[The orthognathic surgery so called « early ¼]. / La chirurgie orthognathique qualifiée de « précoce ¼.

Some young patients with a significant skeletal shift with a strong morpho-aesthetic and psychological impact may require surgical correction during their growth. A good understanding of facial growth, the different treatment options and the effects of surgery on the post-operative growth pattern will allow the practitioner to use the technique most suited to each of his patients and improve long-term treatment outcomes. So-called « interceptive ¼ surgery may therefore be considered in cases of severe skeletal dysmorphism of secondary or functional origin. It will lead to early normalization with the immediate consequence of breaking the « dysmorpho-dysfunctional ¼ spiral.

Severe idiopathic pneumoparotitis: Case report and study review.

Parotitis is a frequent disease in general pediatrics. Pneumoparotitis is a rare affection that belongs to differential diagnoses of parotitis, along with infections, lymphadenitis, autoimmune disorders, inflammatory conditions, vascular malformations or neoplasms. It is usually described in musicians using wind instruments or in other situations involving a Vasalva maneuver. We report the case of a 12 years old boy with severe idiopathic pneumoparotitis without any of these well-known causes and whose autoimmune familial background of Sjögren syndrome might be relevant.

Bioactive glass 45S5 ceramic for alveolar cleft reconstruction, about 58 cases.

BACKGROUND: Secondary alveolar bone grafting in patients with clefts lip and palate is usually performed with iliac crest bone harvesting, however using bone substitute allow to avoid harvesting morbidity. The purpose of our study was to assess if the use of a bioactive glass ceramic is an acceptable alternative to iliac crest bone harvesting in alveolar clefts treatment. METHODS: A prospective study including all patients who have benefited of alveolar grafting by GlassBONE™ (Noraker, France), a synthetic resorbable bioactive glass 45S5 ceramic was conducted. The patients underwent clinical assessments and imaging check-up by dental panoramic radiography and CBCT. RESULTS: Fifty-eight graftings were performed. The mean age at the time of the graft was 7.6 years. Hospitalization, social eviction and antalgic consumption were reduced. Bone continuity was achieved in 63.8% of the cases. Bilateral cleft and dental agenesia increased grafting failure. In the subgroup of 25 patients with isolated unilateral cleft without dental agenesis, 80% had bone continuity at one year. We noted 10.3% of alveolar fistula recurrence. CONCLUSION: The use of GlassBONE™ in alveolar grafts simplifies the surgery procedure and the postoperative management, and ensures satisfactory mucosal healing, tooth eruption and bone continuity in two thirds of the followed grafts.

Update on orbital decompression as emergency treatment of traumatic blindness.

INTRODUCTION: Blindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques. MATERIALS AND METHODS: A literature review was made from articles published between 1994 and 2014 in the PubMed database, on the emergency treatment of AOCS. RESULTS: 59 of the 89 patients treated surgically for AOCS presented with significant improvement of visual acuity (VA) after orbital decompression. The delay between trauma and surgery was short. A lateral canthotomy with inferior cantholysis (LCIC) was the most frequently used technique. DISCUSSION: AOCS with a risk of visual impairment must be decompressed in emergency, at best in the 2 hours following trauma, most often by LCIC to have the best chance of recovering VA. Adjuvant medical treatment (acetazolamide, mannitol, corticosteroids) should not delay surgery. Postoperative corticosteroid therapy is not indicated, especially in patients with severe head trauma.