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Graillon N, Marty P, Foletti JM, Chossegros C, Frandjian H. Idiopathic dilatation of the submandibular gland duct. Int J Oral Maxillofac Surg 2024; 53:389-392. [PMID: 37845088 DOI: 10.1016/j.ijom.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
Lithiasis and stenosis may cause salivary duct dilatation due to the increased pressure in the duct upstream of the obstruction. Idiopathic dilatations, also called megaducts, with no associated increase in pressure, have only been described in the parotid gland. The aim of this study was to describe the characteristics of submandibular duct dilatation unrelated to lithiasis, stenosis, or an imperforate duct, to report the existence of submandibular megaducts. This retrospective single-centre study included patients treated at La Conception University Hospital, Marseille, France, between 2007 and 2019. Patients with submandibular duct dilatation of ≥4 mm confirmed by magnetic resonance imaging sialography (sialo-MRI), who also underwent sialendoscopy to identify any associated stenosis, were included. Patients with lithiasis, stenosis, an imperforate ostium, or a history of trauma or surgery to the floor of the mouth were excluded. Five patients (three female, two male) aged 30-76 years with idiopathic duct dilatations in nine submandibular glands were included. The most commonly reported symptoms were submandibular swelling, pruritus, and discomfort, mostly outside mealtimes. Recurrence of symptoms after treatment was frequent. This study is novel in describing submandibular megaducts as opposed to dilatation caused by high pressure associated with stenosis, with confirmation by sialo-MRI and sialendoscopy.
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Affiliation(s)
- N Graillon
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France.
| | - P Marty
- Department of Oral and Maxillofacial Surgery, Clinique Saint Pierre d'Ottignies, Ottignies-Louvain la Neuve, Belgium
| | - J-M Foletti
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France
| | - C Chossegros
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
| | - H Frandjian
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
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Kün-Darbois JD, Kahn A, Khonsari RH, Gueutier A, Baldini N, Corre P, Bertin H, Provost M, Lesclous P, Ansidei CM, Majoufre C, Louvrier A, Meyer C, Ammari H, Rougeot A, Moret A, Poisbleau D, Nicot R, Marti-Flich L, Ferri J, Lutz JC, Prevost R, Kimakhe J, Poulet V, Lauwers F, Veyssière A, Bénateau H, Pham Dang N, Barthelemy I, Foletti JM, Chossegros C, Queiros C, Laure B, Paré A, de Boutray M. Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study. J Stomatol Oral Maxillofac Surg 2021; 123:16-21. [PMID: 33596475 DOI: 10.1016/j.jormas.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.
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Affiliation(s)
- J D Kün-Darbois
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France.
| | - A Kahn
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - R H Khonsari
- Department of Maxillo-facial and Plastic surgery, Necker-Enfants Malades University Hospital, Paris, France
| | - A Gueutier
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - N Baldini
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - P Corre
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - H Bertin
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - M Provost
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - P Lesclous
- Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - C M Ansidei
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - C Majoufre
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - A Louvrier
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - C Meyer
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - H Ammari
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Rougeot
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Moret
- Department of Maxillo-facial surgery and Stomatology, Aix Hospital Centre, Aix-En-Provence, France
| | - D Poisbleau
- Department of Maxillo-facial surgery and Plastic surgery, Grenobles University Hospital, Grenoble, France
| | - R Nicot
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - L Marti-Flich
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J Ferri
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J C Lutz
- Department of Maxillo-facial surgery and Stomatology, Strasbourg University Hospital, Strasbourg, France
| | - R Prevost
- Department of Maxillo-facial surgery, La Rochelle, Ré, Aunis Hospital, La Rochelle, France
| | - J Kimakhe
- Department of Maxillo-facial surgery and Stomatology, Vendée Hospital Centre, La Roche Sur Yon, France
| | - V Poulet
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - F Lauwers
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - A Veyssière
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - H Bénateau
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - N Pham Dang
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - I Barthelemy
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - J M Foletti
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Chossegros
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Queiros
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - B Laure
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - A Paré
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - M de Boutray
- Department of Maxillo-facial surgery, Gui de Chauliac University Hospital Centre, Montpellier University, Montpellier, France
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Carbonnel E, Le Roux MK, Chossegros C, Scemama U, Graillon N. Tips & tricks for transoral approach for submandibular lithiasis (TASL). Journal of Stomatology, Oral and Maxillofacial Surgery 2020; 121:736-739. [DOI: 10.1016/j.jormas.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022]
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Robardey G, Le Roux M, Foletti J, Graillon N, Gormezano M, Varoquaux A, Lan R, Chossegros C. The Stensen's duct line: A landmark in parotid duct and gland injury and surgery. A prospective anatomical, clinical and radiological study. Journal of Stomatology, Oral and Maxillofacial Surgery 2019; 120:337-340. [DOI: 10.1016/j.jormas.2019.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
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Graillon N, Le Roux MK, Chossegros C, Haen P, Lutz JC, Foletti JM. Botulinum toxin for ductal stenosis and fistulas of the main salivary glands. Int J Oral Maxillofac Surg 2019; 48:1411-1414. [PMID: 31072799 DOI: 10.1016/j.ijom.2019.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/07/2019] [Accepted: 04/25/2019] [Indexed: 11/24/2022]
Abstract
This study was performed to present the authors' experience with botulinum toxin therapy for salivary stenosis and salivary fistula in terms of the procedure, dosage, effectiveness, and complications. A retrospective study of all patients treated in the maxillofacial surgery department for salivary stenosis or fistula from January 2014 to September 2018 was performed. Intraglandular injections of incobotulinumtoxinA (Xeomin) were utilized. The frequency of relapse and the pain recorded before injection and at 3 months after each injection or fistula resolution were assessed. Swallowing dysfunction or any diffusion of toxin into the facial muscles was recorded. This study included 22 patients (mean age 53 years). Botulinum therapy was indicated for parotid duct stenosis in 14 patients, submandibular duct stenosis in four patients, and parotid fistula in four patients. The frequency of relapse (P = 0.0001) and pain level (P = 0.0001) decreased after botulinum therapy. The average duration of the botulinum effect was 4.50±2.00 months after the first injection. No complication was observed. Botulinum therapy with 100 IU of Xeomin proved effective at resolving salivary fistula. Botulinum therapy is an effective treatment for symptoms of salivary duct stenosis in patients for whom minimally invasive procedures have failed. Botulinum therapy can also be used for the treatment of salivary fistulas.
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Affiliation(s)
- N Graillon
- Department of Oral and Maxillofacial Surgery, Aix Marseille Université, APHM, IFSTTAR, LBA, CHU Conception, Marseille, France.
| | - M K Le Roux
- Department of Oral and Maxillofacial Surgery, Aix Marseille Université, APHM, IFSTTAR, LBA, CHU Conception, Marseille, France
| | - C Chossegros
- Department of Oral and Maxillofacial Surgery, Aix Marseille Université, APHM, CHU Conception, Marseille, France
| | - P Haen
- Department of Oral and Maxillofacial Surgery, Hôpital Laveran, boulevard Laveran, Marseille, France
| | - J C Lutz
- Oral and Maxillofacial Surgery Department, Strasbourg University Hospital, Strasbourg, France
| | - J M Foletti
- Department of Oral and Maxillofacial Surgery, Aix Marseille Université, APHM, IFSTTAR, LBA, CHU Conception, Marseille, France
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Graillon N, Mage C, Le Roux MK, Scemama U, Chossegros C, Foletti JM. Mucoceles of the anterior ventral surface of the tongue and the glands of Blandin-Nuhn: 5 cases. J Stomatol Oral Maxillofac Surg 2019; 120:509-512. [PMID: 30981906 DOI: 10.1016/j.jormas.2019.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Mucoceles are cystic diseases of the oral mucosa. The most common are ranula and mococeles of the lower lip. Blandin and Nuhn mucoceles, which develop at the ventral side of the tongue, are rare benign lesions. They are often misdiagnosed and sometimes confused with ranula. The recommended treatment is a complete surgical excision of the gland. PATIENTS AND METHODS We describe 5 clinical cases managed in service between 2009 and 2016. Clinical cases are presented in order to detail their clinical history, paraclinical and treatment. RESULTS The clinical appearance is a longitudinal swelling of the ventral surface of the tongue, parallel to the frenulum. The volume of the swelling is variable; it is normally around 30 × 10 mm. The paraclinical (ultrasound, CT, MRI, or ponction) could be performed. CT showed an cyst located on the ventral surface of the tongue, with liquid density. Blandin and Nunh mucocele were strictly anechogenic. MRI confirms the liquid content of this cyst (low T1signal, high T2signal and no post-contrast-enhanced). The resection of Blandin and Nuhn glands should respect the sublingual gland, the lingual nerve and the lingual veins in the mouth floor. CONCLUSION This study demonstrates that Blandin and Nuhn mucoceles must be understood and recognised to propose complete excision of the Blandin and Nuhn gland and avoid recurrence.
