[Cherubism: a case followed for 18 years]. / Chérubisme : à propos d'un cas suivi pendant 18ans.

Cherubism is a rare and benign bone disease affecting the bones of the face, mainly the mandible, sometimes the maxilla and exceptionally the whole skeleton. The physiopathology is briefly mentioned, especially the genetic aspect of the disease. Subsequently, we present the case of a patient suffering from cherubism, a case we have been following from the age of four and a half to the age of 22. Each step of the surgical treatment is illustrated through a wide iconography. The discussion analyses the intellectual process that leads to diagnosis. The clinical examination is fundamental, as well as the radiological check-up but the latter may not be feasible due to the young age of the patient. The definite diagnosis relies on the histological examination of the bone concerned. It will show an association of dense, abundant and highly vascularised conjunctive tissue together with giant plurinuclear cells, without any mitosis nor any cellular atypia. The other bone diseases affecting the bones of the face will have to be sought, of course, and eliminated through the clinical and radiological examinations and, above all, by the histological examination which is the basis of the definite diagnosis. The treatment of cherubism is still a controversial issue: some authors are in favour of therapeutic abstention while others support the recourse to surgery to deal with the functional and aesthetic dimensions of the disease. In conclusion, the authors insist that the diagnosis of cherubism is apparently easy. Cherubism must be envisaged in the case of a chubby-cheeked child and a sample of pathological bone should be taken in order to ascertain the diagnosis.

[A new method of covering skin loss of the internal canthus: paralateronasal flap]. / Un nouveau moyen de couverture des pertes de substance cutanée du canthus interne: le lambeau para-latéro-nasal.

The author describes a new procedure of coverage of the medial canthus: paralateronasal flap. It is a cutaneous rotation-advancement flap with random vascularisation ensured by the dermal vascular plexus. It is vertical and S-shaped. Its first curve is concave laterally and ascends widely to the lateronasal area, and its second lower curve is concave medially, following the nasolabial fold. This flap has been used 14 times, mostly to repair defects caused by excision of skin cancers of the medial canthus. Mean follow-up is 18 months. The aesthetic results obtained are very satisfactory. The author compares the advantages of the paralateronasal flap with present techniques and thinks that this new flap should find its place in the therapeutic arsenal for repair of the medial canthus.

[Current evaluation of a self-snapping screw system in traumatologic and orthodontic surgery]. / Bilan actuel du vissage auto-cassant en chirurgie traumatologique et orthognathique.

Since the first description in 1970, by F. X. Michelet, of the use of the mini plate system in maxillo-facial surgery, if the fundamental principles remain the same, the equipment has been constantly improved. The plates have been modified in structure and shape, the screws becoming self-tapping and self-drilling and finally self-breaking. The head of the screw has diminished to the point of not going over the level of the plate. The ancillary material is now more performing and easier to use. The authors have presented 3 years ago a new self breaking screw of which they now explain the technical and biomechanical bases, the necessities and the indications insisting on the numerous advantages of this system.

[The value of a previously expanded musculo-cutaneous flap of the lower eyelid for the reconstruction of a full thickness loss of tissue substance of the upper eyelid]. / Intérêt d'un lambeau musculo-cutané de paupière inférieure préalablement expansé pour la reconstruction d'une perte de substance de pleine épaisseur de la paupière supérieure.

The authors report a new technique for the reconstruction of upper eyelid full thickness tissue losses in preserving the inferior edge. They describe a myo-cutaneous inferior eyelid flap which has been preliminarily expanded before transposition. An anatomical study has demonstrated vascularization and innervation of the myo-cutaneous eyelid flap which will remain active. A clinical case presentation confirms a good aesthetic but also functional result with a transferred active orbicularis muscle which allows the regain of a dynamic upper eyelid.

[Barraquer-Simons syndrome and facial lipo-filling. Apropos of a case]. / Syndrome de Barraquer-Simons et lipofilling facial. A propos d'un cas.

Authors present a Barraquer-Simons syndrome case. After a quick historical account, they look at the study of the clinical case. They present the different treatments undertaken in order to correct the two different types of anomaly of this syndrome: these are complementary treatments because they consist in taking the fat in excess in the lower half of the body and reinject it in the face. The different etiopathogenic hypothesis are tackled. To conclude, authors insist on the excellent result obtained after a lipo-aspiration: but they notice a near disappearance of the reinjected fat at the face after 4 years. Anyway, lipo-filling can be renewed without risks for the patient and can be an interesting palliative solution.

[Recklinghausen's disease]. / Maladie de Recklinghausen.

