittal osteotomy for postoperative pain management, consumption of opioids, treatment of nausea and vomiting.

Materials And Methods: We included 30 patients undergoing mandibular sagittal osteotomy in a prospective, randomized, double blind study. The first group of patients (n=14) underwent a standard procedure (general anesthesia with postoperative morphine treatment).

Prosthetic reconstruction of the auricle: indications, techniques, and results.

Extensive defects of the ear require satisfactory cosmetic reconstruction to enable the patient to achieve full social integration. Although surgical procedures are the gold standard for reconstruction of the ear, in some cases they cannot be performed because of extended scars, threatening tumor, or congenital tissue abnormalities. Prosthetic reconstruction of the auricle is an established and reliable alternative technique to autologous surgical reconstructions.

[Implant insertion in distracted bone for reconstruction after gunshot injury].

Distraction osteogenesis is a tissue engineering technique with two clinical applications in maxillofacial surgery: alveolar distraction and basal bone distraction. Even if it appears to be a binding and major surgery, distraction osteogenesis applied to facial bone, and especially to the mandible, has the great advantage of producing a pluritissular reconstruction of ideal quality and quantity, suitable for the ultimate goal of dental implant rehabilitation management. This technique had some drawbacks due to technical constraints related to the material.

["Double barrel" free fibula flap and vascular risk. A national investigation in France].

Introduction: The free fibula flap is the most commonly used flap for mandibular reconstruction thanks to its multiple advantages. Its main drawback is the thin width of the bone section. The "double barrel" fibula flap is a solution to this problem allowing reconstruction of both basilar and alveolar ridges for a stable prosthetic dental rehabilitation.

[Repair of palatal fistulae in cleft patients].

Objectives: Treatment of oronasal fistulae in cleft patients remains a surgical challenge because of its high failure rate. The authors report the results of an aggressive surgical technique using the total elevation of palatal mucoperiosteum, even for small fistulae.

Methods: This approach was used on twelve consecutive patients, from five to 33 years of age, presenting with a Pittsburgh classification type IV palatal fistulae.

[Foreign body granuloma due to Horsley wax®].

Introduction: Horsley wax® is an efficient bone haemostatic agent commonly used in bone surgery. But it is non resorbable and surgeons should be aware of possible complications, which can appear many years later.

Observation: We report three cases of foreign body granulomas due to bone wax.

[Benign cartilaginous tumors of the jaws].

Benign cartilaginous tumors are a rare entity in jaw bones. The histogenesis is still discussed but an embryological hypothesis is suggested. Chondroma, osteochondroma, chondroblastoma and chondromyxoid fibroma are the main benign maxillary cartilaginous tumors.

[Benign bone forming tumors].

Benign bone forming tumors typically produce dense bone (osteoma, enostosis) or osteoid tissue (osteoid osteoma, osteoblastoma). Even though these four lesions have distinct characteristics, it is sometimes difficult to tell them apart and to rule out malignant bone forming lesions such as osteosarcoma. The first line treatment is surgical exeresis.

Salvage of a free flap by cephalic suspension with Tessier's diadem.

The authors present a case of a patient with a large occipital meningioma, treated by embolisation and surgery, in which skin necrosis occurred overlying the craniotomy bone flap. A free Latissimus dorsi flap was used to cover the tissue loss but poor healing and flap condition occurred due to contact with the anti-sore bed system making it impossible to maintain the patient on dorsal position. A cephalic suspension was carried out by Tessier's diadem making it possible to salvage the flap and to treat the patient.

[Management of whole-scalp tumour: the Poncet-Spiegler cylindroma or turban tumour].

Introduction: The Poncet-Spiegler cylindroma (PSC) is a benign annexal cutaneous tumor which preferentially develops on the scalp, neck, or forehead. Localizations may be isolated or multiple and often affect the young adult. The lesions grow progressively.

[The role of Versajet in the surgical treatment of rhinophyma. Case report].

Rhinophyma is an hypertrophy of the nose occurring primarily in men, from the age of 40, secondary to hyperplasia and fibrosis of sebaceous glands. This pathology is particularly unsightly and sometimes responsible of nasal obstruction. The treatment of this pathology is primarily surgical and the purpose of all techniques is to carry out a decortication.