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Affiliation(s)
- N Graillon
- Aix Marseille université, AP-HM, IFSTTAR, LBA, CHU Conception, department of oral and maxillofacial surgery, 13005, Marseille, France.
| | - C Mage
- University of Bordeaux, CHU de Bordeaux, Pellegrin hospital, department of oral and maxillofacial surgery, 33000 Bordeaux, France
| | - M K Le Roux
- Aix Marseille université, AP-HM, CHU Conception, department of oral and maxillofacial Surgery, 13005 Marseille, France
| | - U Scemama
- Aix Marseille université, AP-HM, imaging department, North university hospital, 13015, Marseille, France
| | - C Chossegros
- Aix Marseille université, AP-HM, CHU Conception, department of oral and maxillofacial Surgery, 13005 Marseille, France
| | - J M Foletti
- Aix Marseille université, AP-HM, IFSTTAR, LBA, CHU Conception, department of oral and maxillofacial surgery, 13005, Marseille, France
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Le Roux MK, Gallucci A, Le Flem M, Pech-Gourg G, Chossegros C, Graillon N. Erratum to "Complicated trifocal mandibular fracture in a child" [J. Stomatol. Oral Maxillofac. Surg. 120 (2019) 82-83]. J Stomatol Oral Maxillofac Surg 2019; 120:179. [PMID: 30852113 DOI: 10.1016/j.jormas.2019.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- M-K Le Roux
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France.
| | - A Gallucci
- Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - M Le Flem
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - G Pech-Gourg
- Paediatric neurosurgery department, hôpital de la Timone, rue Saint-Pierre, 13005 Marseille, France
| | - C Chossegros
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - N Graillon
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
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Le Roux MK, Gallucci A, Le Flem M, Pech-Gourg G, Chossegros C, Graillon N. Complicated trifocal mandibular fracture in a child. J Stomatol Oral Maxillofac Surg 2019; 120:82-83. [PMID: 30385426 DOI: 10.1016/j.jormas.2018.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/08/2018] [Accepted: 10/22/2018] [Indexed: 06/08/2023]
Affiliation(s)
- M-K Le Roux
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France.
| | - A Gallucci
- Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - M Le Flem
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - G Pech-Gourg
- Paediatric neurosurgery department, hôpital de la Timone, rue Saint-Pierre, 13005 Marseille, France
| | - C Chossegros
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
| | - N Graillon
- Aix Marseille University, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France; Oral and Maxillofacial department, Conception Hospital, boulevard Baille, 13005 Marseille, France; Paediatric oral and maxillofacial department, Timone Children's Hospital, rue Saint-Pierre, 13005 Marseille, France
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Romanet I, Graillon N, Le Roux MK, Guyot L, Chossegros C, De Boutray M, Foletti JM. Hooliganism and maxillofacial trauma: The surgeon should be warned. J Stomatol Oral Maxillofac Surg 2019; 120:106-109. [PMID: 30641281 DOI: 10.1016/j.jormas.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 09/20/2018] [Accepted: 01/03/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION With more than 270 million spectators, football - or soccer - is the most popular sport in the world. International football events generate many risky situations, including hooliganism and are an opportunity to analyze the incidence and the particularities of associated trauma. We sought to underline the potential rapid and brutal increase in maxillofacial trauma during a world-class competition. MATERIAL AND METHODS A retrospective multicenter study of the epidemiology of maxillofacial traumas during the UEFA 2016 Cup was conducted. All the medical data from each UEFA 2016 World Cup matches from 10 June 2016 to 10 July 2016 were collected. Only the maxillofacial traumas requiring a surgery under general anesthesia and a hospitalization were included. RESULTS 11 patients from 3 different cities were included. The main etiology was interpersonal violence (7/11), followed by road accidents (3/11). Open reduction with internal fixation of a mandibular fracture was the most performed surgery (9/11). Patients were 18 to 50 year-old, with an average age of 30.6 years. DISCUSSION This study underlines the violence of riots between "ultra" supporters during the 2016 UEFA cup. We noticed an upsurge of maxillofacial trauma severe enough to require a surgery under general anesthesia. Hooligan behaviors should be known by every practitioner dealing with trauma care, and may requires transitional adjustment of public health policy.
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Affiliation(s)
- I Romanet
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France.
| | - N Graillon
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France; Aix Marseille université, IFSTTAR, LBA, 13005 Marseille, France
| | - M K Le Roux
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France; Aix Marseille université, IFSTTAR, LBA, 13005 Marseille, France
| | - L Guyot
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France; Aix Marseille université, CNRS, EFS, ADES, 13005 Marseille, France
| | - C Chossegros
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France; Aix Marseille université, CNRS, LPL, 13005 Aix-en-Provence, France
| | - M De Boutray
- CHU de Montpellier Gui de Chauliac, maxillofacial surgery unit, 13005 Montpellier, France
| | - J M Foletti
- AP-HM, Pôle PROM, service de chirurgie maxillo-faciale, 13005 Marseille, France; Aix Marseille université, IFSTTAR, LBA, 13005 Marseille, France
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Pouzoulet P, Cheynet F, Guyot L, Foletti J, Chossegros C, Cresseaux P. Chin wing: Technical note. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:315-318. [DOI: 10.1016/j.jormas.2017.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
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Gagé J, Chossegros C, Haen P, Guyot L, Gallucci A, Graillon N. Retrograde approach for parotid benign tumours: A review. J Stomatol Oral Maxillofac Surg 2018; 120:38-44. [PMID: 30125738 DOI: 10.1016/j.jormas.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/13/2018] [Accepted: 08/11/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Parotidectomy for benign tumours is usually performed after facial nerve trunk discovery through an anterograde approach (AA) of the nerve. More recently, a retrograde approach (RA) toward the facial nerve, which begins on the facial nerve branches and ends on the nerve trunk, has been described. A literature review of the RA was conducted to evaluate the RA and to compare it with AA. METHODS A literature review was conducted for the years 1980 through 2016. Nine studies out of 216 were included, including 558 parotidectomies and 370 RA. We studied the operative time (OT), the postoperative complications including facial paralysis (FP), tumour recurrences, and possibilities for reoperation. RESULTS Operative time was shorter in RA than in AA. Transitory FP significantly less frequent in RA than in AA in only one studies and not significantly in four studies. Incidence of Frey syndrome was similar in RA and AA. Tumour relapses were reported in 1.8% of cases with RA, comparable to AA. CONCLUSION Retrograde parotidectomy is recommendable. OT was significantly shorter for the RA. The FP rate was lower for RA than for AA, but the difference was not significant. The recurrence rate appeared to be similar between RA and AA. Possibilities of reoperation were better after RA.
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Affiliation(s)
- J Gagé
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France; Service de chirurgie maxillo-faciale, stomatologie et plastique, HIA Laveran, 34, boulevard Lavéran, 13013 Marseille, France.
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France; Service de chirurgie maxillo-faciale, stomatologie et plastique, HIA Laveran, 34, boulevard Lavéran, 13013 Marseille, France; Aix-Marseille university, Jardin-du-Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Laboratoire parole et langage (LPL), UMR 6057, 5, avenue Pasteur, 13100 Aix-en-Provence, France
| | - P Haen
- Service de chirurgie maxillo-faciale, stomatologie et plastique, HIA Laveran, 34, boulevard Lavéran, 13013 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - A Gallucci
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France
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Castro R, Guivarc'h M, Foletti JM, Catherine JH, Chossegros C, Guyot L. Endodontic-related inferior alveolar nerve injuries: A review and a therapeutic flow chart. J Stomatol Oral Maxillofac Surg 2018; 119:412-418. [PMID: 29730463 DOI: 10.1016/j.jormas.2018.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/30/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Inferior alveolar nerve (IAN) lesions related to endodontic treatments can be explained by the anatomical proximity between the apices of the mandibular posterior teeth and the mandibular canal. The aim of this article is to review the management of inferior alveolar nerve lesions due to endodontic treatments and to establish a therapeutic flow chart. METHODS A review of publications reporting IAN damage related to endodontic treatment over the past 20 years has been conducted, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combines an electronic search of the Pubmed® and Google Scholar® databasis. Forty-two full-text articles corresponding to 115 clinical cases have been selected. Two personal clinical cases were additionally reported. RESULTS IAN lesions due to endodontic treatments require urgent management. Early surgical removal of the excess of endodontic material, in contact with the nerve allows the best recovery prognosis (72h). Beyond this delay, irreversible nervous lesions prevail and a medical symptomatic treatment, most of the time with pregabalin, must be/can be carried out. A delayed surgical procedure shows some good benefits for patients. However, the healing prognosis remains poorly predictable.
