Bruno Salazard

Congenital ptosis: Long-term outcome of frontalis suspension using autogenous temporal fascia or fascia lata in children

Children with severe congenital blepharoptosis are at risk of developing amblyopia. For this reason, ptosis repair is indicated as soon as the diagnosis is made. Frontalis suspension of the upper lid is an effective and simple method of treatment. This study reports on the long-term outcome of frontalis suspension surgery for congenital ptosis using autogenous sling material. Twelve children with severe congenital ptosis underwent frontalis suspension surgery using autologous fascia lata or temporal fascia. The results were assessed with a mean follow-up period of 8 years. Eleven children had good or excellent functional and aesthetic results. There were no cases of recurrence or overcorrection. Frontalis suspension using autologous material is a harmless procedure, which does not alter the upper eyelid structures. It is an effective procedure in the long term. In our opinion, it is the technique of choice to treat young children with severe congenital ptosis.

Auguste and Louis Lumière, inventors at the service of the suffering

One evening in 1877 in a cave in Brittany, two children with the prophetic name of Lumière swore an oath: they swore they would work together all their lives. Thirty years of work followed, with hundreds of scientific papers presented to scientific societies and over 200 books. Together, Auguste and Louis Lumière wrote a masterpiece, a complete chapter in the history of the world. If history remembers them for the invention of the cinematograph and the discovery of autochromatic plates, it should definitely glorify them for their commitment to the suffering. Their involvement in medical photography and surgical cinema has enabled generations of medical students to learn examination and surgical techniques. These workers with big hearts spent their lives resolving the problems of humanity. A motto led them throughout their long journey: “Persistence in work, look upwards, learn beyond, continue to rise.” Louis made the following conclusions on his life: “I always enjoyed resolving problems... I was a born enthusiast—one gets older slower because one is always waiting for something.” During the Great War, their commitment to the wounded was total: their generosity and inventiveness enabled them to save hundreds of lives. Auguste Lumière devoted the last 40 years of his life to medicine and biology. While his neo-Hippocratic theories were rapidly contradicted by science, he was an extraordinary “stimulator of ideas”, a nonconformist scientist at the service of those who were suffering socially and medically. He concluded: “I have done some good—that is my best work.”

SFCP-041 – Chirurgie plastique – Prise en charge des malformations artério-veineuses chez l’enfant

Objectifs Les malformations arterio-veineuses sont rares chez l’enfant et posent des problemes de strategie therapeutique. Le but de ce travail est de tenter de preciser, en fonction de la classification de Schobinger, la prise en charge therapeutique de ces malformations vasculaires. Materiels Nous rapportons les cas de deux enfants âges de 5 ans et de 6 ans presentant respectivement une lesion perineale et une lesion temporo occipitale. Le bilan initial a repose sur la realisation d’un echo-doppler et d’une angio-IRM. Resultats Dans les deux cas la chirurgie a ete precedee d’une embolisation selective. Le recul est de un an sans recidive. Conclusion Nous pensons que l’embolisation la plus selective possible suivie dans un delai de quelques heures d’une chirurgie la plus complete reste la meilleure attitude. Le geste chirurgical doit permettre une eradication complete de la lesion afin d’esperer une guerison. La chirurgie doit etre reservee aux formes evolutives ou source de complications. Mais une exerese meme complete ne met pas a l’abri d’une recidive.

Prise en charge d’une malformation artérioveineuse périnéale chez un enfant de 5 ans

Arteriovenous malformations are seldom in children but raise important therapeutic problems. Apart from intracranial arteriovenous malformations, few observations have been described in the literature. We report the case of a superficial perineal arteriovenous malformation in a 5-year-old child. Tailored embolization followed shortly by thorough surgery is the best attitude. Surgery must totally eradicate the lesion to allow hope for a cure. Surgery should be reserved for forms that are extensive or a source of complications. Even total resection does not ensure non-recurrence.