[Gardner's syndrome. Review of the literature. Report of a familial form]. / Le syndrome de Gardner. Revue de la littérature. A propos d'une forme familiale.

Through a family form study and a literature review, the authors define the symptoms of the Gardner's disease and the checkup to be carried out. Sometimes, the surgical treatment, proposed in an aesthetical purpose, is difficult to carry out due to the tumor location and consistency. Incomplete forms are likely to be more frequent but the risk of colic degeneration remains the same as for the usual form. Examination and multi-departmental care are required.

[Fractures of the mandible. A critical study of repair procedures]. / Les fractures de la mandibule. Etude critique des procédés de réparation.

Based on their personal experience of 110 patients operated on for mandibular trauma, the authors analyse the results of the various techniques used. Screwed micro-plates may be very useful but only complete the therapeutic arsenal of the surgeon. In fact classical methods continue to provide satisfactory results. Poorer results may occur with fractures which combine involvement of the articular surfaces with a lesion of the body of the mandible.

[Use of the conjunctival approach in orbital-palpebral plastic surgery]. / Utilisation de la voie conjonctivale en chirurgie plastique orbito-palpébrale.

The conjunctival route has several indications in palpebral surgery and traumatology. After a brief anatomical summary, the authors review the principles of the technique and differentiate between the preseptal and retroseptal dissection planes. This technique has two indications: in subcutaneous lipectomy for isolated palpebral lipoptosis and in surgery involving the orbital bones, for example in osteotomies or relatively undisplaced fractures of the orbital floor. The conjunctival route has numerous advantages and enlarges the surgical arsenal of the specialist by providing another approach to the orbito-palpebral structures.

[Autograft procedures in reparative cancer surgery of the loss of substance of the nose. Critical study]. / Les procédés d'autoplastie dans la chirurgie réparatrice carcinologique des pertes de substance nasales. Etude critique.

Using several examples, the authors analyse the choice of reconstructive methods available after excision of cutaneous tumours of the nose. Although a variety of procedures exist, one or two specific flap procedures may be preferred in terms of their safety and cosmetic result. Before describing these procedures, the authors briefly review the basis of surgical treatment in the particular case of the nasal region.

[Malignant maxillofacial non-Hodgkin's lymphoma. Apropos of 15 cases involving the naso-sinus cavities]. / Lymphomes malins non hodgkiniens maxillo-faciaux. A propos de 15 localisations aux cavités naso-sinusiennes.

Non-Hodgkin's lymphomas include malignant conditions developing within lymphoid tissue, both lymph nodes and extranodal lymphoid tissue. Due to its rich lymphatic supply, the cervico-facial region is frequently involved: 10 to 15% of all NHL (1, 2, 8, 15), i.e. a similar incidence to primary GI involvement (4). The cervical glands and lymphatic structures of the Waldeyer ring are most often and most classically involved. The nasosinusal cavities may be involved, producing diagnostic problems which have to be resolved by the specialist (6). Between 1972 and 1989, 20 cases of NHL involving the bony cavities of the face were seen at the Centre Antoine-Lacassagne. These include the 15 cases reported below involving the naso-sinusal cavities.

[Paraganglioma of the head and neck. Familial forms]. / Paragangliomes de la tête et du cou. Formes familiales.

The clinical, epidemiological and genetic aspects of familial paragangliomas of the head and neck are discussed in relation to 6 recent cases from two families which accounted for 2 and 4 patients respectively. Tumors of the carotid body are the most frequent. Bilaterality and association with other paragangliomas are suggestive of a hereditary disorder and should lead to investigation of the family. The establishment of a family tree will define those subjects at risk in whom systemic screening should be performed. The recent advances obtained using new imaging techniques in the diagnosis, evaluation of extension and treatment should enable treatment to be instituted at an earlier stage and thus reduce functional sequelae.

[Malignant non-Hodgkin's lymphoma of the bony cavity of the face. Apropos of 17 cases]. / Lymphomes malins non hodgkiniens des cavités osseuses de la face. A propos de 17 cas.

Malignant non Hodgkin lymphomas (NHL) are fairly frequent, but involvement of the bony cavities of the face is less common than invasion of the cervical lymph nodes and the lymphoid components of Waldeyer's ring. In connection with a series of 17 personal observations, the authors discuss the main features of NHL and review the diagnostic problems and therapeutic alternatives. Two histologic-clinical entities can be defined: orbital NHL: generally stage I, with a low or intermediate histoprognostic grade and a good prognosis; naso-sinusal NHL: often locally advanced, these lesions are often associated with other visceral disease sites; the prognosis for these intermediate or high histo-prognostic grade lesions is much more somber.

[Induction chemotherapy with Cis DDP-5FU in cancers of the upper respiratory and digestive tract after 70 years of age]. / Chimiothérapie première Cis DDP-5 FU des cancers des voies aéro-digestives supérieures après 70 ans.

Sixty one aged patients with advanced squamous cell carcinoma of the upper aerodigestive tract were given a chemotherapy Cis DDP-5 FU before any local treatment. The objective response rate was 77% which included 46% of complete response. Toxic manifestations were more severe than those observed in the general population with the same protocol (nine deaths during the course of the treatment). A few appropriate measures may contribute for the improvement of the therapeutic index: consideration of nutritional and cardiac status, reduction of doses according to age, pharmacokinetic monitoring of 5 FU. An acceptable level of toxicity will be necessary in the design of future, intensive induction trials. The possibility of conservative treatment with a high level of reliability would justify the use of induction chemotherapy in the aged subjects.

[Mycotic osteitis of the facial bones. A review of the literature apropos of a case]. / L'ostéite mycotique du massif facial. Revue de la littérature à propos d'un cas.

The authors report a case of mycotic osteitis of the upper maxillary bone due to Candida Albicans occurring in a 56 year old female patient under treatment for chronic myeloid leukemia. The etiologically difficult diagnosis could only be confirmed after deep surgical biopsy with mycological study of a fragment. A review of the literature confirmed the rarity of upper maxillary involvement by Candida Albicans. Particularly when there is isolated involvement and no evidence of a distant primary focus. The differential diagnosis essentially includes centro-facial malignant granuloma.

[Fractures of the floor of the orbit. A critical study of methods of repair]. / Les fractures du plancher de l'orbite. Etude critique des procédés de réparation.

Based on a personal series of 160 cases of surgically treated closed orbital floor fractures, the authors discuss the various reconstruction procedures and their respective indications. Emphasis is placed on surgical access and osteoplasty techniques. In this series, both cutaneous upper eyelid (127 patients) and transconjunctival approaches (33 cases) were used. Access through the upper eyelid gave the fewest complications; transconjunctival surgery was reserved for pure "blow-out" fractures. Several materials were tested for osteoplasty: conventional techniques included Silastic sheets (112 cases), corticospongiosal bone grafts (16 cases), and lyophilized dura mater (9 cases); new techniques included use of resorbable thermoplastic sheets (23 cases). Choice of a material depends on the size of the defect to be filled. Thin Silastic sheets are the ideal solution for small defects. Bone grafts are reserved for extensive losses of substance.