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Affiliation(s)
- R Castro
- Chirurgie maxillo-faciale, chirurgie orale, Hôpital la Conception, Université Aix-Marseille, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Service de chirurgie orale, pavillon odontologie, Hôpital Timone, Université Aix-Marseille, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
| | - M Guivarc'h
- Service de chirurgie orale, pavillon odontologie, Hôpital Timone, Université Aix-Marseille, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - J M Foletti
- Chirurgie maxillo-faciale, chirurgie orale et chirurgie plastique, Hôpital Nord, Université Aix-Marseille, AP-HM, chemin des bourrely, 13015 Marseille, France
| | - J H Catherine
- Chirurgie maxillo-faciale, chirurgie orale et chirurgie plastique, Hôpital Nord, Université Aix-Marseille, AP-HM, chemin des bourrely, 13015 Marseille, France; Service de chirurgie orale, pavillon odontologie, Hôpital Timone, Université Aix-Marseille, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France
| | - C Chossegros
- Chirurgie maxillo-faciale, chirurgie orale, Hôpital la Conception, Université Aix-Marseille, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - L Guyot
- Chirurgie maxillo-faciale, chirurgie orale et chirurgie plastique, Hôpital Nord, Université Aix-Marseille, AP-HM, chemin des bourrely, 13015 Marseille, France
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Lan R, Hadj-Saïd M, Foletti JM, Massereau E, Chossegros C. WITHDROWN: Osteonecrosis of the jaw in patients traited by denosumab for malignant bone disease: Descriptive study on 9 cases. Med Oral Patol Oral Cir Bucal 2018:22312. [PMID: 29680853 DOI: 10.4317/medoral.22312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/12/2017] [Indexed: 11/05/2022] Open
Abstract
Ahead of Print article withdrawn by publisher
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Affiliation(s)
- R Lan
- Timone Hospital, Pr Tardieu Department of Oral Surgery and Odontology 264 rue St Pierre 13385, Marseille, France
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Lafont J, Graillon N, Hadj Saïd M, Tardivo D, Foletti JM, Chossegros C. Extracorporeal lithotripsy of salivary gland stone: A 55 patients study. J Stomatol Oral Maxillofac Surg 2018; 119:375-378. [PMID: 29571815 DOI: 10.1016/j.jormas.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 03/03/2018] [Accepted: 03/18/2018] [Indexed: 11/26/2022]
Abstract
Sialolithiasis are the most frequent salivary gland disease, mainly affecting the submandibular gland. With the advent of minimally invasive techniques, total salivary gland removal should not be considered as the first-line treatment anymore. Extracorporeal Shock Wave Lithotripsy (ESWL) is an alternative to surgery preserving the gland. The objective of our retrospective study was to evaluate the efficiency of ESWL on pain and obstructive syndrome in patients suffering from sialolithiasis. The global result felt by the patients was also considered. All patients treated between October 2009 and July 2016 for sialolithiasis by ESWL in our department were included. They were divided into two groups according to the concerned gland: a parotid gland (PG) and a submandibular gland (SMG) group. Our retrospective telephone questionnaire consisted in 4 questions about their symptomatology before and after ESWL, including pain self-evaluation before and after treatment. They were finally asked to evaluate the global result of the ESWL treatment: excellent, good, mean, or poor. In total, 55 patients were included in this study, 38 patients in PG group and 17 patients in SMG group. We observed a decrease of pain and obstructive syndrom after ESWL procedure in both groups. Better results were found on the obstructive syndrome in the PG group. Very few side-effects were reported by patients. Given that it has very few side effects, ESWL can easily be considered as first line treatment for sialolithiasis to avoid heavier treatments such as surgery. It should be the first-line treatment for symptomatic parotid sialolithiases. The treatment of symptomatic submandibular sialolithiases depends on the topography of the lithiasis.
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Affiliation(s)
- J Lafont
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France; Oral surgery department, odontology, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - N Graillon
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - M Hadj Saïd
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 7268 ADES, EFS, CNRS, medical school-north sector, Aix-Marseille university, boulevard Pierre-Dramard, 13344 Marseille, France
| | - D Tardivo
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 7268 ADES, EFS, CNRS, medical school-north sector, Aix-Marseille university, boulevard Pierre-Dramard, 13344 Marseille, France
| | - J M Foletti
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial & plastic surg department, Nord hospital, AP-HM, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France
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Gardon MA, Foletti JM, Avignon S, Graillon N, Chossegros C. CT scan assessment in salivary gland lithiasis diagnosis. J Stomatol Oral Maxillofac Surg 2017; 119:110-112. [PMID: 29175510 DOI: 10.1016/j.jormas.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/22/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of the study was to assess computed tomography (CT) scan efficiency for the diagnosis of salivary lithiasis. METHODS Patients who were included were all the patients who consulted in our department for main salivary gland (submandibular and parotid) obstruction symptoms between June 2014 and December 2016. A CT scan without injection was prescribed for all of them. The 163 patients were divided into two groups after the CT scan: patients with and without lithiasis. During surgery, we confirmed the presence or absence of the lithiasis previously diagnosed on the CT scan. The patients were divided in two groups: case and control groups. For statistical analysis, the sensitivity, specificity, and the negative and positive predictive values of the preoperative CT scan were calculated. RESULTS A total of 163 patients with a salivary obstructive syndrome were included. On the CT scans, we found lithiases (hyperdense images) in 157 glands ("CT scan⊕" group), and we found no lithiasis in 6 glands ("CT scan" group). In the "CT scan⊕" group, 203 lithiases were present. During surgery, we found and removed lithiases in 155 patients (case group), and 8 patients had no lithiases (control group). The overall sensitivity, specificity, positive predictive value, and negative predictive values of the CT scan for the detection of lithiasis were 100%, 75%, 99%, and 100%, respectively. The specificity of CT scans for the lithiasis located in the anterior and middle third of the duct was 100%. DISCUSSION According to our study, the CT scan is very efficient in diagnosing salivary main gland lithiases in patients with an obstructive syndrome.
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Affiliation(s)
- M A Gardon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France.
| | - J M Foletti
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial & plastic surg department, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - S Avignon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - N Graillon
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France
| | - C Chossegros
- Aix-Marseille university, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseilles cedex 07, France; Oral & maxillofacial department, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille cedex 5, France; Laboratoire parole et langage, 5, rue Pasteur, 13100 Aix-en-Provence, France
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Pouzoulet P, Graillon N, Guyot L, Chossegros C, Foletti JM. Double palatal flap for oro-nasal fistula closure. J Stomatol Oral Maxillofac Surg 2017; 119:164-167. [PMID: 29129711 DOI: 10.1016/j.jormas.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/29/2017] [Accepted: 11/01/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The management of oral fistula to the nose depends on its etiology, its size and its location. Here, we describe a simple technique, inspired by the ones initially developed by Bardach for cleft palates repair. The surgical alternatives are discussed. TECHNICAL NOTE The double palatal flap is a simple technique, allowing closure in a single session of a central or centro-lateral palate fistula. The key of this technique is the dissection between nasal and palate mucous layers, providing a sufficient amount of laxity to close the defect without tension. DISCUSSION The double palatal flap can cover centro-lateral palate mucosal fistulae. It provides both aesthetic and functional results in a single stage. Reliability, simplicity and quickness are its main advantages. Outcomes are usually simple; Velar insufficiency may occur, that can be corrected by speech therapy.
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Affiliation(s)
- P Pouzoulet
- Aix-Marseille université, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France; Service de chirurgie maxillo-faciale, hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - N Graillon
- Aix-Marseille université, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France; Service de chirurgie maxillo-faciale, hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - L Guyot
- Aix-Marseille université, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France; Service de chirurgie maxillo-faciale, hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - C Chossegros
- CNRS, LPL UMR 7309, Aix-Marseille université, 13100 Aix-en-Provence, France; Service de chirurgie maxillo-faciale, hôpital de la Conception, AP-HM, 13005 Marseille, France
| | - J M Foletti
- IFSTTAR, LBA UMR_T 24, Aix-Marseille université, faculté de médecine campus nord, chemin des Bourrely, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France.
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Raskin A, Ruquet M, Weiss-Pelletier L, Mancini J, Boulogne O, Michel J, Fakhry N, Foletti JM, Chossegros C, Giorgi R. Upper aerodigestive tract cancer and oral health status before radiotherapy: A cross-sectional study of 154 patients. J Stomatol Oral Maxillofac Surg 2017; 119:2-7. [PMID: 28911982 DOI: 10.1016/j.jormas.2017.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/04/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We aimed to determine primarily the oral health status of patients with upper aerodigestive tract cancer before radiotherapy, and secondarily the prevalence of risk factors for poor oral status. METHODS A cross-sectional study was conducted in Marseille University hospital. Assessment criteria were the Decay, Missing and Filled (DMF) Index and periodontal status. RESULTS One hundred and fifty-four patients, mean age 60.9years, were included. The most common sites of primary tumors were the larynx (28.6%) and oral cavity (26.6%). Current or past smokers accounted for 80.5% of patients and 67% were alcohol abusers. Most patients (83.8%) did not have xerostomia. They ate three meals a day (61%), with sugar consumption in 40%. The median number of daily tooth brushings was 2, with a manual toothbrush (81.2%). Few patients used dental floss or interproximal brushes. Individual DMF index was 17.6 (D=2.3, M=9.3, F=6.0) and was higher in patients with xerostomia and alcohol abusers (P=0.01). Osseous level was 62.3% and 57.8% of patients had osseous infections, which were more common with poor hygiene (P=0.04). Most patients (85.7%) had periodontal disease, but incidence did not significantly differ according to risk factors. DISCUSSION The DMF index was higher in presence of periodontal disease and osseous infections. Alcohol and xerostomia were associated with a high individual DMF index and osseous infections were more frequent in patients with poor hygiene. Patients with upper aerodigestive tract cancer are at high risk of osteoradionecrosis if they do not receive dental treatment before radiotherapy.
