Publications by authors named "Thomas Schouman"

The vascularized periosteal free flap transposes a non-irradiated soft tissue with neoangiogenesis, bone induction, and osteogenesis qualities. A surgical technique using a humeral periosteal free flap is described for the treatment of recurrent osteoradionecrosis of the lower jaw. The humeral periosteal free flap is a technique associated with low morbidity.

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Article Synopsis
  • Primary chronic Non-Bacterial Osteomyelitis of the jaw is a rare inflammatory disease that shares similarities with SAPHO syndrome and chronic recurrent multifocal osteomyelitis, and TNF-alpha blockade may be an effective treatment option despite limited clinical data.
  • In a study of 15 patients with refractory CNOM, 10 were treated with anti-TNF-alpha therapy due to previous treatment failures and the promising efficacy seen in related conditions.
  • The results showed that most patients experienced rapid and lasting remission without serious side effects, though male patients appeared to have poorer outcomes, indicating that TNF-alpha blockade is both safe and effective for CNOM management.
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Objectives: Segmentation of anatomical structures on dento-maxillo-facial (DMF) computed tomography (CT) or cone beam computed tomography (CBCT) scans is increasingly needed in digital dentistry. The main aim of this research was to propose and evaluate a novel open source tool called DentalSegmentator for fully automatic segmentation of five anatomical structures on DMF CT and CBCT scans: maxilla/upper skull, mandible, upper teeth, lower teeth, and the mandibular canal.

Methods: A retrospective sample of 470 CT and CBCT scans was used as a training/validation set.

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The study aimed to evaluate and discuss the use of an innovative PSI made of porous hydroxyapatite, with interconnected porosity promoting osteointegration, called MyBone Custom® implant (MBCI), for maxillofacial bone reconstruction. A multicentric cohort of 13 patients underwent maxillofacial bone reconstruction surgery using MBCIs for various applications, from genioplasty to orbital floor reconstruction, including zygomatic and mandibular bone reconstruction, both for segmental defects and bone augmentation. The mean follow-up period was 9 months (1-22 months).

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Objective: This study aimed to evaluate the long-term stability of surgical maxillary expansion using patient-specific fixation implants (PSFIs) without intraoral retention.

Materials And Methods: Fifteen patients who had undergone segmented Le Fort I osteotomy and PSFIs with available preoperative (t0) early (t1) and 1-year follow-up computed tomography (CT) scans (t2) were evaluated. The early and 1-year 3D models were superimposed to transfer the bony landmarks; the distances between each pair of landmarks at the different time points were then measured.

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This study assesses the efficacy of Geriatric Assessment (GA)-driven interventions and follow-up on six-month mortality, functional, and nutritional status in older patients with head and neck cancer (HNC). HNC patients aged 65 years or over were included between November 2013 and September 2018 by 15 Ear, Nose, and Throat (ENT) and maxillofacial surgery departments at 13 centers in France. The study was of an open-label, multicenter, randomized, controlled, and parallel-group design, with independent outcome assessments.

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Objectives: To evaluate the performance of the nnU-Net open-source deep learning framework for automatic multi-task segmentation of craniomaxillofacial (CMF) structures in CT scans obtained for computer-assisted orthognathic surgery.

Methods: Four hundred and fifty-three consecutive patients having undergone high-resolution CT scans before orthognathic surgery were randomly distributed among a training/validation cohort (n = 300) and a testing cohort (n = 153). The ground truth segmentations were generated by 2 operators following an industry-certified procedure for use in computer-assisted surgical planning and personalized implant manufacturing.

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Article Synopsis
  • The study evaluates the effectiveness of biplanar 2D/3D X-ray technology (BPXR) in providing reliable cephalometric analysis for assessing facial morphology using lateral skull views.
  • A total of 17 landmarks and 11 angles were measured on BPXR lateral images and traditional lateral cephalograms from 13 patients, comparing different methods of angle measurement for reliability.
  • Results showed that BPXR had excellent reliability and that BPXR-A method achieved the best alignment with the reference technique, indicating it’s a suitable option for cephalometric analysis.
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In some dentofacial deformity patients, especially patients undergoing surgical orthodontic treatments, Computed Tomography (CT) scans are useful to assess complex asymmetry or to plan orthognathic surgery. This assessment would be made easier for orthodontists and surgeons with a three-dimensional (3D) cephalometric analysis, which would require the localization of landmarks and the construction of reference planes. The objectives of this study were to assess manual landmarking repeatability and reproducibility (R&R) of a set of 3D landmarks and to evaluate R&R of vertical cephalometric measurements using two Frankfort Horizontal (FH) planes as references for horizontal 3D imaging reorientation.

