[Hair micrograft technique for eyebrow reconstruction]. / Reconstruction du sourcil par microgreffe capillaire.

SUBJECT: The eyebrow reconstruction should restore an eyebrow with a natural shape and with matching hair direction. METHOD: We describe the micrograft hair technique for eyebrow reconstruction, using either hair from the opposite eyebrow or hair from the scalp. We illustrate our technique with three clinical cases: a traumatic eyebrow injury, a burn scar and a progressive hair loss. DISCUSSION: We insist on the advantages of this technique which is simple, "taylor-made" and which allows to choose the hair direction according to the eyebrow topography. The micrograft hair technique has many advantages in comparison with scalp strip grafting or hair-bearing island scalp flap techniques. CONCLUSION: The eyebrow reconstruction using micrograft hair technique is a simple effective technique offering a better cosmetic result than usual techniques by achieving a natural hair direction and density.

Cherubism. Findings in three cases in the same family.

Cherubism is a benign hereditary giant-cell lesion of the mandibular and maxillary spongiosa which appears during childhood between the age of 2 and 5 years and progresses until puberty when it spontaneously regresses. It appears as a bilateral, painless swelling. It normally requires no treatment. Three children in the same Algerian family who suffered from this disease were brought to our department. Radiographic examinations were carried out, giving good definition of the lesions. The 3 patients were finally operated on, as operative treatment was, effectively, necessary.

Cinegammography and 3-D emission tomoscintigraphy for evaluation of revascularized mandibular bone grafts: a preliminary report.

The following reports a study conducted to investigate a scintigraphic monitoring procedure for bone free flap in mandibular reconstruction. This procedure is based on the one hand, on vascular and bone cinegammography, and on the other hand, on vascular and bone 3-D tomoscintigraphy. We used a prospective cohort study design. All patients who underwent free flap mandibular reconstruction from April 1993 to April 1998 in the Salpêtrière University Hospital, France (20 cases) have been evaluated in relation to this scintigraphic procedure. Vascular and bone scintigraphy were performed within the second week after surgery during 2 consecutive days. All images were read by one author (J.- Y. B.), who did not know the skin status of the flap. The results were compared with the viability of revascularized bone grafts as evaluated by the skin status and Greenberg classification based on bone radiographs three months after reconstruction. Vascular cinegammography seems to be closely related to anastomosis patency. Bone cinegammography gives appreciable information on bone viability. 3-D vascular tomoscintigraphy remains difficult to interpret. 3-D bone tomoscintigraphy gives precise information on the viability of the different segments of the bone flap. These results suggest that vascular and bone 3-D tomoscintigraphy coupled with cinegammography have an excellent prognostic value. In the event of partial failure it can give information on the location of the impaired patency and on the osseous fragment which has lost any viability.

[Baldness: indications]. / Calvitie: indications.

The author presents his indications for the various types of baldness. Grafts, for which the technique used has been recently modified, allow covering small patches of alopecia, especially on the anterior frontal line. High-hinged flaps are used for more advanced baldness. Lastly, scalp lift and scalp expansion allow solving the problem of extensive baldness of the vertex and of the anterior frontal line.

[Comparison of anatomy and imaging of the orbital area and the nasolacrimal duct]. / Comparaison anatomie-imagerie de la région orbitaire et du canal lacrymo-nasal.

The orbit and its appendages were analysed on anatomical sections, CT scans and magnetic resonance imaging in order to define the various constituents of the orbitonasolacrimal apparatus in the various planes. The series of sections presented should enable surgeons to define the landmarks in this region, especially in the approach to deep structures.

[Unusual breast scars]. / Des cicatrices mammaires inhabituelles.

The authors report the case of an unusual form of skin tattoo, discovered on the breasts of a young woman, corresponding to several scars forming a symbolic image, performed deliberately with a burning object. This form of mutilation is called "branding". Imported from England, it is developing in France as a result of fashion, but its followers could one day regret the permanent scars left by this deep burn.

[Value of interrupted resection of the lateral crus in surgery of the nasal tip]. / Intérêt de la résection interruptrice de la crus latérale dans la chirurgie de la pointe du nez.

Three goals have to be achieved in the surgery of the tip of the nose. Separately or joined together, they contribute to modify the height, rotation or width of the tip. Interrupting resection of the upper legs gives the ability to modify both the projection and the rotation of the tip. The authors present this technique, emphasizing the precise location of the knee of the upper legs and the interest to perform interrupting resections laterally to this region.

[Cherubism. Apropos 3 cases]. / Chérubisme. A propos de 3 cas.

Cherubism is a benign hereditary giant-cell lesion of the mandibular and maxillary spongiosa which appears during childhood between 2 and 5 years old and progresses until puberty when it spontaneously regresses. It appears under the form of a bilateral painless swelling. It normally requires no treatment. Three children of a same algerian family who suffered from this disease were brought into our ward. Radiographic examinations were realized among which scanner allowed the establishment of a good definition of the lesions. The 3 patients were finally operated, the surgical intervention having been effectively necessary.

[Cervical lipoma or Launois-Bensaude syndrome]. / Lipome cervical ou Launois-Bensaude.

The authors report a clinical case of a borderline form between two types of lipomatosis: simple lipoma and Made-lung's disease. The authors review the clinical features of these two diseases and stress the fundamental importance of the intraoperative appearance. The diagnosis in the present case was that of cervial lipoma.

[The trapezoid face: transversal excess in the maxillary area]. / Le visage trapézoïdal: excès transversal au niveau de l'étage inférieur de la face.