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Affiliation(s)
- A Raskin
- Faculté d'odontologie, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle d'odontologie, UF des soins spécifiques, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; EFS CNRS, faculté de médecine, UMR 7268 ADES, Aix-Marseille université, 51, boulevard Pierre-Dramard, 13944 Marseille cedex 15, France.
| | - M Ruquet
- Faculté d'odontologie, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle d'odontologie, UF des soins spécifiques, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; EFS CNRS, faculté de médecine, UMR 7268 ADES, Aix-Marseille université, 51, boulevard Pierre-Dramard, 13944 Marseille cedex 15, France
| | - L Weiss-Pelletier
- Pôle d'odontologie, UF des soins spécifiques, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - J Mancini
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle de santé publique BIOSTIC, service biostatistique et technologies de l'information et de la communication, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; SESSTIM sciences économiques et sociales de la santé et traitement de l'information médicale, UMR 912 Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - O Boulogne
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle de santé publique BIOSTIC, service biostatistique et technologies de l'information et de la communication, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; SESSTIM sciences économiques et sociales de la santé et traitement de l'information médicale, UMR 912 Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - J Michel
- EFS CNRS, faculté de médecine, UMR 7268 ADES, Aix-Marseille université, 51, boulevard Pierre-Dramard, 13944 Marseille cedex 15, France; Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle PROMO, service ORL et chirurgie cervico-faciale, hôpital de la conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France
| | - N Fakhry
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle PROMO, service ORL et chirurgie cervico-faciale, hôpital de la conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France
| | - J M Foletti
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France
| | - C Chossegros
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle PROMO, service ORL et chirurgie cervico-faciale, hôpital de la conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France
| | - R Giorgi
- Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France; Pôle de santé publique BIOSTIC, service biostatistique et technologies de l'information et de la communication, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; SESSTIM sciences économiques et sociales de la santé et traitement de l'information médicale, UMR 912 Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
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Moreddu E, Baumstarck-Barrau K, Gabriel S, Fakhry N, Sebag F, Mundler O, Chossegros C, Taïeb D. Incidence of salivary side effects after radioiodine treatment using a new specifically-designed questionnaire. Br J Oral Maxillofac Surg 2017; 55:609-612. [DOI: 10.1016/j.bjoms.2017.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/28/2017] [Indexed: 11/16/2022]
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Ordioni U, Benat G, Hadj Saïd M, Gomez-Brouchet A, Chossegros C, Catherine JH. Clear cell odontogenic carcinoma, diagnostic difficulties. A case report. J Stomatol Oral Maxillofac Surg 2017; 118:302-305. [PMID: 28502762 DOI: 10.1016/j.jormas.2017.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/17/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Clear cell odontogenic carcinoma (COCC) is a rare tumor described by Hansen et al. in 1985. The clinical and radiological manifestations are multiple and the diagnosis is histological. OBSERVATION A 64-year-old patient consulted us for a right mandibular osteolytic lesion associated to a homolateral labial hypoesthesia. A biopsy was performed under local anesthesia. Histology was consistent with a metastatic lesion of clear kidney cell carcinoma, COCC, or odontogenic squamous tumor. Additional tests eliminated a metastatic lesion. A wide excision of the lesion by hemi-mandibulectomy associated with lymph node dissection and reconstruction by a fibula osteoseptocutaneous flap was performed. Presence of a fission of the EWSR1 gene on the histological examination of the surgical specimen made the diagnosis of COCC. DISCUSSION Our observation illustrates the difficulty of diagnosing COCC. The new contribution of the cytogenetic techniques such as FISH-type techniques makes possible the improvement of the diagnosis.
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Affiliation(s)
- U Ordioni
- Department of oral surgery, odontology, Timone hospital, 13385 Marseille, France; Centre Massilien de la face, 24, avenue du Prado, 13006 Marseille, France.
| | - G Benat
- Department of pathological anatomy and cytology, university cancer institute Toulouse Oncopole, 31059 Toulouse, France; Department of plastic and maxillofacial surgery, Pierre-Paul-Riquet hospital, 31059 Toulouse, France
| | - M Hadj Saïd
- Department of oral surgery, odontology, Timone hospital, 13385 Marseille, France; Department of stomatology, oral and maxillofacial surgery, Conception hospital, 13005 Marseille, France; UMR 7268 ADES, Aix-Marseille university/EFS/CNRS, faculty of medicine, 13344 Marseille, France
| | - A Gomez-Brouchet
- Department of pathological anatomy and cytology, university cancer institute Toulouse Oncopole, 31059 Toulouse, France
| | - C Chossegros
- Department of stomatology, oral and maxillofacial surgery, Conception hospital, 13005 Marseille, France
| | - J-H Catherine
- Department of oral surgery, odontology, Timone hospital, 13385 Marseille, France; UMR 7268 ADES, Aix-Marseille university/EFS/CNRS, faculty of medicine, 13344 Marseille, France
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Adam S, Sama HD, Chossegros C, Bouassalo MK, Akpoto MY, Kpemissi E. Improvised Vacuum-Assisted Closure for severe neck infection in poorly equipped conditions. J Stomatol Oral Maxillofac Surg 2017; 118:178-180. [PMID: 28391076 DOI: 10.1016/j.jormas.2017.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/11/2017] [Accepted: 03/29/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Dental infections are common and are mainly due to dental caries. When left untreated, these infections can lead to severe life-threatening sepsis. CASE REPORT The authors reported a case of a severe odontogenic deep neck space infection in a 54-year-old male. The patient was a heavy smoker with incidentally discovered diabetes. He was successfully treated by surgical drainage combined with an improvised Vacuum-Assisted Closure (VAC) system. The results of surgical drainage followed by insertion of an improvised VAC system were spectacular. The abscess resolved in response to dual-agent antibiotic therapy on day 17 and blood glucose control was achieved with insulin. Full-thickness skin graft was performed to repair the necrotic zone of the neck. DISCUSSION The use of VAC can be a valuable alternative to conventional dressings and hyperbaric oxygen therapy in poorly equipped conditions. Public awareness campaigns remain the most effective form of prevention against these odontogenic infections.
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Affiliation(s)
- S Adam
- Service d'ORL et de Chirurgie Cervico-Maxillo-faciale, CHU Sylvanus Olympio, 08 BP 8146 Lomé, Togo; Service d'Odontostomatologie et de Chirurgie Maxillo-faciale, CHU Sylvanus Olympio, Lomé, Togo.
| | - H D Sama
- Service d'anesthésie réanimation, CHU Sylvanus Olympio, Lomé, Togo
| | - C Chossegros
- Stomatologie-Chirurgie Maxillo-Faciale & Orale CHU de Marseille, Hôpital de la Conception, 147 boulevard Baille, 13385 Marseille cedex 5, France
| | - M K Bouassalo
- Service d'Odontostomatologie et de Chirurgie Maxillo-faciale, CHU Sylvanus Olympio, Lomé, Togo
| | - M Y Akpoto
- Service de Chirurgie traumatologique et d'Orthopédie, CHU Sylvanus Olympio, Lomé, Togo
| | - E Kpemissi
- Service d'ORL et de Chirurgie Cervico-Maxillo-faciale, CHU Sylvanus Olympio, 08 BP 8146 Lomé, Togo
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Avignon S, Foletti JM, Collet C, Guyot L, Chossegros C. [Calcifications of the parotid space. A review]. J Stomatol Oral Maxillofac Surg 2017; 118:167-172. [PMID: 28391078 DOI: 10.1016/j.jormas.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/22/2016] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.
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Affiliation(s)
- S Avignon
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Collet
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Romeu M, Foletti J, Chossegros C, Dales J, Berbis P, Cribier B, Guyot L. Les tumeurs cutanées malignes à différentiation pilaire de la face et du cuir chevelu : mise au point diagnostique et thérapeutique. Journal of Stomatology, Oral and Maxillofacial Surgery 2017; 118:95-102. [DOI: 10.1016/j.jormas.2017.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/02/2016] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
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Vatin L, Foletti JM, Collet C, Varoquaux A, Chossegros C. A case of bilateral megaducts: Diagnostic and treatment methods. J Stomatol Oral Maxillofac Surg 2017; 118:125-128. [PMID: 28345516 DOI: 10.1016/j.jormas.2017.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/20/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The pathology of the saliva glands comprises both tumoral and obstructive disorders. The latter include lithiasis, stenosis and megaduct. In this paper, we describe a clinical case of bilateral megaduct, a rare pathology, using sialo-MRI imaging and a conservative diagnostic-cum-therapeutic technique, sialendoscopy with dilation followed by catheterization. CLINICAL CASE Our female patient presented oversized parotids with an unsightly deformation of the face (parotid ducts visible beneath the skin) and itchy cheeks, from which she had suffered for several years. Sialo-MRI revealed bilateral hypertrophied parotid saliva glands. We opted to perform diagnostic sialendoscopy to explore the branches of the salivary gland system and found ducts shaped like strings of sausages associated with mucous plugs. The treatment procedure was combined with rinsing of both parotid ducts in physiological serum followed by initiation of antibiotic-corticotherapy within the saliva ducts and, lastly, by placement of transpapillary drains, which were left in place for 10 days. Immediately following the procedure, the patient felt a considerable improvement regarding both local discomfort and her cheek deformation. Postoperative control at 10 weeks by sialo-MRI confirmed the reduction of the dilation of the salivary ducts. At 3 months, the patient continued to display a marked clinical improvement despite her saliva retaining a thick consistency. She no longer suffered from pruritis or deformation of the cheeks. DISCUSSION Sialendoscopy could become the reference treatment tool since it is both efficient and conservative. Duration of her postoperative catheterization remains to be defined.
