P. Jammet

Malar bone fractures and their sequelae: A statistical study of 1.393 cases covering a period of 20 years

The authors analyse the results of 1.393 cases of malar fractures treated in the maxillo-facial Departments of Montpellier and Perpignan. A clinical and therapeutic classification is given. Study of the sequelae demonstrated that the most frequent were infra-orbital nerve lesions, residual displacement of the malar bone, diplopia, and enophthalmos. A point is made about the use of Francheboiss inflatable balloon as a means of retention. Its indications as well as its contra-indications are clearly defined. The reduction in the number of bone sequelae, when compared to cases treated without the balloon, demonstrates the efficacy and simplicity of this method.

The effect of different porosities in coral implants: an experimental study

Goniopora lobata and polyphyllia talpina were tested in 10 sheep with a follow-up of 12 months. The reference material was a glass ceramic CAP 42. Different implantation sites are used: craniofacial and orthopaedic. A macro and microscopic postoperative study was performed at 3, 6, 9 and 12 months. The results show: (1) biocompatibility with bone and soft tissues; (2) disappearance, without colonisation, of Goniopora Lobata associated with complete bone regeneration at 12 months and (3) later resorption of polyphyllia talpina with a fibrous colonisation, without osseous transformation. The possibility of using these materials in cranio-maxillo facial surgery is discussed.

Oral and maxillofacial surgery: what are the French specificities?

PURPOSE Oral and maxillofacial surgery has expanded rapidly over the past century. Recognition in France has grown since the first face transplantation in the world performed by Professor Bernard Devauchelle. This speciality, which seems to correspond to a narrow scope of services, actually involves oral, plastic, reconstructive, and cosmetic surgeries of the face. French training for maxillofacial surgeons differs from the Anglo-Saxon course of study. After examining surveys carried out in Great Britain, the United States, and Brazil, the perception of this speciality in the general public and among regular correspondents (general practitioners and dental practitioners) was ascertained. MATERIALS AND METHODS More than 4,000 questionnaires were sent to health care workers and patients attending dental practices. The returned questionnaires concerning recognition of this profession in France were analyzed. Evaluating awareness of maxillofacial surgery among practitioners and the public was of particular interest because it can overlap with several other specialities (ear, nose, and throat; plastic surgery; odontology). The questionnaire included the 20 items used in other similar studies so the results could be compared. RESULTS Several fields of expertise were identified in maxillofacial surgery, in particular traumatology, surgery for facial birth defects, and orthognathic surgery. Moreover, dental practitioners were found to be the most regular correspondents of maxillofacial surgeons compared with general practitioners. Compared with Anglo-Saxon and Brazilian peers, French recognition of maxillofacial surgery was better. CONCLUSION Despite encouraging results, maxillofacial surgery remains a somewhat obscure speciality for health care workers and the general public. Better awareness is necessary for this speciality to become the reference in facial surgery.

Lésions du nerf lingual lors de l’extraction d’une dent de sagesse inférieure: Plaidoyer pour une intervention précoce

Introduction La lesion du nerf lingual est l’une des complications majeures de l’avulsion des dents de sagesse mandibulaires. Cas cliniques Nous illustrons cette complication par deux cas cliniques. Dans la premiere observation, la reparation put etre effectuee immediatement et la recuperation fut complete ; dans la seconde observation, le nerf ne fut pas explore et l’anesthesie fut definitive. Discussion Si les avis divergent sur le delai d’attente acceptable avant d’explorer le nerf lingual traumatise, il est necessaire de l’aborder chirurgicalement si la recuperation sensitive est inexistante. En raison des lesions degeneratives du nerf lese, un delai inferieur a trois mois parait preferable pour cette exploration. Un delai d’intervention court et une suture de qualite favorisent la recuperation nerveuse surtout si le sujet est jeune et si le nerf ne presente pas de perte de substance.INTRODUCTION Lingual nerve injury is one of the most important complications after removal of a lower third molar. CASE REPORT We report two cases of this complication in our experience. In the first case, lingual nerve injury was repaired immediately and the patient recovered total tongue sensitivity. In the second case, lingual nerve exploration was not undertaken and the patient developed complete tongue anesthesia. DISCUSSION Opinions are quite different about the delay before exploration of an injured lingual nerve. However, absence of sensory improvement incited us to undertake surgical exploration of the nerve. Due to the degenerative lesion of the damaged nerve, timing of repair before three months seems preferable. In young patients, early repair, and good quality nerve suture without tissue loss improve sensitive recovery of the tongue.

The role of microsurgery in salvage operations for cranio-cerebral gunshot wounds: a case report

A case of gunshot wound of the brain associated with a scalp defect is presented. Repair of the scalp defect was primarily achieved by multiple rotation flaps. Successive complications occurred in the postoperative course related to wound breakdown and infection. The patient underwent a secondary reconstruction by a free forearm flap. Despite an infected recipient bed and poor general condition, the postoperative course was uneventful and the healing was complete within 1 month.

Note techniqueLa blépharoplastie inférieure par voie conjonctivaleTransconjunctival inferior blepharoplasty

La lipoptose palpebrale inferieure sans atteinte cutaneo-musculaire est l’indication ideale de l’utilisation de la voie conjonctivale pour realiser la blepharoplastie inferieure. L’incision conjonctivale est effectuee a 2 mm sous le bord inferieur du tarse et la voie d’abord est retroseptale. Aucune suture conjonctivale n’est necessaire. La blepharoplastie inferieure par voie conjonctivale diminue le risque de complications par rapport a la voie cutanee et apporte un meilleur confort a l’opere, mais ne dispense pas des precautions indispensables que sont l’examen ophtalmologique preoperatoire et le consentement eclaire signalant le risque dramatique mais exceptionnel d’amaurose.

La blépharoplastie inférieure par voie conjonctivale

La lipoptose palpebrale inferieure sans atteinte cutaneo-musculaire est l’indication ideale de l’utilisation de la voie conjonctivale pour realiser la blepharoplastie inferieure. L’incision conjonctivale est effectuee a 2 mm sous le bord inferieur du tarse et la voie d’abord est retroseptale. Aucune suture conjonctivale n’est necessaire. La blepharoplastie inferieure par voie conjonctivale diminue le risque de complications par rapport a la voie cutanee et apporte un meilleur confort a l’opere, mais ne dispense pas des precautions indispensables que sont l’examen ophtalmologique preoperatoire et le consentement eclaire signalant le risque dramatique mais exceptionnel d’amaurose.