[The Antia-Buch flap technique in reconstruction of marginal ear defects].

Introduction: The aim of this study was to evaluate the results of ear defect reconstruction using the Antia-Buch flap technique and to compare it to other techniques described in international literature.

Materials And Methods: We performed 19 Antia-Buch flaps between November 1998 and November 2002: 15 cases after neoplastic treatment and four post-traumatic cases. Defect ranged between 15 and 40 mm.

[Labial sequels after uni- and bilateral cleft lip repair].

Children born with labial-alveolar-velopalatine clefts must be managed by multidisciplinary teams in order to decrease the frequency and the importance of sequels, by implementing a true therapeutic strategy. It is indeed easier to avoid a secondary deformation than to correct it. Labial sequels are often associated to nasal sequels, and are managed in a single surgical intervention, with total revision of the cheilorhinoplasty.

[Salivary nitrates. New perspectives concerning the physiological function of saliva].

For many years, nitrate ions have been thought to be "toxic agents", but scientific reality seems very different. The source of nitrate ions is double: exogenous and endogenous, and the metabolism of nitrates is partly salivary. The strong concentration of nitrate ions in saliva has many beneficial physiological effects.

[Nasal reconstruction with a three-staged forehead flap: assessment of 16 cases].

Introduction: We report our experience in 16 patients with a three-staged forehead flap, described by Millard (1974) and Burguet (1992) for nasal reconstruction. We wanted to determine whether the three-stage procedure improves the quality of the final aesthetic result.

Materials And Methods: Sixteen patients underwent forehead flap nasal reconstruction between June 2002 and February 2005.

Effect of interleukin-1beta on transforming growth factor-beta and bone morphogenetic protein-2 expression in human periodontal ligament and alveolar bone cells in culture: modulation by avocado and soybean unsaponifiables.

Background: In periodontal disease, interleukin-1beta (IL-1beta) is responsible for the matrix breakdown through excessive production of degrading enzymes by periodontal ligament fibroblasts and osteoblasts. Transforming growth factor-beta (TGF-beta) plays an important role in tissue regeneration as one of the factors capable of counteracting IL-1beta effects. In this study, we investigated the in vitro effect of avocado and soya unsaponifiables (ASU) on the expression of TGF-beta1, TGF-beta2, and bone morphogenetic protein-2 (BMP-2) by human periodontal ligament (HPL) and human alveolar bone (HAB) cells in the presence of IL-1beta.

[Anhidrotic ectomermal dysplasia (AED): four cases].

Introduction: Anhidrotic ectodermal dysplasia (AED) or Christ-Siemens-Touraine syndrome is a rare, hereditary genodermatosis, classically X-linked recessive disorder.

Material And Methods: [corrected] We report the cases of 3 children and a male adult.

Results: The mode of diagnosis, the clinical signs and the therapeutic option are detailed.

[Detection of the sentinal node in squamous-cell carcinoma of the oral cavity and oropharynx. Preliminary study].

Introduction: The sentinel lymph node is defined as the first relay of the lymphatic drainage of the tumor. Isotopic detection of the sentinel lymph node and absence of its metastatic invasion should theoretically be predictive of total drainage of the tumor. The goal of this study was to evaluate sentinel lymph node detectability by lymphoscintigraphy in N0 and/or N1 squamous-cell carcinoma of oral cavity and oropharynx and to determine its negative predictive value.

Gunshot wounds: reconstruction of the lower face by osteogenic distraction.

Background: Although osteogenic distraction is a well-established technique, the distraction device still needs to be improved, miniaturized, and made lighter, more flexible, and more adaptable for mandibular reconstruction in adults with gunshot wounds. The authors successively used unidirectional and bidirectional devices, followed by a bone transporter with a horseshoe-shaped trammel. The trammel system was then replaced by an endless screw, and finally by a customized endless screw.

Tumour of the juxtaoral organ.

The juxtaoral organ is a normal and constant structure of the oral cavity. It consists of benign epithelial nests. We describe an intraoral tumour of the juxtaoral organ in a child.