[Maxillary sinus septa. Prevalence and anatomy]. / Les septums du sinus maxillaire. Prévalence et anatomie au travers d'une revue de la littérature de 1980 à 2009.

BACKGROUND: Maxillary sinus septa may complicate sinus elevation procedures, especially when they are not diagnosed prior to surgery. The authors had for aim to review published data, to analyze the etiology, the prevalence, the localization, and the size of maxillary sinus septa, and to determine what were the best preoperative radiological examinations. PATIENTS AND METHODS: The Medline search was made with keywords such as "maxillary sinus anatomy, maxillary sinus augmentation, maxillary sinus septa, sinus graft/complications, dental implants". The search was limited to studies published in English from 1980 to January 2009. RESULTS: Twenty-two articles were analyzed. The prevalence of maxillary sinus septa ranged between 14.3% and 33.3%. There was no specific geographic distribution within the sinuses. The mean heights of septa ranged between 2.8 and 8.1 mm. DISCUSSION: It is recommended to systematically use preoperative CT or CBCT scan imaging because of the prevalence, the variable anatomy, and the bad contribution of conventional X-rays.

[Diagnostic and surgical approach to an hourglass-shaped nasopalatine glioma in an infant]. / Approche diagnostique et chirurgicale d'un gliome naso-palatin "en sablier" chez un nourrisson.

The authors report a case of glioma nasopalatine Multifoil in wallet, location-intra nasal and palatal left. The nasal glioma is a rare congenital malformation presenting as a nasal mass composed of neuroglial tissue heteropias resulting from an abnormality in embryonic development. It is a benign tumor that fits into the nosology of the masses of the midline. This abnormality arises primarily a diagnostic problem because often mistaken for a meningo-encephalocele or a nasal dermoid cyst. Localization nose and palate, an hourglass, is extremely rare if not exceptional; The computed tomography (CT) has enabled the accurate assessment of injury and has guided the choice of surgical technique. The resection was done successfully without recurrence. Histology examination of the surgical specimen confirmed the nature of astrocytic neuroglial tumor. The location of the tumor pedide palate to that of the left nostril is special and especially histological diagnosis of this congenital malformation.

Congenital granular cell epulis causing polyhydramnios.

We report a case of an extremely large granular cell epulis situated on the maxillary alveolar ridge of a newborn. It obstructed the infant's mouth and caused polyhydramnios. The lesion was detected in utero by ultrasonography and removed after birth in the delivery room, with satisfactory results. It is evident that the epulis increased in size during the last phase of pregnancy. The literature concerning this peculiar lesion is reviewed and theories of histogenesis are discussed.

[Surgical correction of congenital alveolar cleft: report of 10 cases].

The paper reports our experience in surgical correction of unilateral maxillary alveolar cleft complicated with oronasal fistula by iliac spongy bone marrow autografts in cases. Primary healing of the surgical wounds occurred in all the 10 cases and obvious improvement in external appearance was achieved 3 to 6 months after the surgery. Clear evidence of osteogenesis was found by X-ray examination, and the density of the newly generated bone was comparable to that of normal bones, without visible bounds between the autografts and the normal bones.

[Becker's nevus and hemimaxillary hypoplasia: coincidence or syndrome?]. / Nævus de Becker et hypoplasie hémimaxillaire: association fortuite ou syndrome ?

INTRODUCTION: Becker's nevus is a dermatological disease sometimes associated with a malformation such as hemifacial bone dysplasia. OBSERVATION: A 11-year-old male patient presented with a delayed growth of the left maxillary and dental impactions. At 15 years of age, Becker's nevus appeared on the upper torso, both shoulders and cheeks. Le Fort I segmented osteotomy with an iliac bone graft was complicated because of maxillary dysplasia. DISCUSSION: The chronology of our patient's cutaneous and maxillary abnormalities was similar to previously reported cases. Conversely, the Becker's nevus-bone dysplasia association has been reported only twice. It may not be a coincidence and could belong to a Becker's nevus syndrome.

Comparison of minimally invasive versus conventional open harvesting techniques for iliac bone graft in secondary alveolar cleft patients.

BACKGROUND: Autologous bone grafts, often harvested from the iliac crest, are the criterion standard for secondary alveolar cleft repair. The best technique for harvest remains controversial. Minimally invasive techniques have been used for bone graft harvest in cleft patients, but outcome studies have been limited by small numbers of patients. METHODS: A total of 104 patients undergoing bone grafting for alveolar cleft were reviewed. Fifty-five consecutive patients underwent minimally invasive iliac bone graft harvest using the Acumed power-driven trephine system performed by the same surgeon. These patients were compared with 49 control patients undergoing a similar procedure in which the traditional method of open iliac bone harvest with an osteotome was used. RESULTS: Operative time for the bone graft harvest was significantly shorter with the Acumed device when compared with the osteotome (2.37 hours versus 3.26 hours, p < 0.001). Patients who underwent minimally invasive Acumed bone harvest required significantly less postoperative analgesia than did patients who underwent osteotome harvest, for both narcotic (0.31 mg/kg versus 1.64 mg/kg, p < 0.001) and nonnarcotic (15.1 mg/kg versus 27.2 mg/kg, p < 0.01) pain medication. Acumed patients had significantly less pain on discharge (0.26 versus 3.1 pain scores on a scale from 0 to 10, p < 0.001) and left the hospital more quickly (23.3 hours versus 30.1 hours, p < 0.001). CONCLUSION: Minimally invasive bone graft harvest technique using the trephine system offers a superior alternative to the conventional open iliac bone harvest method for patients undergoing secondary alveolar cleft repair, with shorter operative time, decreased requirement for pain medications, less pain on discharge, and a shorter hospital stay. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Distraction osteogenesis in adolescents with maxillary arch deficiency and dental crowding: a 3-year follow-up.

