[Medico-legal assessment in the sequelae of burns (1st part)]. / Évaluation médicolégale des sequelles de brulures (1re partie).

The assessment of physical injury in after-effects of burns is very specific. Indeed, the evolution of burn scars is particular compared to the scarring process in general. The expert needs to know these specific aspects in order to objectively assess the after-effects due to burns, in order to compensate for the loss of autonomy in major burn victims. The assessment has to analyze all the effects, functional and aesthetic, of the after-effects due to burns and has to particularly specify: the mending, which can never be set before one year, the pressure test allowing to check the complete maturation of the scars; the functional disability which results from skin retractions (due to after-effects) on the limbs mobility but which also must consider the burnt skin surface; the aesthetic damage, often important, with a discrimination between hypertrophic and keloid scars; the suffering, always significant in view of specialized and prolonged therapeutics; the sexual damage, often unrecognized in this type of injured people.

[Malignant lymphoma of the mandible. A new case]. / Lymphome malin de la mandibule. A propos d'un nouveau cas.

Primary extranodal malignant lymphoma is relatively rare. Clinical and radiological features may lead to the misdiagnosis of chronic osteomyelitis. We report a case of primary non-Hodgkin's lymphoma that involved the mandibular region in a 53-year-old man. Differential diagnosis with other mandibular diseases is difficult because there is a non specific clinico-radiological features and the difficulty of histologic interpretation. This pathology is important to recognize because of specific treatment. Global prognosis is relatively favorable if the lesion is localized.

[Temporomandibular ankylosis in Gabon (apropos of 13 case reports)]. / Les ankyloses temporo mandibulaires au Gabon (à propos de 13 observations).

The authors report on 13 cases of temporomandibular ankylosis observed in Gabon. Based on an epidemiologic and etio-pathogenic study, they dwell on the existing therapy of this affection, i.e. broad osteotomy with silicone interposition followed by mechanotherapy prolonged in time. Prophylaxis is discussed in the framework of Primary Health Care.

[In situ penicillin therapy in the treatment of epulis]. / Pénicillinothérapie in situ dans le traitement des épulis.

An epulis is a hyperplastic tumor of the oral mucosa. The pathophysiology of epulis is unclear. Standard treatment consists of surgical excision but in situ penicillin therapy was recently proposed. In situ treatment consists of injecting 1,000,000 IU of penicillin G into the tumor every three days until complete disappearance is obtained. Absence of allergy to penicillin must be ascertained prior to treatment. The purpose of this report is to describe results in 5 patients presenting different histological forms of epulis treated by in situ penicillin therapy at the Dental Care Center of Rabat, Morocco. Complete disappearance of the tumor was achieved after 3 to 5 injections in all 5 patients. In 4 patients the tumor first necrotized and then fell off. In the remaining patient, the tumor regressed gradually. No complications were observed and no recurrence has been noted with follow-up ranging from 24 to 30 months. Since in situ penicillin therapy is more cosmetic, easier to perform, and less expensive than surgical excision, it should be included in the arsenal of therapeutic modalities for management of epulis.

[Mandibular fractures caused by a machete. Apropos of 3 cases]. / Les fractures mandibulaires par coupe-coupe. A propos de 3 observations.

The authors report on 3 cases of facial trauma with mandibular fracture caused by machete, and associated to more or less deep lesions of cutaneo-muscular coating planes and noble intra-facial organs. Treatment of such traumas must be performed in an emergency surgical unit, after a thorough check-up of the lesions. It is a traumatology peculiar to Peulh population, to be classified in the etiologic chapter of assaults.

[Dietetics and maxillofacial pathology in Africa]. / Diététique et pathologie maxillo-faciale en Afrique.

Alimentation of patients having an infection interfering with normal feeding sets intricate problems in developing countries, because some socio-economic conditions often precarious. The authors describe a practicable and realistic approach of such a diet by giving some examples of "recipes" which seem to be easy to apply not only in hospital conditions but also in rural environment.

[Sequelae of dental trauma: forensic medical aspects]. / Séquelles des traumatismes dentaires: aspects médico-légaux.

Dental trauma is a frequent condition which may occur alone or in combination with craniofacial trauma and/or other injuries. Many factors influence the gravity of the trauma and subsequent prognosis including age, anterior state, trauma etiology, treatment and follow up. In order to establish a prudent provisional or definitive expertise, the medical expert must have a panoramic view of the trauma. Time should be taken to consolidate facts and estimate prejudices on sound evidence. In certain cases outcome can be predicted. The medical expert should provide advice and counselling both for the patient and the mandating authority. In this article, iatrogenic dental accidents occurring during anesthesia or extraction will not be discussed.

[Surgical management of cutaneous pathomimia. A report case]. / Prise en charge chirurgicale de la pathomimie cutanée. A propos d'un cas avec revue de la littérature.

UNLABELLED: Cutaneous pathomimia is a behaviour disorder witch interest the skin. In some cases, self-mutilation can be serious and require a surgical treatment. CASE REPORT: A 60 year old woman consults for extensive scar interesting the face and the scalp and realising the aspect of burn face in cicatricle level. The treatment consisted on excision and skin graft. The patient was addressed to Psychodermatology consultation. Authors show the place of plastic surgery in management of cutaneous pathomimia.

[An unusual fracture of the orbital floor]. / A propos d'une fracture insolite du plancher de l'orbite.

The various anatomopathologic forms of orbital fractures correspond to precise pathophysiologic mechanisms. We would like to detail an exceptional case of an orbital fracture in professional a diver. This case can be associated to barotraumatic accidents categories. After a brief review of the anatomy and the pathophysiological fractures of the orbit, we examine the different mechanisms which can be linked to this particular and unexpected pathology.

[Radiographic scanning of the temporomandibular joint. Technic and results]. / L'arthroscanner de l'articulation temporo-mandibulaire (A.T.M.). Technique et résultats.

The authors report a prospective study involving investigation of the temporo-mandibular joints for algo-dysfunctional syndromes by gaseous arthroscanning. They propose a double articular compartment injection technique using CT scan localization. The CT scan study is performed using fine sagittal sections with the mouth both closed and open, and also Hirtz coronal sections. Early results directly demonstrate menisco-ligamentary structures, the position of the meniscus in the closed position and its displacement on mouth opening, these being of fundamental importance to the practitioner. The authors present normal results and the principal pathological results encountered in the investigation of algodysfunctional syndromes involving this joint (T.M.A.D.S.). CT scan allows more precise localization for joint injection than radioscopy, and while the images obtained are markedly better than those obtained on opaque arthrograms, they offer less dynamic information in view of the lack of radioscopy.

[Myxoma of the nerve sheath. Apropos of a case]. / Myxome de la gaine d'un nerf. A propos d'une observation.

A case of oral nerve sheath myxoma is presented with the findings of light microscopy and immunochemistry. The tumor consists of well-defined lobules which are separated by septa composed of fibrous connective tissue that reassembled the perineurium. Each lobule is composed of elongated and stellate cells in a basophilic mucoid matrix. Immunohistochemically, S-100 protein is strongly positive in all tumor cells. The histogenesis and differential diagnosis are discussed.