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3D-printing is part of the daily practice of maxillo-facial surgeons, stomatologists and oral surgeons. To date, no French health center is producing in-house medical devices according to the new European standards. Based on all the evidence-based data available, a group of experts from the French Society of Stomatology, Maxillo-Facial Surgery and Oral Surgery (Société Française de Chirurgie Maxillofaciale, Stomatologie et Chirurgie Orale, SFSCMFCO), provide good practice guidelines for in-house 3D-printing in maxillo-facial surgery, stomatology, and oral surgery.

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Purpose: Meeting with local needs of low- and middle-income countries during maxillofacial humanitarian mission is not easy. This article aimed to report on 5 years of experience in humanitarian maxillofacial surgery missions. In addition, several key points for best practices and meeting the medical needs of local populations are discussed.

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This case series study evaluates head and neck injuries caused by electric scooters in Paris, 2017-2019, focusing on user behavior and injury types.

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Craniofacial fractures management is challenging to teach due to the complex anatomy of the head, even when using three-dimensional CT-scan images. DIVA is a software allowing the straightforward visualization of CT-scans in a user-friendly three-dimensional virtual reality environment. Here, we assess DIVA as an educational tool for craniofacial trauma for undergraduate medical students.

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Background: This study aimed to evaluate the feasibility of a new biplanar low-dose X-ray device for facial skeletal imaging.

Methods: We evaluated 48 biplanar radiographs from 12 patients (posteroanterior/lateral), originally taken for a scoliosis examination with a biplanar low-dose X-ray device. For this study, the images were further evaluated for the perceptibility of 38 facial skeleton landmarks.

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Purpose: Conventional orthognathic osteotomies provide appropriate functional outcomes but might be unable to correct midface deficiency, achieve a satisfactory outcome in asymmetrical cases, or allow sufficient chin advancement. We evaluated the outcome of both standard and customized facial high-density porous polyethylene implants used to refine the cosmetic outcome of orthognathic surgery.

Patients And Methods: We implemented a retrospective study.

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Obstructive sleep apnea (OSA) is a common, multifactorial disease resulting in high morbidity and mortality. Gold standard treatment is nocturnal positive airway pressure. Maxillomandibular advancement is a surgical technique used to treat obstructive sleep apnea.

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Temporo-mandibular disorders -TMD- involve a whole set of anatomical, physiological and clinical disorders that exceed by far the sole temporo-mandibular joint. The main symptom of this condition, most frequent in female patients, is pain. Three syndromes are associated with TMD: a muscular syndrome, not only involving masticatory muscles but also muscles of the neck and pain in seemingly unrelated anatomical regions, which can be misleading; an inflammatory articular syndrome; a mechanical syndrome affecting mouth-opening path.

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Introduction: Neoadjuvant chemotherapy (neo-CT) for osteosarcomas is the standard of care. Management of maxillo-facial osteosarcomas (MFOS) is challenging. In this rare disease, we collected a large cohort of patients with the aim to report the histological and radiological local response rates to neo-CT.

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Objectives: There is no consensus for the specific management of elderly patients presenting with oral cavity squamous cell carcinomas (OC SCC). We report our findings in the treatment of primary OC SCC, for patients of 70 years of age or more, in a French university hospital center.

Patients And Methods: One hundred and twenty five patients diagnosed between 2000 and 2010, were included retrospectively.

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Introduction: Parietal bone grafts are commonly used in cranio-maxillo-facial surgery. Both the outer and the internal layer of the calvarium can be harvested. The bone defect created by this harvesting may induce significant weakening of the skull that has not been extensively evaluated.

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Purpose: The authors had for aim to further assess the predictive power and the relevance of a previously published radiological decision taking score for pure fractures with recording of clinical data.

Methods: The authors retrospectively included all patients managed in the authors' department for a pure orbital floor fracture, from June 2012 to November 2013. The authors collected clinical data including diplopia and enophtalmos, at initial status and after 3-months of follow-up.

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Introduction: A possible relation between an upper airway space decrease and the development of obstructive sleep apnea syndrom explains the importance to know the effect of the modification of dental arch length on the upper airway during orthodontic treatment.

Objectives: The aim of this article is to expose recent knowledge about upper airway development and dental arch length decrease factors, to determine the influence of this decrease on upper airway development.

Methods: A review was done to determine the upper airway normal development, to define dental arch to specify if an ideal position of dental arch on apical base exists.

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Background: Facial cellulitis is an infectious disease that may require emergency surgical drainage based on clinical assessment. To date, no biological marker has been reported to be useful for risk stratification. Procalcitonin (PCT) is a diagnostic and prognostic sepsis biomarker.

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