B. Raphaël
Centre Hospitalier Universitaire de Grenoble
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by B. Raphaël.
Journal of Oral and Maxillofacial Surgery | 1996
Georges Bettega; V Dessenne; B. Raphaël; Philippe Cinquin
PURPOSE The correct placement of the mandibular condyle in the glenoid fossa during the osteosynthesis after the sagittal ramus osteotomy is often a problem. This article describes a computer-assisted positioning device. METHODS The procedure is based on the use of a three-dimensional optical localizer to establish the condylar segment position. The operative procedure is only slightly different from the usual. RESULTS The system is very easy to use, it does not require preoperative data acquisition, and the accuracy obtained is in fractions of a millimeter.
Revue De Stomatologie Et De Chirurgie Maxillo-faciale | 2006
J. Lebeau; V. Kanku; F. Duroure; B. Morand; H. Sadek; B. Raphaël
Introduction Les traumatismes faciaux representant 30 % de l’activite du service de chirurgie maxillo-faciale du CHU de Grenoble. Les auteurs ont evalue ce recrutement sur un an par une analyse des facteurs etiologiques, du type de population touchee, des differentes lesions tant squelettiques que tegumentaires, des lesions associees et du delai de prise en charge. Ils ont compare ensuite cette etude avec deux etudes precedentes afin de connaitre l’evolution de la traumatologie faciale en pays de montagne. Materiel et methode Une fiche stereotypee a ete etablie pour chaque patient ; 994 dossiers ont ete analyses, 961 ont ete retenus. Les parametres etudies ont ete la prevalence, l’âge par tranches de 10 ans, le sexe, la repartition mensuelle, les etiologies traumatiques, les types de lesion par secteurs faciaux, les associations morbides et le delai de prise en charge. Resultats La moyenne mensuelle etait de 80 traumatises recus en urgence. Le pic periodique se situait en juillet avec 97 patients. 65,6 % des patients etaient hospitalises en chirurgie maxillo-faciale. L’incidence etait la plus elevee dans la tranche d’âge de 21 a 30 ans (25,4 %). Il y avait 2,7 hommes pour une femme. Les etiologies traumatiques etaient par ordre decroissant le sport (25,8 %), les accidents de la voie publique (23,1 %), les accidents domestiques (17,6 %), les agressions (3,4 %), les accidents de travail (3,4 %), les morsures (3,2 %). Les accidents de montagne representaient 10,5 % de tous les traumatismes et 40,7 % des accidents de sport, 95 % se produisaient aux sports d’hiver. Il y avait 65,5 % de fractures et 34,5 % de lesions des parties molles isolees. Des lesions associees se retrouvaient chez 33,6 % des patients. 67,2 % des blesses ont ete traites en urgence et 86,9 % avant le cinquieme jour post-traumatique. Discussion L’incidence regionale des traumatismes faciaux se manifeste par un recrutement avant tout sportif. Les sports de glisse dominent le recrutement hivernal. Ce n’est pas le cas d’autres series (canadiennes ou australiennes) dans lesquelles le sport ne vient qu’en troisieme ou quatrieme position. Ce recrutement explique que la population la plus touchee est celle des 20 a 30 ans. La comparaison avec nos deux etudes precedentes montre une recrudescence preoccupante des accidents de ski. La grande proportion (33,6 %) de lesions associees temoigne de la violence des chocs. Les 1 035 fractures sont dues a des chocs frontaux dans 77 % des cas. Les 31 morsures ont ete infligees a des enfants dans 82 % des cas. Une organisation specifique du CHU de Grenoble reservant des plages de bloc operatoire pour la traumatologie hivernale a permis de traiter la grande majorite des blesses dans les premiers jours post-traumatiques.INTRODUCTION The purpose of this study was to determine the types of facial injuries treated in a one-year in a maxillo-facial unit operating in a mountainous region. METHODS All patients admitted to the Grenoble University Hospital maxillo-facial unit for a one year period were studied. We noted cause of