Aetiology and incidence of facial fractures sustained during sports: a prospective study of 140 patients.

A prospective study was carried out involving patients presenting with facial fractures sustained during sports. One hundred and forty patients were admitted to the Pitié-Salpêtrière University Hospital of Paris between March 1998 and March 2000, accounting for 13.3% of all patients with facial bone fractures. The ratio of males to females was 7.2:1 and the mean age was 28.5 years. The majority of accidents occurred during soccer (25.0%), followed by rugby (15.0%), and as a consequence of collisions between players (50.7%). The majority of the injuries involved the mandible (34.4%), the zygomatic bone (23.4%) and the nasal bone (15.6%). The sporting activities were classified as either contact or non-contact sports. Frontal sinus, central midface and LeFort fractures were seen more often in vehicular sports such as mountainbiking and skiing. The authors stress the importance of preventive measures, including the use of protective equipment, periodic sports medical check-ups and personal discipline.

[Orbital filling using a vascularized parietal bone graft: a case report of rehabilitation with an orbital graft of axial implants]. / Comblement orbitaire par greffe osseuse pariétale vascularisée: à propos d'un cas de réhabilitation par épithèse oculopalpébrale sur implants axiaux.

Orbital and intracranial complications of dental cellulitis are exceptional. The authors report such a case with orbital cellulitis and frontal abscess that dictated orbital exenteration with resection of the eyelids. Before realization of an implant supported epithesis, the orbit was filled with a prefabricated vascularized fascio-osseous parietal bone flap. This allowed placement of two extra-oral fixtures (Nobel biocare) in an antero-posterior axis. In some cases, preimplant orbital bone graft appears to be the only solution when implant placement in the orbital rim is impossible or contra-indicated. Indications, advantages and disadvantages of this technique will be discussed.

[Whole saliva flowmetry. Evaluation of 3 measurement technics]. / Débimétrie salivaire globale. Evaluation de 3 techniques de mesure.

Several methods traditionally have been used to collect and measure whole mouth saliva. The purpose of the study was to determine resting and stimulated whole saliva secretion rates and to evidence decreased saliva production (xerostomia) in outpatients' clinic. In this prospective study, saliva production was quantified by swab weighing, suction method (before and after chewing) and by oral sugar clearance. The 3 methods were carried out in 30 healthy subjects (16 females and 14 males) and 7 subjects with dry mouth (2 females and 5 males). Our results indicate that whole saliva formation can be reliably quantitated by standardized procedures of weighing sterile sponge and suction methods on healthy subjects. But the suction technique was found to be inferior in the group with xerostomia (impossibility of quantitative measurement in 5 patients out of 7). The 3 methods did significantly differ when mean flow rates in the group with xerostomia and in the healthy group were compared (p < 0.01). To conclude, in a physician's office, direct weighing of the swabs can be done easily and more reliable when using a balance that is accurate to 0.1 gm. Oral sugar clearance can be used to screen for xerostomia.

[Eckelt's technic: an evaluation of the access route used at Salpêtrière Hospital]. / Technique d'Eckelt: évaluation de la voie d'abord utilisée à la Salpêtrière.

AIM: We report a prospective study undertaken to investigate the morbidity connected with the approach of lag screw osteosynthesis for the treatment of subcondylar fractures in the department of Maxillo-Facial Surgery at the Salpêtrière University Hospital. METHOD: 24 patients have been operated between November 1997 and December 1998. We estimated the accessibility, the size and quality of scars the satisfaction index, and the complication rate. RESULTS: The average size of scars was 3 cm (2.5-4). Their quality was satisfactory, except for an hypertrophic and an invaginated one. The satisfaction index was always excellent and often superior to the surgeon one. COMPLICATIONS: three paresis in the mental territory of the facial nerve regressive in three months, a salivary fistula regressive in three weeks, an hematoma and a subcutaneous infection. These different criteria improved during the study. CONCLUSION: The approach is not free of risks but these ones seem to decrease with surgeon's experience.

[Osteosynthesis of subcondylar fractures using compression screws with the Eckelt technic. Experiences and difficulties with the technic over 5 years]. / Ostéosynthèse des fractures sous-condyliennes par vissage en compression selon la technique d'Eckelt. Expérience et difficultés de la technique sur 5 ans.

With creation of new fixation material, the surgical treatment of displaced subcondylar fractures is most frequently used in adults. The Eckelt compression osteosynthesis is described as an easy procedure in the current literature, but, in our experience, several problems require our attention. We report the treatment of 57 patients with displaced subcondylar fractures where compression osteosynthesis was indicated. The difficulty of this technique is presented on the basis of a 5-years experience.

[A large mucocele of unusual location]. / Une mucocèle de taille et de localisation inhabituelle.

We present the case of a patient who presented an unusually large mucoid cyst measuring 38 x 25 mm in an uncommon localization, the right maxillary. We examine the topographic and histological characteristics of mucoceles together with their treatment. The main differential diagnoses of liquid tumoral formations of the maxillary are also discussed.