De l'histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 4 : la rhinoplastie.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This fourth original article will focus on the inventors of rhinoplasty instruments: Joseph, Killian, Aufricht, Cottle and Claoué.

[About history of surgeons hidden behind our daily surgical instruments: Retractors]. / De l'histoire des chirurgiens cachés derrières nos instruments du quotidien. Partie 2 : écarteurs.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of History of Surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This second original article will focus on the inventors of modern retractors: von Langenbeck, Farabeuf, Leriche, Gillies and Tessier.

[About history of surgeons hidden behind our daily surgical instruments: Scissors]. / De l'histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 3 : ciseaux.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This third original article will focus on the inventors of modern scissors: Mayo, Metzenbaum, Stevens and Lister.

[About history of surgeons hidden behind our daily surgical instruments: Forceps]. / De l'histoire des chirurgiens cachés derrières nos instruments du quotidien. Partie 1 : pinces et pincettes.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of History of Surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This first original article will focus on the inventors of modern forceps: Debakey, Adson, Kocher, Péan, Tuffier and Halsted.

Long-term stability of basilar mandible osteotomy: Chin Wing.

The Chin Wing is a modified genioplasty extended along the basilar border and the angles of the mandible. This technique may be a better choice than standard genioplasty for correction of lip incompetence, retrogenia and high angle position associated with hyperdivergent cases. Our objective was to analyse the overall movement realized during surgery and the long-term stability of this procedure. Ten patients underwent a Chin Wing surgery from June 2018 to August 2019. All patients were operated on by the same surgeon. We performed a preoperative (PO), an immediate postoperative (POI), and an over 6 months postoperative (PO6) Cone Beam Computed Tomography (CBCT) for every patient. 3D reconstructions were performed for each CBCT with Proplan software. We were thus able to determine by subtractions acquired and resorbed bone volume. Some section plans were chosen in order to perform 2D measurements. The CBCT volume comparisons reveal a gain of 7.6cc between the PO and the POI, for a bone resorption of 2.5cc between POI and PO6 (33% of the volume gained). In 2D evaluation, we observe an average resorption of 1.7 mm corresponding to approximately 20% of the height gained, at the level of the mandibular angle. Given the low bone resorption we can consider Chin Wing stable over time. The important quantity of mobilized bone and the basilar rotational movement may explain over-standing aesthetic and functional outcome, compared to classical genioplasty.

Three-dimensional acquisition technologies for facial soft tissues - Applications and prospects in orthognathic surgery.

The management of patients with dento-maxillofacial deformities is based on assessments of the dental occlusion - facial skeleton - soft tissues triad. As societal demands and surgical practices have evolved, facial soft tissues have moved to the forefront of considerations in orthognathic surgery. Techniques are therefore required to analyze facial soft tissues objectively and reproducibly, for diagnosis, preoperative planning, and follow-up. Several technologies are currently capable of providing three-dimensional (3D) models of the face, either by 3D reconstruction of traditional computed tomography or cone beam computed tomography data, or directly by stereophotogrammetry, laser scanning or structured light scanning. Multimodal image registration techniques allow bone base, dental occlusion and facial soft tissue information to be combined in a 3D virtual patient. Three-dimensional cephalometric analysis of the facial skeleton and skin is now perfectly integrated in virtual planning and is gradually gaining in automation and accuracy. Photorealistic 3D simulations allow optimal soft tissue planning and facilitate physician-patient communication. Finally, these facial modeling techniques facilitate post-operative studies of soft tissues, which generally involve comparisons of volumetric data. There are many research avenues to pursue and technical improvements are to be expected, particularly through the development of big data and artificial intelligence approaches.