The authors report a case of Von Recklinghausen's disease of hereditary origin presenting with maxillo-faciale manifestations. They also discuss the therapeutic indications and consider the psycho-social problems associated with facial dysmorphism.

Cranio-facial trauma and cerebral SPECT studies using N-isopropyl-iodo-amphetamine (123I).

Cerebral SPECT studies with N-isopropyl-iodo-amphetamine (123I) (IMP) were performed in patients who had suffered cranio-facial trauma, with and without loss of consciousness (LOC). The results were compared with computed tomography (CT). Nine out of ten of those with LOC had normal CT scans and evident photopaenia in IMP studies. It is clear that IMP SPECT scans complement CT in the investigation of patients who have suffered cranio-facial trauma.

[Surgical treatment of basocellular carcinoma of the auricular concha. Our experiences apropos of 11 cases]. / Traitement chirurgical des carcinomes basocellulaires de la conque auriculaire. Notre expérience à propos de 11 cas.

Next to an anatomical come back authors describe different surgical technics they used for the rebuilding of the ear concha, after exeresis of basal cells epitheliomas: Post auricular island flap. Pretragian flaps superior pedicle. Post auricular flaps with a superior pedicle in two or one time. Clinical cases show what they said. To conclude, authors insist on the advantages of surgery: It allows, in the "conchal area" a protection of contiguous cartilage, in addition to a total check-up of the tumor. Surgical treatment can also be used to correct failures or resumption after radiotherapy.

[The "kite" flap in the reconstruction after excision of a basal cell carcinoma of the face. Our experience with 45 cases]. / Le lambeau "Cerf-volant" dans la reconstruction après exérèse de carcinome baso-cellulaire de la face. Notre expérience à propos de 45 cas.

The "Kite" flap is a triangular protruding flap attached underneath the skin. The authors present the results of the utilisation of this type of flap in reconstruction after removal of baso-cellular cancer of the face. After a brief historical and technical recall, they contemplate a study of 45 patients operated on by this method. The preferential localisations of this type of flap are analyzed (sub-orbital region, naso-genien region, labiogenien region). Other techniques of repair are discussed region by region. However, the authors emphasize the facility of execution of the "Kite" flap and its excellent aesthetic results, its principal use being in the reconstruction of the sub-orbital region.

[Craniofacial injuries and cerebral tomographic scintigraphy using N-isopropyl-iodo-amphetamine 123 I-AMP]. / Traumatismes cranio-faciaux et tomoscintigraphie cérébrale à la N. isopropyl-iodo-amphétamine 123 I. AMP.

An investigation was done with N.-isopropyl-iodoamphetamine (123I AMP) in 20 patients: 10 patients with craniofacial injury and 10 patients without brain dysfunction or injury. Brain X ray computerized Tomography was normal. SPECT 123 I AMP detected functional defects related with traumatic impacts. Sensitivity is higher with SPECT than with CT Scan. The indications for the initial evaluation of head injury, and the relations with later sequelae i.e. post traumatic epilepsia and subjective syndrome are discussed.

[Craniofacial injuries and osteomeningeal ruptures. When should the anterior fossa be approached?]. / Traumatismes cranio-faciaux et brèches ostéo-méningées. Quand faut-il aborder l'étage antérieur?

A retrospective analysis was carried out of 142 cases of craniofacial traumas divided into 5 types according to the Fain classification. The incidence of cerebrospinal fistula of fronto-basal skull is very high in types III and IV traumas (60% of the cases). It is less important in type II2 traumas representing severe naso-orbital lesions (40% of the cases). It is only of 20% in type II1 traumas (Lefort II and III). Uncontrollable rhinorrhea and late meningitis are mainly due to types II and IV traumas. From these findings surgical indications and technique of the approach of the fronto basal skull are discussed.

[Chemodectoma. Apropos of a case located on the course of the inferior dental nerve]. / Chémodectome. A propos d'un cas situé sur le trajet du nerf dentaire inférieur.

The case of a chemodectoma on the inferior dental nerve is reported. This site can be rarely found because no recent observation of this kind was published.

[The amount of maxillofacial risk in playing rugby]. / Part du risque maxillo-facial dans la pratique du rugby.

123 cases of maxillo-facial injuries due to rugby and treated in the Department of Maxillo-Facial Surgery at the University Teachers Hospital (C.H.U.) of Bordeaux between 1981 and 1984 are analyzed. The high rate of injuries decreases considerably if accidents caused by intentional brutality are excluded. This then approaches the rate for other team sports. Rugby is not basically a violent sport but can be made so by the unfairness of certain players. It would be most advisable to educate players along these lines.