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Affiliation(s)
- L Vatin
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J M Foletti
- Oral, Maxillo-Facial & Plastic Surgery Department, Hospital Nord, chemin des Bourrelys, 13015 Marseille, France; Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France
| | - C Collet
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - A Varoquaux
- Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Parole et Langage Laboratory (LPL), UMR 6057, Pr N.N'Guyen, 13100 Aix-en-Provence, France
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Oddon PA, Royer G, Graillon N, Marchal F, Chossegros C, Foletti JM. Treatment of salivary stones by intraductal pneumatic lithotripsy: A preliminary presentation of the StoneBreaker with sterile bag covering. J Stomatol Oral Maxillofac Surg 2017; 118:119-121. [PMID: 28345515 DOI: 10.1016/j.jormas.2017.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/12/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Sialendoscopy has changed the management of obstructive sialadenitis. Nowadays, minimally invasive techniques evolve to preserve salivary gland function. Intraductal lithotripsy allows stones fragmentation and retrieval without opening the salivary duct. We report our experience with the StoneBreaker (SB), a new lithotripter with improvement using a sterile bag that permits reuse of the SB without passing to sterilization. TECHNICAL NOTE The non-sterilized SB was used into a sterile camera sleeve in 5 patients, 3 submandibular lithiases and 2 parotid lithiases. Technique and outcomes were described with a review of the literature. An explanatory video of the procedure was performed. DISCUSSION Complete fragmentation was achieved and all fragments were extracted without any ductal damage. Utilization of the sterile sleeve did not change the SB efficiency and the procedure duration. The use of a sterile bag allowed several consecutive procedures with a single non-sterilized handpiece. However, the gas cartridge change may be more delicate when more than 80 impacts are needed. Patients remained symptoms and stones free one month after surgery.
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Affiliation(s)
- P A Oddon
- Oral & Maxillofacial Department, Conception Hospital, AP-HM, 147, boulevard Baille, 13385 Marseille, France.
| | - G Royer
- Oral & Maxillofacial Department, Conception Hospital, AP-HM, 147, boulevard Baille, 13385 Marseille, France
| | - N Graillon
- Oral & Maxillofacial Department, Conception Hospital, AP-HM, 147, boulevard Baille, 13385 Marseille, France
| | - F Marchal
- Department of Otolaryngology-Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - C Chossegros
- LPL, UMR 6057, Aix Marseille University, CNRS, 13100 Aix-en-Provence, France; Oral & Maxillofacial Department, Conception Hospital, AP-HM, 147, boulevard Baille, 13385 Marseille, France
| | - J M Foletti
- Oral & Maxillofacial Department, hôpital Nord, AP-HM, chemin des Bourrelys, 13015 Marseille, France
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Chossegros C, Foletti J, Graillon N, Mage C. GTD classification for main salivary gland lithiasis. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chossegros C, Foletti J, Graillon N, Oddon P. Salivary lithiasis intraductal fragmentation with stonebreaker and sterile sheet. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arnaud M, Gallucci A, Graillon N, Guyot L, Chossegros C, Foletti JM. [Combined approach for parotid lithiases: A 9 cases retrospective study]. J Stomatol Oral Maxillofac Surg 2017; 118:35-38. [PMID: 28330572 DOI: 10.1016/j.jormas.2016.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/26/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Minimally invasive techniques (MIT), including sialendoscopy, extracorporeal lithotripsy and intraoral approach, have to be preferred in parotid stones removal. In case of MIT failure, a combined intra- and extra-oral approach can be achieved. The aim of our study was to evaluate the efficacy and the complications of these combined approaches. MATERIALS AND METHODS A retrospective study has been conducted on patients treated between 2006 and 2015. All adult patients presenting with one or more parotid stones and in whom TMI failed have been included. Age and sex of the patients, number, size and location of the stones, result of the procedure, occurrence of pain, swelling, or infection have been recorded. RESULTS Nine patients were included (mean age: 56). Mean follow-up was 48 months. Eighty-eight percent of patients had an unique stone. Nine stones were extracted by combined approach. Mean diameter of the stones was 8.5mm and 33% of them were located at the junction between middle and posterior third of parotid duct. All the patients suffered preoperatively from daily retention symptoms, such as pain (55%) and swelling (100%). Two patients had an infectious complication (duct and/or gland infection). Seventy-five percent (9/12) of stones were removed. Complications consisted of 1 fistula, 1 facial paresis, 3 recurrences. Seven of 9 patients (77%) had a total relieve after surgery. DISCUSSION Surgical combined approaches for parotid stones removals are indicated after failure of MIT when symptoms affect quality of life.
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Affiliation(s)
- M Arnaud
- Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France
| | - A Gallucci
- Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France
| | - N Graillon
- Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France
| | - L Guyot
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, AP-HM, 13915 Marseille cedex 20, France
| | - C Chossegros
- Pôle PROM, service de chirurgie maxillo-faciale, CHU de la Conception, AP-HM, 13005 Marseille cedex 5, France; CNRS, LPL UMR 7309, Aix-Marseille université, 13100 Aix-en-Provence, France
| | - J M Foletti
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, AP-HM, 13915 Marseille cedex 20, France; IFSTTAR, LBA UMR T 24, Aix-Marseille université, 13916 Marseille, France.
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Gerni M, Foletti J, Collet C, Chossegros C. Evaluation of the prevalence of residual sialolith fragments after transoral approach of Wharton’s duct. J Craniomaxillofac Surg 2017; 45:167-170. [DOI: 10.1016/j.jcms.2016.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/09/2016] [Accepted: 04/07/2016] [Indexed: 11/29/2022] Open
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Romanet I, Foletti JM, Massereau E, Graillon N, Chossegros C. [An unexplained palatal inflammation]. ACTA ACUST UNITED AC 2016; 117:359-360. [PMID: 27448515 DOI: 10.1016/j.revsto.2016.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Affiliation(s)
- I Romanet
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - E Massereau
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, CHU Conception, 147, boulevard Baille, 13005 Marseille, France
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Gallucci A, Graillon N, Foletti JM, Chossegros C, Cheynet F. [Congenital malformations of the temporo-mandibular joint and the mandibular ramus: Grafting vs distraction osteogenesis]. ACTA ACUST UNITED AC 2016; 117:240-4. [PMID: 27554489 DOI: 10.1016/j.revsto.2016.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
Abstract
Congenital deformities of the mandibular ramus and of the temporo-mandibular joint are treated by surgery since the early 20th century. However, morphological and functional results are often disappointing, accounting for iterative operations. Today, a clear consensus concerning the type of intervention to be proposed, and at what age it should be carried out does not yet exist. For mild cases, "conventional" orthognathic or osteogenic distraction procedures seem to work well, especially if they are carried out at the end of growth. In severe cases, it is often necessary to proceed in several surgical steps, usually starting with a chondrocostal graft, especially when interceptive surgery, performed before the end of growth, is preferred in order to improve the patient's quality of life.
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Affiliation(s)
- A Gallucci
- Service de chirurgie maxillofaciale et stomatologie hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - N Graillon
- Service de chirurgie maxillofaciale et stomatologie hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
| | - J M Foletti
- Service de chirurgie maxillofaciale et plastique de la face-stomatologie, hôpital Nord, chemin des Bourrelly, 13015 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillofaciale et stomatologie hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
| | - F Cheynet
- Service de chirurgie maxillofaciale et stomatologie hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
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Ray AC, Foletti JM, Graillon N, Guyot L, Chossegros C. [De novo (type 3) primary intraosseous carcinoma of the jaws]. ACTA ACUST UNITED AC 2016; 117:411-420. [PMID: 27527660 DOI: 10.1016/j.revsto.2016.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature. MATERIAL AND METHODS Two search engines (Pubmed®, Sciencedirect®) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected. RESULTS Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No. 46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on. DISCUSSION The PIOC3 is a rare tumor, mainly arising in males around 50. Diagnosis should be evoked in the presence of painful swelling and nervous symptoms. The time to diagnosis is long. Tumors are usually seen at late stages. Treatment classically combines surgery and radiotherapy.
