Clinical results of therapeutic temporomandibular joint arthroscopy: a prospective study of 34 arthroscopies with prediscal section and retrodiscal coagulation.

Thirty-four therapeutic temporomandibular arthroscopies were done during a 24-month period for patients with debilitating joint disorders (mainly disc displacements with or without reduction) who had not responded to non-invasive treatment. Lysis and lavage with prediscal section and retrodiscal coagulation were the techniques used. Analysis of the results indicated subjective improvement of pain in 71% of cases, noise in 78%, jaw opening in 88% and diet in 97% and objective evidence of disappearance of noise in 29% and improvement of jaw opening in 94% (mean 9.24 mm). In jaw opening, improvement was highly significant, compared with the preoperative results, P < 0.01. We conclude that temporomandibular arthroscopy is safe and indicated in disc displacements and joint luxation if medical treatment has failed.

[A brown tumor of the mandible and hyperparathyroidism secondary to chronic renal insufficiency. Review of the literature apropos of a case]. / Tumeur brune de la mandibule et hyperparathyroïdie secondaire à une insuffisance rénale chronique. Revue de la littérature à propos d'un cas.

We report on a brown tumor of the mandible in a hemodialysed female patient with severe uncontrolled secondary hyperparathyroidism. Multiple other brown tumors were associated. The hyperparathyroidism was treated with a subtotal parathyroidectomy because only three parathyroids were found. Parathyroid removal led to normal C-terminal parathyroid hormone concentration (0 ng/ml). A review of the literature has shown that parathyroidectomy is usually curative. Our patient demonstrated, eleven days after the parathyroid surgery, rapid growth of the mandibular tumor. This unusual evolution has justified a local excision of the tumor. Histological preparations have confirmed the diagnostic of brown tumor with an important capillary proliferation.

[Long-term complications of silicone implants used in the repair of fractures of the orbital floor]. / Complications à long terme des implants de Silicone utilisés dans la réparation des fractures du plancher de l'orbite.

A 15 patients series is presented concerning complications following the use of silicone orbital floor implants. The more frequent complications are inferior eyelid swelling, pain and ocular dystopia. Complications may occur very belatedly, 10 years for a patient, 9 years for an other. The mean delay from insertion to removal for complication of the implant is 4.3 years. Sinus troubles are found in 70% patients that may indicate a relationship between sinusal pathology and complications observed. The CT study is described. Precautions in insertion of the implant are given. Suggestions are done to prevent such complications.

[The contribution of arthroscopic treatment in temporomandibular disk-condyle displacements]. / Apport du traitement arthroscopique dans les désunions disco-condyliennes temporomandibulaires.

We report a prospective study of thirty four therapeutic temporomandibular arthroscopies that were done during a 24 months period for patients with debilitating joint disorders (mainly disc displacements with or without reduction) who had not responded to no-invasive treatment. The technics used were lysis and lavage with prediscal section and retrodiscal coagulation. Analysis of the results indicated subjective lessening of pain in 71% of cases, noise in 78% (with objective evidence of disappearance of noise in 29%), jaw opening in 94% (mean 9.4 mm) and diet in 97% (mean 9.4 mm). In jaw opening, improvement was highly significant, compared with the preoperative results, p < 0.01. We conclude that temporomandibular arthroscopy is safe and indicated in disc displacements and joint luxation if medical treatment has failed.

[Bone lengthening: application to the mandible. Review of the literature]. / La distraction osseuse: applications à la mandibule. Revue de la littérature.

In literature, the authors demonstrate that progressive distraction osteogenesis, according to the Ilizarov method, is applicable to the mandible. Mandibular distraction is achievable through external approach or through oral approach. Further experimental and clinical studies will be necessary to define the most stable apparatus and the best indications that are currently hemifacial microsomia and facial asymmetry associated with T.M.J. ankylosis.