[Reconstruction of hard palate defects using a facial artery musculomucosal flap]. / Utilisation du lambeau myomuqueux pédiculé par l'artère faciale dans les reconstructions palatines.

The facial artery musculomucosal flap (FAMM) is usually used in reconstruction of defects in oral cavity, most frequent being the mouth floor. This flap has many advantages from its surgical procedure, its great reliability, its mucous tissue origin, its usable surface, its large axis of rotation and the little of after-effects of the donor site. The hard palate defects with bucconasal communication can raise difficulties of reconstruction. We show, by a case report, the many advantages of FAMM flap in these reconstructions.

Microbiology of otitis media in the Paris, France, area from 1987 to 1997.

PURPOSE OF THE STUDY: To investigate epidemiologic trends in the bacteriology of acute otitis media, data were recorded during a 10-year period by the same group of investigators during clinical studies in pediatric outpatients. METHODS: Bacterial samples were obtained before antibiotic treatment from 2149 children (age 3 to 36 months) with acute otitis media. All samples were transported, handled and cultured in the same way throughout the 10-year period. RESULTS: From the study patients 1862 samples of middle ear secretion were collected by tympanocentesis and 287 samples were collected from spontaneous otorrhea occurring within 24 h. Pathogens were isolated from 70% of patients. Pathogens included Haemophilus influenzae (40%), Streptococcus pneumoniae (31%) and Moraxella catarrhalis (8%). The incidence of beta-lactamase-producing H. influenzae was approximately 20% from 1987 to 1989, was approximately 35% from 1990 to 1995 and increased to 60 and 70% during the last 2 years. The rate of S. pneumoniae with decreased susceptibility to penicillin gradually increased from 7% in 1987 to 70% in 1996 and 1997. CONCLUSION: The very high incidence of antimicrobial resistant strains reached during a short period in pediatric acute otitis media in our area, emphasizes the need for frequent epidemiologic studies.

[Unfavorable effects induced by mandibular surgery in Class II malocclusions]. / Effets disgracieux induits par la chirurgie mandibulaire des classes II.

The sagittal split ramus osteotomy is probably the most frequently used procedure for correction of mandibular skeletal dento-facial deformities. In the 30 years since the procedure was introduced, a number of complications has been reported: unfavorable fracture during surgery, paresthesia or anesthesia and relapse. The literature seems to be very poor concerning the esthetical and morphological complications of the sagittal split ramus osteotomy; especially when treating Class II dento-facial deformity frequently associated with a genioplasty. The purpose of this study was to determine and analyze the esthetical complications occurring after mandibular surgery in patients with Class II dento-facial deformities: Pre-angular notches, Widening of the bi-angular distance, The unaesthetic effects of the associated genioplasty, Class III like "dento-facial deformities", Plates and screws visibility. Each of those complications has been analyzed to find a preventive treatment.