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Affiliation(s)
- A C Ray
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France.
| | - J M Foletti
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Aix-Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France
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Foletti JM, Cheynet F, Graillon N, Guyot L, Chossegros C. [TMJ arthroscopy. A review]. ACTA ACUST UNITED AC 2016; 117:273-9. [PMID: 27523442 DOI: 10.1016/j.revsto.2016.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Temporomandibular joint (TMJ) dysfunction associates pain, limited mouth opening and joint noise. Failures of conservative treatments may lead to arthroscopy. The aim of our study was to evaluate the current interest of arthroscopy in the treatment of TMJ dysfunction. MATERIAL AND METHODS Using the keywords "TMJ" and "Arthroscopy", 1668 articles were found in the Sciencedirect database. We selected 17 papers published between September 2012 and May 2016. Six questions were asked: (1) what treatment should be given to patients suffering from TMJ dysfunction? (2) What treatment should be performed for TMJ disorders when conservative treatments failed? (3) Does Wilkes staging change the surgical indication? (4) What has to be done in case of arthroscopy failure? (5) Can disc position be improved after surgery? (6) Should the disc position be improved? RESULTS AND DISCUSSION (1) Conservative treatment should always be considered in first intention (2) In case of conservative treatment failures, surgery can be proposed, beginning with the less invasive one (3) Whatever the Wilkes stage, treatment should begin by the less invasive one (4) In case of arthroscopy failure, TMJ arthrotomy can be indicated (5) Disc position may be improved in the long term but it is complex to obtain (only one paper) (6) there is no evidence that disk has to be repositioned.
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Affiliation(s)
- J M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - F Cheynet
- Service de chirurgie maxillo-faciale et stomatologie, CHU conception, 147, boulevard Baille, 13005 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale et stomatologie, CHU conception, 147, boulevard Baille, 13005 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, CHU conception, 147, boulevard Baille, 13005 Marseille, France.
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Hadj Said M, Foletti JM, Graillon N, Guyot L, Chossegros C. Orofacial manifestations of scleroderma. A literature review. ACTA ACUST UNITED AC 2016; 117:322-326. [PMID: 27475503 DOI: 10.1016/j.revsto.2016.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 03/06/2016] [Accepted: 06/09/2016] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Scleroderma is a rare disease of the connective tissue (50 to 200 patients/1 million people; 60,000 patients in France). We conducted a literature review about the orofacial manifestations of scleroderma that have been little studied. MATERIAL AND METHODS The 45 articles found in 6 different databases by using the keywords "scleroderma", "systemic sclerosis", "oral medicine", "face" and published between 1944 and 2016 were selected, for a total of 328 patients. RESULTS A total of 1187 orofacial manifestations of scleroderma were identified, occurring mainly in women (84.5%) with a mean age of 40.2 years, 10 years on average after the first manifestation of the disease. The main ones were limitation of mouth opening (69.8%), widening of the periodontal ligament (67.3%), xerostomia (63.4%), telangiectasia (36.2%) and bone lesions (34.5%). Dental root resorptions, pulp and nose calcifications were also reported but with no evident link with scleroderma. DISCUSSION Orofacial manifestations of scleroderma are probably more common than reported. They mostly affect women with a mean age of 40. The most common oral manifestations are limitation of mouth opening, widening of the periodontal ligament and xerostomia. Because of the handicap they may be responsible for, these manifestations must be detected early in order to prevent from functional impairments and from dental and periodontal lesions.
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Affiliation(s)
- M Hadj Said
- Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Aix-Marseille Université, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Aix Marseille Université, CNRS, LPL UMR 7309, 13100 Aix-en-Provence, France.
| | - J M Foletti
- Service de chirurgie maxillo-faciale, Hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille Université, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - N Graillon
- Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Aix-Marseille Université, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, Hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille Université, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Aix-Marseille Université, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Aix Marseille Université, CNRS, LPL UMR 7309, 13100 Aix-en-Provence, France
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Foletti JM, Bruneau S, Puech B, Guyot L, Chossegros C. Life-threatening hemorrhage after zygomatic bone surgery. About 2 posttraumatic cases. ACTA ACUST UNITED AC 2016; 117:183-7. [PMID: 27185204 DOI: 10.1016/j.revsto.2016.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/18/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Management of zygomatic bone fractures is still debated. Method and delay for intervention has to be chosen considering respective issues of operative or conservative treatments, especially hemorrhagic complications. The maxillofacial surgeon must be able to determine life-threatening situations and to react appropriately. CASES REPORT We report 2 cases of external carotid branches pseudoaneurysm leading to massive hemorrhage after early or delayed zygomatic fracture surgery. The first patient underwent open reduction of fracture by intraoral approach. An active bleeding occurred in the immediate postoperative time. In the second case, a zygomatic osteotomy was performed 1 year after fracture. Bleeding occurred 2 weeks after surgery. In both cases, angiography demonstrated a pseudoaneurysm developed from the external carotid branches. Embolisation led to rapid bleeding control. DISCUSSION Severe hemorrhage resulting from maxillofacial trauma may be life-threatening. Once the "damage control" principles applied, selective embolisation of external carotid branches is an efficient alternative to surgery for the control of bleeding resulting from ruptured pseudoaneurysm.
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Affiliation(s)
- J-M Foletti
- Aix Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France; Service de chirurgie maxillo-faciale et plastique de la face, hôpital Nord, CHU Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France; Aix-Marseille université, 13284 Marseille, France.
| | - S Bruneau
- Service de chirurgie maxillo-faciale et plastique de la face, hôpital Nord, CHU Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France; Aix-Marseille université, 13284 Marseille, France
| | - B Puech
- Aix-Marseille université, 13284 Marseille, France; Service d'imagerie, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France
| | - L Guyot
- Service de chirurgie maxillo-faciale et plastique de la face, hôpital Nord, CHU Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France; Aix-Marseille université, 13284 Marseille, France
| | - C Chossegros
- Aix Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital de la Conception, hôpital Nord, AP-HM, pavillon étoile, chemin des Bourrely, 13005 Marseille, France
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Massereau E, Laurans R, Foletti JM, Gallucci A, Chossegros C. [Epidemiology of oral diseases in a university hospital specialized consultation]. ACTA ACUST UNITED AC 2016; 117:136-41. [PMID: 26988142 DOI: 10.1016/j.revsto.2016.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/13/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Oral diseases (OD) are common and affect, according to studies, 2.5 to 61.6% of general population. The main objective of our study was to determine the most common diagnoses of OD in a dedicated consultation in a University Hospital. MATERIAL AND METHOD We conducted a descriptive observational study over 12 months from weekly OD consultations provided within the oral and maxillofacial surgery department at the Timone university hospital, Marseille, France. We divided our patient population into 4 subgroups: subgroup A, in which each patient was considered as a new one for each consultation; subgroup B, in which each patient was only considered once; subgroup C, including patients seen three times at least and subgroup D, including the children. At each consultation, were identified: age, sex, alcohol and tobacco consumption, corresponding physician specialty, time between onset of symptoms and consultation, reason for consultation and final diagnosis. RESULTS Subgroups A, B, C and D respectively included 393, 208, 23 and 11 cases. Age and sex were similar in the subgroups A, B and C (mean age: 53.6, 54.3 and 51.4 years, respectively; female predominance: 62.9%, 66.8% and 65.2%, respectively). The most commonly encountered diagnoses were similar in the subgroups A and B: oral lichen planus (19.6% and 19.2%), aphthous stomatitis (11.5 and 7.2%), burning mouth syndrome (11.5 and 14.9%). In subgroup C, were found: oral lichen planus (34.8%), aphthous stomatitis (21.7%), cicatricial pemphigoid (13%) and pemphigus (13%). In the subgroup D, the most common diagnoses were aphthous stomatitis (45.5%) and traumatic injury (18.2%). The mean time before diagnosis was about 2 years. DISCUSSION The most common diagnoses in a specialized OD consultation are: lichen planus, aphthous stomatitis and burning mouth syndrome. The time before diagnosis could be improved by means of more information for practitioners and patients.