The patient who consults for "big cheeks" usually desires correction for an excess of tissue in the masseter region. First all neoplastic pathologies recognized by their unilateral asymmetry are excluded in order to focus on bilateral phenomena. Three anatomical elements can be responsible either alone or in association for this excess: the parotid gland, the masseter muscle and the angle of the jaw. The clinical and complementary examinations leading to the etiological diagnosis are described. The treatment recommended is specific to the structure involved and is not necessarily surgical.

[Complex reconstruction of the lower lip. Apropos of various cases]. / Reconstruction complexe de la lèvre inférieure. A propos de quelques cas.

Preservation of buccal cavity relations raises problems when treating extensive defects of lower lip. After a review of anatomical features, several case reports are presented to illustrate the advantages and inconveniences of three interventions for labial reconstruction.

[Cherubism. Apropos of a major case]. / Le chérubisme. A propos d'un cas majeur.

Cherubism is a benign, hereditary giant-cell lesion located in the mandible and both maxillaries, which appears during childhood as a painless bilateral swelling, progressing until puberty and then receding spontaneously without normally requiring any treatment. In a previous publication, the authors had presented the case of three young children from the same Algerian sibship, who were eventually all operated when surgery proved to be necessary. The case published in this presentation is that of a young Italian girl presenting with a monstrous form of cherubism. In view of this malignant form, the authors decided to perform surgical treatment in several steps in order to decrease this abnormality as much as possible, considering the physical and psychological consequences reported.

[mandibular reconstruction by free bone flaps with micro-anastomosis. Our current indications]. / Reconstruction mandibulaire par lambeaux libres osseux micro-anastomosés. Nos indications actuelles.

The frequency with which difficulties were encountered in the reconstruction of the continuity of the mandible led us to attempt to systematize our indications. Although grafts, composite pedicle flaps and prosthetic guides still have their appropriate applications. Local conditions are more and more frequently amenable to free flaps. The factors guiding our choice are presented in detail: physical conditions, etiology and anatomy of the defect. In addition, the reason for choosing the type of free flap--iliac crest, fibula or external brachial--is discussed.

[A simple procedure for the passive suspension of the paralyzed labial commissure]. / Procédé simple de suspension passive de la commissure labiale paralytique.

Different techniques can be used to repair paralytic labial commissurae. Ideally, microsurgical procedures or dynamic suspension methods can correct kinetic paralysis but in certain patients (elderly subjects, poor general health, precarious postsurgical rehabilitation) such procedures may represent an excessively aggressive procedure. We therefore used static suspension of the paralytic labial commissurae based on desepidermization of a nasogeneal flap. This simple technique is easy to perform and is our method of choice for static suspension because the flap pulls the paralysed commissurae upward and doubles the tissue cover, helping overcome buccinator incompetence.

[Radiologic pitfalls of mandibular fractures]. / Pièges radiologiques des fractures mandibulaires.

Analysis of a large series of patients treated for mandibular fractures showed pitfalls in assessment of radiologic images in six cases. Factors predisposing to these radiologic pitfalls are discussed, multiple radiographic projections being suggested if discordance exists between radiologic and clinical findings, to obtain maximum data from a three dimensional picture of the mandible.

[Loss of substance of the lateral region of the face]. / Pertes de substance de la région latérale de la face.

The lateral region of the face is often exposed to trauma and may also be the site of tumor localization. Exeresis may lead to major tissue loss. We report several surgical techniques, from the most simple to more complicated, available for facial repair. Neighboring regions in the frontal or temporal area are used but a submental flap may also be useful.

[Restoration of the alveolar crest with a biomaterial filler. A clinical and histological study]. / Restauration de crête alvéolaire par biomatériau de comblement. Etude clinique et histologique.

The implantation of biocompatible hydroxyapatite is used for human mandibular ridge augmentation in edentulous patients. Histologically, we studied such a material after a long period of implantation (1 1/2 to 2 years) in two patients. The histologic study showed a narrow meshed net of collagen tissue surrounding the hydroxylapatite particles. In the periphery of that tissue, we could see an osteogenesis: the bony trabeculae thus formed firstly were made of an immature bony matrix with an irregular "woven" pattern; secondarily, a mature bone, quite similar to the normal bone, occurred. In our two observations, there was an unusual inflammatory reaction characterized by cellular infiltration of lipophages, lymphocytes and plasma cells in the connective tissue and in one case by a true ischaemic necrosis with granuloma and bacteria. In spite of that inflammation, the whole material was well tolerated, without foreign-body granuloma. Such a granuloma was only found in superficial areas of the gingiva, around extruded particles of the biomaterial.

[Isolated sub-orbital plexiform neurofibroma]. / Neurofibrome plexiforme sous-orbitaire isolé.

An unexpected finding on histology in a 73 years old patient was an isolated suborbital plexiform neurofibroma. Since this tumor is specific for von Recklinghausen's disease, the diagnosis was that of a minor form of the disease. The different cephalic manifestations of von Recklinghausen's disease are reviewed.

[Apparently primary malignant cervical adenopathy]. / Adénopathies cervicales malignes en apparence primitives.

Despite a thorough examination it is not always possible to detect the primary cancer responsible for malignant cervical adenopathy. In the vast majority of cases the metastases arise from an epidermoid carcinoma of the upper respiratory or digestive tract. A possible diagnostic, but also therapeutic procedure is exploratory cervicotomy with extemporaneous examination. The prognosis is poor, both locally (glandular involvement) and generally (metastatic spread).