BACKGROUND: In this study, the authors evaluated the long-term results after using anterior segmental osteotomy and distraction osteogenesis for the correction of sagittal maxillary deficiency associated with dental crowding. METHODS: Six young adolescents (four boys and two girls) underwent surgery and distraction at a mean age of 11.2 years (range, 10 to 12 years) and were followed up for 3 years. A tooth-borne distraction device was used for interdental distraction. The evaluation consisted of hard- and soft-tissue profile analysis and dental arch measurements before, immediately after, and 3 years after distraction. RESULTS: The results showed that the facial profile, the occlusion, and the dental crowding could be successfully corrected and that the results were stable after 3 years' follow-up. The mean facial convexity angle was changed from 1 to 8 degrees. The average advancement at point A was 4 mm and the SNA increased by an average of 4 degrees. Lengthening of the dental arch by an average of 4 mm created approximately 8 mm of new space, sufficient to resolve the dental crowding in all patients, thus avoiding an extraction of healthy teeth. CONCLUSION: The results of this study demonstrated that anterior segmental maxillary osteotomy combined with distraction osteogenesis offers an alternative for the treatment of adolescents suffering from sagittal maxillary deficiency with dental crowding.

Congenital epulis of the newborn.

Reported is a case of congenital epulis of the newborn occurring in the mandible and the maxilla. The masses were of such size as to cause respiratory and nursing difficulties. The theories of pathogenesis, the surgical treatment, the histologic appearance, and a 5-year follow-up are described. As with previous cases reported, there has been no recurrence.

Syngnathia: a report of two cases.

Syngnathia is a rare anomaly involving soft tissue or bony adhesions between the maxilla and mandible. Two cases of congenital syngnathia secondary to interalveolar soft tissue synechia are presented. These children present problems with airway protection and feeding in the immediate neonatal period. Most have multiple associated anomalies requiring concurrent management. Less than 50 cases have been described, most commonly in association with popliteal pterygium syndrome. Surgical management involves division of the adhesions in the first few days of life. Depending on the severity, these patients may present formidable anesthetic challenges. The prognosis is generally favorable in cases of soft tissue adhesions with eventual restoration of normal mandibular motion and function.

Syngnathia and Van der Woude syndrome: a case report and literature review.

OBJECTIVE: Syngnathia is a rare anomaly involving soft tissue or bony adhesions between the maxilla and mandible. We review the literature and present a case of syngnathia associated with Van der Woude syndrome. Syngnathia can have very different etiologies, but this has rarely been reported in Van der Woude syndrome. Treatment of this condition is rarely discussed in the literature because of a paucity of case reports. RESULTS: Oral adhesion (syngnathia) in our patient was caused by a mandibular to maxillary fibrous band. Surgical treatment was successful. Clinical implications and review of literature for the treatment of this rare association of syngnathia and Van der Woude syndrome are discussed.

Congenital epulis: an ultrastructural and immunohistochemical study.

In the light of recent findings concerning the presence of S-100 antigen in granular cell myoblastoma (GCM), we investigated by immunoperoxidase the presence of this antigen in a case of congenital epulis (CE). The absence of S-100 in CE granular cells is suggestive for antigenic differences with GCM. Upon ultrastructural investigation, bundles of collagen fibers were observed in the cytoplasm of CE granular cells and cells displaying features of initial cytoplasmic vacuolar transformation were also detected. Interstitial cells containing angulated bodies, a common finding in GCM, were not found.

[A case of facial fibrous dysplasia in brothers]. / A propos d'un cas de dysplasie fibreuse faciale dans une fratrie.

Fibrous dysplasia is a benign bone tumor. The cranio-facial localization concern 20% of fibrous dysplasia. A congenital etiology is evoked by all the authors. Our observations ask for the real etiology of this affection: Congenital? Familial? The diagnosis is done by anatomo-pathology, and surgery is the treatment for severe cases. Relapses are frequent.

Predominant of exclusive orbital and facial involvement in infantile cortical hyperostosis (de Toni-Caffey's disease). Report of four cases and a review of the literature.

Four patients who presented with predominant or exclusive face and orbital involvement by de Toni-Caffey's disease are reported. Facial manifestations of infantile cortical hyperostosis may be the first and sometimes the only manifestion of the disease. A mandibular involvement is almost always present and its characteristic appearance leads to the diagnosis of de Toni-Caffey's disease.