trauma, age, sex, type and location of fracture, type of soft tissue injury, time between trauma and surgery. RESULTS A total of 994 patients presenting maxillo-facial trauma underwent surgery over one year; 30% of the units maxillo-facial surgical activity. On average, 80 patients were treated for maxillo-facial trauma per month, with a peak of 97 facial injuries in July; 65.6% were hospitalized in the maxillo-facial unit; 25,4% of the injured were aged between 21 and 30 years. Sex-ratio was 2.7M/1F. The most frequent cause was sports injuries (25.8%) followed, in decreasing order, by traffic injuries (23.1%), home injuries (17.6%), fight injuries (3.4%), work injuries (3.4%) and dog bites (3.2%). 10.5% of the injuries occurred in a mountainous setting and 40.7% were sports injuries, 95% of which during practice of winters sports. Injuries included facial fractures (65.5%) with or without soft tissue damage, and soft tissue injuries only (34.5%); 33.6% of the patients had other lesions of the body. 67.2% underwent surgery within the first 24 hours and 86.9% before the fifth day. DISCUSSION Sports accidents are the leading cause of facial trauma in the mountainous regions. Most facial injuries result from ski, surf and other winter sports accidents. Most of the victims were given surgical care within the first 24 hours following the accident.
medical image computing and computer assisted intervention | 1998
Yohan Payan; Georges Bettega; B. Raphaël
Many surgical technics act on the upper airway in general, and on the tongue in particular. For example, tongue is one of the anatomical structures involved in the case of Pierre Robin syndrome, mandibular prognathism, or sleep apnoea syndrome.
Ophthalmology | 1998
Béatrice Morand; Georges Bettega; Vincent Bland; Nicole Pinel; J. Lebeau; B. Raphaël
OBJECTIVE The authors report the case of an 83-year-old patient with a benign oncocytoma of the inferior eyelid. DESIGN INTERVENTIONal case report. INTERVENTION Treatment consisted of a large orbital exenteration followed by reconstruction with a pedicled temporalis muscle flap. MAIN OUTCOME MEASURES Histologic evaluation and clinical follow-up were measured. RESULTS After a year of follow-up, there was no sign of local recurrence. CONCLUSIONS Oncocytomas, even if benign, must be considered as very aggressive tumors and treated accordingly.
Revue De Stomatologie Et De Chirurgie Maxillo-faciale | 2005
E. Soriano; V. Kankou; B. Morand; H. Sadek; B. Raphaël; Georges Bettega
Introduction Les fractures de l’angle de la mandibule exposent aux complications locales, en particulier infectieuses. Nous avons essaye de determiner s’il existait des facteurs predictifs de la survenue de ces complications. Materiel et methodes Une etude retrospective menee sur 26 mois a recense toutes les fractures de l’angle mandibulaire. Deux groupes ont ete compares : les fractures avec dent de sagesse et celles sans dent de sagesse. Nous avons etudie pour chaque groupe les caracteristiques cliniques et radiologiques de ces fractures puis recense les complications infectieuses. Resultats Sur 72 fractures de l’angle, 30 comportaient une dent de sagesse dans le foyer contre 42 sans dent de sagesse. Le delai moyen de prise en charge a ete de 2 jours et le traitement a presque toujours ete une osteosynthese par mini-plaque vissee. Dans le groupe « avec dent de sagesse » nous avons recense 16,6 % de complications infectieuses contre 9,5 % dans le groupe « sans dent de sagesse ». Tous les patients du premier groupe presentaient sur l’orthopantomogramme pre-operatoire des foyers infectieux potentiels. Pour le deuxieme groupe, seul un taux eleve de suivi irregulier a ete recense comme facteur de risque. Discussion La localisation angulaire augmente le risque de complications infectieuses surtout si la dent de sagesse se trouve dans le trait de fracture. Nous proposons une conduite a tenir vis-a-vis de la conservation ou non de la dent de sagesse dans les fractures de l’angle.