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Affiliation(s)
- E Massereau
- Service de chirurgie maxillo-faciale et de stomatologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Service d'odontologie, hôpital de la Timone, 13385 Marseille, France.
| | - R Laurans
- Service de chirurgie maxillo-faciale et de stomatologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; Service de dermatologie, hôpital de la Timone, 13385 Marseille, France
| | - J-M Foletti
- Service de chirurgie maxillo-faciale et de stomatologie, hôpital Nord, chemin des Bourrely, 13015 Marseille, France
| | - A Gallucci
- Service de chirurgie maxillo-faciale et de stomatologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et de stomatologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France
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Gagé J, Gallucci A, Stroumsa R, Foletti JM, Guyot L, Chossegros C. [Transoral coronoidectomy: Technical note]. ACTA ACUST UNITED AC 2015; 116:368-71. [PMID: 26598241 DOI: 10.1016/j.revsto.2015.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/01/2015] [Accepted: 08/19/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Among the skeletal causes of limited mouth opening, uni- or bilateral coronoid process hypertrophy, or Langenbeck disease, is the most frequent. It can be associated with an osteochondroma or a coronoid-malar bone conflict and is then called Jacob disease, an unilateral pathology. Treatment rests on coronoidectomy in both cases. This technique is illustrated via two cases, one Langenbeck and one Jacob disease. TECHNICAL NOTE A transoral approach was performed. After subperiosteal dissection, the coronoid process was cleared. The process was than severed at its base by means of a burr, freed from its temporal muscular fibers and removed. Mouth opening improved peroperatively. The surgical procedure was completed by active long-term physiotherapy beginning immediately after surgery. DISCUSSION Transoral coronoidectomy is a simple, quick and safe procedure. Extra-oral approaches present a high risk of facial nerve injury. In our first case, mouth opening improved from 24 to 36 mm after bilateral coronoidectomy and to 40 mm after physiotherapy. In our second case, mouth opening improved from 22 to 38 mm after unilateral coronoidectomy and to 43 mm after one year physiotherapy. Long-term post-operative physiotherapy is mandatory to get and maintain good results.
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Affiliation(s)
- J Gagé
- Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France.
| | - A Gallucci
- Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - R Stroumsa
- Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
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Adam S, Sama HD, Chossegros C, Bedrune B, Chesnier I, Pradier JP. [Iatrogenic palatine necrosis by embolization of sphenopalatine arteries during management of a rebel epistaxis]. ACTA ACUST UNITED AC 2015; 116:170-2. [PMID: 25975866 DOI: 10.1016/j.revsto.2015.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 03/26/2015] [Accepted: 04/14/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The treatment of epistaxis sometime requires an embolization. This may result in ischemic palate necrosis, oronasal communication and dental losses. The repair of these lesions is complex. OBSERVATION A 53-year-old patient, suffering from high blood pressure and hypercholesterolemia, benefited from bilateral embolization of the sphenopalatine arteries in order to treat a persistent epistaxis. He developed a middle cerebral artery stroke in the aftermath. During the treatment of the neurological sequelae, a necrosis of the 2/3 of the posterior aspect of the hard palate was discovered. The angio-MRI showed an obstruction of both sphenopalatine arteries and of their vascular supplies resulting in a bilateral involvement of the alveolar bone. The diagnosis of iatrogenic palate necrosis was made. Tissue repair was successfully achieved by two loco-regional flaps. The dental rehabilitation was made by mean of a removable prosthesis. DISCUSSION Palatine necrosis following embolization of the sphenopalatine arteries is uncommon. Ischemia resulted in a loss of substance in form of a punch, similar to noma's lesions. It could also be a consequence of the vascular background. The management of these lesions is complex and calls for forensic reflection about the iatrogenic origin.
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Affiliation(s)
- S Adam
- Service de chirurgie maxillo-faciale, chirurgie plastique et stomatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon cedex 9, France; Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - H D Sama
- Service d'anesthésie réanimation, CHU Sylvanus Olympio Lomé, 08 BP8146, Lomé, Togo.
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - B Bedrune
- Service de chirurgie maxillo-faciale, chirurgie plastique et stomatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon cedex 9, France
| | - I Chesnier
- Service de chirurgie maxillo-faciale, chirurgie plastique et stomatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon cedex 9, France
| | - J-P Pradier
- Service de chirurgie maxillo-faciale, chirurgie plastique et stomatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon cedex 9, France
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Garconnet J, Foletti JM, Guyot L, Chossegros C. [Suture of lingual nerve: Technical note]. ACTA ACUST UNITED AC 2015; 116:143-6. [PMID: 25912855 DOI: 10.1016/j.revsto.2015.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/23/2014] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Because of its anatomical position, the lingual nerve may be severed during oral surgical procedures, such as third molar removal. Early suturing of the nerve promotes better recovery. We describe the end-to-end suture of this nerve. OPERATIVE PROCEDURE The suture is carried-out under general anesthesia. The approach is made in the mouth floor, in the same way as for submandibular gland lithiasis transoral removal. This approach allows good exposure and some laxity to displace the nerve stumps. The latter can then be sutured under microscope assistance before closing the mucosa. DISCUSSION Lingual nerve suture is a simple, quick and inexpensive procedure. Unlike other procedures, it cannot be used in case of large loss of substance because of the small amount of laxity of the nerve. Nerve function recovery is better if performed before the 6th post-traumatic month, and in young patients.
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Affiliation(s)
- J Garconnet
- Service de stomatologie et chirurgie maxillofaciale, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J-M Foletti
- Service de chirurgie maxillofaciale et chirurgie plastique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - L Guyot
- Service de chirurgie maxillofaciale et chirurgie plastique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - C Chossegros
- Service de stomatologie et chirurgie maxillofaciale, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Louvrier A, Foletti JM, Guyot L, Chossegros C. [Combined approach of parotid lithiasis. A technical note]. ACTA ACUST UNITED AC 2015; 116:139-42. [PMID: 25841269 DOI: 10.1016/j.revsto.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/18/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sialendoscopy, extracorporeal lithotripsy and transoral removal are the usual treatments for parotid lithiasis. These techniques cannot treat all the patients. In fact, removal of lithiasis bigger than the ductal diameter and situated in the middle or posterior third of the duct may fail with such techniques. For this reason the combined approach has been developed. Our technical note describes this procedure. TECHNICAL NOTE Preoperative check-up needs an ultrasound or a CT scan of the parotid region. The procedure is conducted under general anesthesia. It begins with the localization of the lithiasis with help of the sialendoscope light visible through the skin. A face lift approach is performed giving access to the SMAS that is opened over the lithiasis and the transilluminated area. A window is opened on the duct and the lithiasis is removed. Proximal duct permeability is assessed with the sialendoscope. The different layers are sutured and a suction drainage is left in place. DISCUSSION Combined approach is indicated in case of failure of conservative techniques. It provides good results in removal of lithiasis located in the posterior or middle thirds of the duct. Its morbidity is low. It can avoid performing a parotidectomy and lowers the risk of facial palsy. In case of failure, botulinum toxin injection may be indicated.
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Affiliation(s)
- A Louvrier
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Aix-Marseille université, 13284 Marseille, France
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Vatin L, Lagier A, Legou T, Galant C, Arnaud-Pellet MN, Hadj M, Cheynet F, Chossegros C, Giovanni A. [Dynamic palatography: Diagnostic tool for dysfunctional swallowing? Feasibility study]. Rev Laryngol Otol Rhinol (Bord) 2015; 136:181-184. [PMID: 29400042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Dysfunctional swallowing may cause transverse occlusal disorders. The speech re-education of dysfunctional swallowing aims to correct or prevent the recurrence of occlusal disorders. The main objective was to test the dynamic palatography as a diagnosis and quantification tool of the dysfunctional swallowing. MATERIAL AND METHODS The study was prospective and descriptive. Twelve average 23.5 years old women with a clinical dysfunctional swallowing have been included between January and May 2014. None was aware of presenting an atypical swallowing or dento-facial dysmorphism of class II. The dynamic palatography device measured the pressure force of the language on the palate during the lingual rest, swallowing saliva and water. Parameters measured were the duration and magnitude of support of the tongue on the palate. RESULTS Dynamic palatography showed a trend to predominant anterior contact during rest position (25%), and lower position of the language with little contact during swallowing of saliva and water. DISCUSSION Palatography results are consistent with the clinical diagnostic criteria of atypical swallowing. Our palatography tool has the advantage of being unobtrusive in the mouth compared to other pre existing systems. This device should be tested on larger patient populations and could enable monitore atypical swallowing rehabilitation efficiency. The palatography could complete the swallowing assessment and be a monitoring and rehabilitation tool in real time.
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Graillon N, Gallucci A, Foletti JM, Guyot L, Chossegros C. [Intermaxillary fixation screws--complications]. ACTA ACUST UNITED AC 2014; 115:329-30. [PMID: 25454287 DOI: 10.1016/j.revsto.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 10/24/2022]
Affiliation(s)
- N Graillon
- Clinique de stomatologie et chirurgie maxilla-faciale, CHU de la Timone, boulevard J.-Moulin, 13385 Marseille cedex 5, France.
