Nadia Benmoussa

A 1842 skull from Dupuytren’s museum of Paris: an original artifact of Joseph Gensoul first maxillectomy technique

Joseph Gensoul was a pioneer of ENT surgery. In 1827, he performed the first total maxillectomy on 17-year-old boy. His work inspired many surgeons, who were previously unwilling to remove maxillary tumours. A paleopathological study performed in the Dupuytren museum allowed us to identify a skull from the early 19th century, with a large maxillar tumour. There were indications that this skull was operated according to Gensoul’s technique. The aim of this study is to confirm that this patient had, in fact, received this surgical treatment. This is a historical and descriptive paleopathological study of a skull of the early 19th century of Dupuytren Museum in Paris. The historical research was conducted in collaboration with the French Academy of Medicine and the Museum of Medicine History (Paris). Bones mark cut studies allowed us to confirm that the patient was operated according to the method described by Gensoul in his “Surgical letter” in 1833. Our historical research has allowed us to understand the perspectives of surgeons in the 19th century and the intellectual processes that led to this discovery. At a time when the robotization and industrialization dominate our art, it is interesting to look to our past, our origins, and our history. The study of ancient humans remains and allows us to understand the origin of our specialty and pay tribute to these pioneering surgeons. Their intellectual approach and boldness should be acknowledged and applauded, especially as it is also the key to our success.

Did René Descartes have a giant ethmoidal sinus osteoma

1348 www.thelancet.com Vol 384 October 11, 2014 episode of migraine with aura on the night of Nov 10, 1619 (characterised by sudden visual and auditory hallucinations); however, simple benign masses do not usually cause such phenomenon, especially in the fi rst 24 h as seen in vascular headache. Such an organic lesion probably had no role in the cause and circumstances of death of Rene Descartes, who died due to an acute pneumonia in Stockholm, Sweden, on Feb 11, 1650, at the age of 54 years.

New techniques on uropaleopathology

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. New techniques on uropaleopathology Maximillien Gilles Baron, Nadia Benmoussa, Dominique Bazin, Isabelle Abadie, Michel Daudon, Philippe Charlier

Hippocrates the otolaryngologist: an epidemiological analysis of ear–throat–nose diseases in the Corpus Hippocraticum

Abstract Introduction: Hippocrates, a Greek physician during the fifth century BC., is often considered the father of medicine. The Corpus Hippocraticum comprising of 58 volumes was attributed to him alone for a long time. Nowadays, it is considered that several authors contributed to its creation between 450 and 150 BC., so over a period of 300 years. The objective of our study was to develop a nosological classification of all passages treating head and neck diseases. Material and methods: We read and analyzed all volumes of the Corpus Hippocraticum in French translation and extracted all passages dealing with oto–rhino–laryngological and maxillo-facial conditions (n = 65). We classified all pathologies into five distinctive nosological groups: traumatic, infectious, malformation, cancerous and inflammatory Results: Traumatic diseases represented 36.9% (n = 24), infectious 52.3% (n= 34), malformation 0% (n = 0), cancerous 11.5% (n = 1) and inflammatory 9.3% (n= 6). These results represent the living conditions of this era, during which diseases were mostly of infectious or traumatic nature (wars, physical labor and recreational sporting activity, living together on close quarters, etc.). Conclusion: The meticulously detailed observations of the corpus give us a precious insight into the early perception of diseases, their progression and early attempts of treatment.

Use of Fat Grafts in Facial Reconstruction on the Wounded Soldiers From the First World War (WWI) by Hippolyte Morestin (1869–1919)

Introduction During the Great War of 1914 to 1918, spectacular progress was made in the field of facial reconstruction. The sheer number and severity of facial lesions inflicted during the fighting obliged French and German surgeons to take a close interest in the treatment of patients wounded in such a manner. As head surgeon of the fifth division “blessés de la face” at the hospital of Val-de-Grace, Hippolyte Morestin was responsible for one of the largest surgical departments specializing in facial surgery and reconstruction during the war. During his time of service, he developed various surgical techniques such as autoplasties using cartilaginous and adipose grafts to reconstruct tissue defects. This study focuses primarily on the adipose graft techniques and their aesthetic outcome used by Morestin during and in the aftermath of World War I. Methods This is a historical descriptive study. Our research is based on documents available at the museum and archives of the Val-de-Grace Army Health Service (hospital activity reports, pre- and postoperative patient photographs, newspaper clippings, documented accounts of ward nurses, wax anatomy models). Thirty-four clinical cases published by Hippolyte Morestin dealing with facial reconstruction during the World War I were studied. Results Fat was mainly used to fill craniofacial substance losses after carrying out often complex reconstructions. The surgical technique is well documented and subdivided into 3 succeeding procedures. Most of the time, the grafts were of autologous origin but sometimes heterologous samples were used. Although the primary objective was to increase volume, an improved quality of skin healing and better skin flexibility were observed. The fat thus allowed the filling of substance losses, and its positive effects on scarring were noticed even before the regenerative properties of the stem cells present in body fat were discovered. Conclusions Hippolyte Morestin can be named one of the pioneers of facial reconstruction. A retroperspective analysis of his work with adipose grafts proves interesting because even though not being the first to apply this technique, he contributed, by means of experimentation and reproduction to proving it an innovative and useful method in facial reconstruction. It was not until the 1990s that adipose grafts were again applied under the name of lipostructure. Nowadays, they are commonly used in cosmetic and restorative surgery.