Annales De Chirurgie Plastique Esthetique | 2001
G. Bettega; B. Morand; J. Lebeau; B. Raphaël
Otomandibular dysplasia is a congenital malformation defined by a certain degree of temporomandibular or pterygomandibular hypoplasia. The syndrome is characterised by the variability of clinical findings, but the three major features are auricular, mandibular and maxillary hypoplasia. All the laterofacial structures may be affected. The deformity is usually unilateral but bilateral cases exist; a lot of associated malformations have been described. Multiple classification systems have been published. Some of them are very complex, but it is possible to define a simple diagnostic diagram based on ethiopathogenic data. Bilateral involvement affects predominantly the zygoma, and concerns hereditary syndromes. When the mandibular hypoplasia is evident Franceschetti or Goldenhar syndrome is suspected; otherwise Treacher-Collins syndrome is probable. Unilateral cases are not, in general, hereditary and the hypoplasia predominates on the mandible. The difference between hemifacial microsomia or mandibular dysplasia is made by the presence of associated laterofacial deformities.
Plastic and Reconstructive Surgery | 2006
Jaques Lebeau; Thucydides Rodrigues Lopes; Antonella Gallodoro; B. Raphaël
Background: During breast reconstruction after mastectomy, the long-term deterioration of the projection of neonipples led the authors to modify Thomass technique in its design and use. Methods: The results were evaluated after at least 10 months, in 14 patients, by comparative measurement of diameters and projection of the neonipple and contralateral nipple. Results: In two cases, the authors had a 3-mm loss of height; in six cases, the authors had a variation of 1 mm compared with the referent nipple; and the heights appeared identical in the six other cases. The height variation was thus lower or equal to 1 mm compared with the contralateral nipple in 80 percent of cases. There was no or little diameter variation of approximately 1 mm in 12 cases (85.7 percent). Conclusion: This technique allows rebuilding of a nipple that remains identical to the contralateral nipple over the long run.
Annales De Chirurgie Plastique Esthetique | 2001
B. Raphaël; J. Lebeau; G. Bettega
A thorough knowledge of mandibular growth is necessary for proper comprehension of growth disorders and malformations affecting the lateral cranio-facial region. The growth mechanisms are complex and multifactorial, the mandible itself is subdivided into two heterogeneous and interdependent segments, as far as growth is concerned. These are the ramus and the corpus. The ramus is interacting with the middle cranial base through the TMJ and the temporo-pterygoid muscle belt. The mandibular body is interacting with the maxilla and the anterior cranial base. Its occlusal role is a function of the adaptive capacity of the alveolodental region.
medical image computing and computer assisted intervention | 2000
Georges Bettega; Francois Leitner; Olivier Raoult; Vincent Dessenne; Philippe Cinquin; B. Raphaël
Purpose and method: Computer-assisted systems, as any medical technology, have to go through several steps within an endless loop before becoming routine. The first step is the conception of a prototype, the second is its adaptation to the clinical modalities (via animals or cadavers studies), the third is the clinical validation and the last one is the ergonomics optimization preceding the industrialization.
Annales De Chirurgie Plastique Esthetique | 2010
B. Raphaël; M. Brix; H. Sadek; François Moutet; J. Lebeau
Central-facial mutilations, located within the nose lips and chin triangle, require great quality repairs regarding morphology and function. Plastic surgery history affords the ideas evolution in this field crossing over nose and lips reconstructions, which were the subject of successive reports within our society, in 1994 (nose reconstruction) and 2002 (lips reconstruction). Now a day, following this progress, the plastic surgeon has a large choice of reliable techniques. His choice is dictated by a precise evaluation of the limits of the substance loss to repair, according to a (mapping) classification of the nose-lip and chin triangle. This classification defines three units (nose-labial, bilabial and chin-labial) as reflexion bases to the therapeutic indications. This anatomical and surgical approach was built starting from a retrospective study of 195 central-facial mutilations caused by ballistic damage and dog bites. The results evaluation makes possible to carry out a reflexion on the potential indications regarding allograft as a therapeutic alternative to the traditional reconstructions of this territory.