| | - A Gallucci
- Clinique de stomatologie et chirurgie maxilla-faciale, CHU de la Timone, boulevard J.-Moulin, 13385 Marseille cedex 5, France
| | - J M Foletti
- Service de stomatologie, chirurgie maxillo-faciale et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - L Guyot
- Service de stomatologie, chirurgie maxillo-faciale et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Clinique de stomatologie et chirurgie maxilla-faciale, CHU de la Timone, boulevard J.-Moulin, 13385 Marseille cedex 5, France
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Hadj Saïd M, Stroumsa R, Foletti JM, Chossegros C. [An unusual case of gingival hyperplasia]. ACTA ACUST UNITED AC 2014; 115:e39-40. [PMID: 25001549 DOI: 10.1016/j.revsto.2014.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 03/28/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
Affiliation(s)
- M Hadj Saïd
- Aix-Marseille université, 13284 Marseille, France; Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - R Stroumsa
- Aix-Marseille université, 13284 Marseille, France; Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - J-M Foletti
- Aix-Marseille université, 13284 Marseille, France; Service de stomatologie et de chirurgie maxillo-faciale, CHU Nord, APHM, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - C Chossegros
- Aix-Marseille université, 13284 Marseille, France; Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Desmots F, Chossegros C, Salles F, Gallucci A, Moulin G, Varoquaux A. Lithotripsy for salivary stones with prospective US assessment on our first 25 consecutive patients. J Craniomaxillofac Surg 2014; 42:577-82. [DOI: 10.1016/j.jcms.2013.07.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 04/09/2013] [Accepted: 07/17/2013] [Indexed: 11/29/2022] Open
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Pascual D, Roig R, Chossegros C. [Bone graft reconstruction for posterior mandibular segment using the formwork technique]. ACTA ACUST UNITED AC 2014; 115:105-10. [PMID: 24674931 DOI: 10.1016/j.revsto.2014.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 06/18/2013] [Accepted: 01/09/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Pre-implant bone graft in posterior mandibular segments is difficult because of masticatory and lingual mechanical constraints, because of the limited bone vascularization, and because of the difficulty to cover it with the mucosa. The formwork technique is especially well adapted to this topography. TECHNICAL NOTE The recipient site is abraded with a drill. Grooves are created to receive and stabilize the grafts. The bone grafts were harvested from the ramus. The thinned cortices are assembled in a formwork and synthesized by mini-plates. The gaps are filled by bone powder collected during bone harvesting. DISCUSSION The bone volume reconstructed with the formwork technique allows anchoring implants more than 8mm long. The proximity of the inferior alveolar nerve does not contra indicate this technique. The formwork size and its positioning on the alveolar crest can be adapted to prosthetic requirements by using osteosynthesis plates. The lateral implant walls are supported by the formwork cortices; the implant apex is anchored on the native alveolar crest. The primary stability of implants is high, and the torque is important. The ramus harvesting decreases operative risks.
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Affiliation(s)
- D Pascual
- Service de chirurgie maxillo-faciale et stomatologie du Pr Blanc, centre hospitalier La-Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - R Roig
- 13, boulevard Lord-Duveen, 13008 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie du Pr Blanc, centre hospitalier La-Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Guyot L, Dumont N, Foletti J, Thiery G, Chossegros C. Description and evaluation of post-operative orbital hematomas after surgical orbital procedures. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bertrand B, Foletti JM, Bruneau S, Stroumsa R, Mancini J, Guyot L, Chossegros C. [Comparison between Polyglactin 910 (Vicryl®) versus irradiated Polyglactin 910 (rapid Vicryl®) for mucosal suture after wisdom teeth avulsion]. ACTA ACUST UNITED AC 2013; 114:63-6. [PMID: 23838242 DOI: 10.1016/j.revsto.2012.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 12/16/2012] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Two different types of suture are used in our unit after wisdom tooth extraction, Polyglactin 910 [PGS] (Vicryl®, Ethicon) and rapid absorption irradiated Polyglactin 910 [PGI]. No objective comparative study was available so we decided to conduct a preliminary prospective study to check if there was any difference between these two types of suture. PATIENTS AND METHODS Forty patients were included in our study, consecutively operated for impacted wisdom teeth by the same surgeons, between April and June 2010. The symmetry of impaction was systematically controlled on panoramic views before including a patient in the study. PGS and PGI were both used for every patient, PGS on one side and PGI on the other. The "right or left" PGS-PGI distribution was randomized and double-blinded. The patient was his own control. Thirty-two patients were examined at the postoperative consultation, during which an evaluation questionnaire was completed with the surgeon. Pain, difficulty to chew, duration of swelling, dysgeusia, and major complications (inflammation, disunion, infection) were analyzed. RESULTS The statistical analysis revealed that postoperative pain was greater on the PGS side (VAS=3.7) than on the PGI side (VAS=2.8) without any significant difference. The duration of swelling was significantly higher on the PGS side (5.5days) than on the PGI side (3.1days). Coming back to normal food intake did not seem different; it was not interrupted. PGI also significantly reduced the difficulty to chew and dysgeusia. There was no difference in complications between PGS and PGI. DISCUSSION This study proved the superiority of PGI over PGS during the three postoperative weeks after extraction of wisdom teeth, in terms of comfort and edema.
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Affiliation(s)
- B Bertrand
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264 rue Saint-Pierre, Marseille cedex 5, France.
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Lari N, Salles F, Thiery G, Chossegros C, Guyot L. [Total nasal reconstruction with a titanium miniplate as structural support]. ACTA ACUST UNITED AC 2013; 114:4-8. [PMID: 23711210 DOI: 10.1016/j.revsto.2012.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/26/2012] [Accepted: 12/21/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Total nasal reconstructions using bone graft, as structural support is the gold standard. We retrospectively studied an alternative technique relying on a titanium miniplate as a structural support. PATIENTS AND METHODS Five patients underwent total nasal reconstruction, using a 1mm titanium miniplate fixed to the frontal bone and to the anterior maxilla. The miniplate was covered by a fascia lata graft in three cases. The functional and aesthetic results were evaluated on a scale from 0 (disappointing results) to 3 (excellent results) by the patient and by the surgeon, at 1 month and at 3 years after the total nasal reconstruction. RESULTS The functional results were assessed on average at 2.2/3 at 1 month, and 2.4/3 at 3 years postoperatively. The aesthetic results are estimated at 2 (patient) and 1.8 (medical team) at 1 month and at 2.6 (patient) and 2.2 (medical team) at 3 years. There were no major complications. The minor complications were exposure of the two miniplates, which had not been covered with fascia lata. These complications were resolved by local surgery. DISCUSSION The functional and aesthetic results of total nasal reconstruction relying on a titanium miniplate were similar to those obtained with a bone graft. This technique is simple, there is no need for an osseous donor site, it is stable at long-term, and its cost is moderate.
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Affiliation(s)
- N Lari
- Service de chirurgie maxillofaciale, chirurgie plastique et stomatologie, hôpital Nord, chemin des Bourrely, 13915 Marseille, France
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Pascual D, Dumont N, Breton P, Cheynet F, Chossegros C. [Modelization of bone graft reconstruction for posterior mandibular segment using the Simplant® software]. ACTA ACUST UNITED AC 2012; 113:108-14. [PMID: 22398191 DOI: 10.1016/j.stomax.2012.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 07/04/2011] [Accepted: 01/13/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Pre-implant reconstruction techniques of edentulous molar mandibular ridges take into account the height and the width of the initial ridge, but not the initial geometry. The Simplant(®) software allows modeling these techniques by taking into account this geometry. TECHNICAL NOTE Four surgical techniques for crestal volume reconstruction (apposition, interposition, distraction, formwork) were used on seven hemi-mandibles and modeled with the Simplant(®) software. This reconstructed volume was visualized according to the initial crestal geometry. The average gain in height was 4.1mm for the onlay graft, 2.3mm for the interposition graft, 4mm for distraction, 5.1mm for the boxing. The average gain of crestal width was -0.3mm for the onlay graft, 1mm for the interposition, -0.5mm for the distraction, and 1.3mm for the boxing. DISCUSSION Modeling with the Simplant(®) software shows that boxing technique gives the closest bone reconstruction to the ideal crestal geometry, whatever the initial crestal geometry.
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Affiliation(s)
- D Pascual
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, Marseille, France.
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Varoquaux A, Larribe M, Chossegros C, Cassagneau P, Salles F, Moulin G. [Cone beam 3D sialography: preliminary study]. ACTA ACUST UNITED AC 2011; 112:293-9. [PMID: 21981976 DOI: 10.1016/j.stomax.2011.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 03/14/2011] [Accepted: 08/19/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Stones, stenosis and inflammatory lesions are the main causes of mealtime syndrome. The aim of paraclinical exam is to find the cause of these obstructive symptoms. Ultrasound is often sufficient to confirm the lithiasic origin of salivary gland swelling. Non-lithiasic salivary obstructions are more difficult to diagnose. We studied the feasibility and quality of a new medical imaging device: three-dimensional (3D) sialography using the technique of cone beam with flat panel (CPCT). PATIENTS AND METHODS Five patients were included, referred for diagnostic management of non-lithiasic salivary gland parotid colic. It was performed for each patient in the angiography room, conventional sialography and 3D CPCT. Images were compared to conventional sialography. RESULTS None of catheterization failure or side effects were observed in five patients. 3D CPCT sialography enabled to view gland ducts until their fifth or sixth division. Compared to conventional sialography, 3D CPCT improves signal and contrast to noise ratio. DISCUSSION This technique allows an anatomic resolution and signal/noise ratio unmatched. It also allows to reduce metallics artefacts. Its main drawback is those associated with ductal catheterization, exposure to ionizing radiation and potential allergy to iodinated contrast agents.
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Affiliation(s)
- A Varoquaux
- Services de radiologie et de chirurgie maxillofaciale, CHU de la Timone, 264 rue Saint-Pierre, Marseille cedex 5, France.
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