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Bach E, Sigaux N, Fauvernier M, Cousin AS. Reasons for failure of total temporomandibular joint replacement: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 51:1059-1068. [PMID: 35012826 DOI: 10.1016/j.ijom.2021.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 07/29/2021] [Revised: 10/10/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the revision rate after total alloplastic temporomandibular joint replacement (TMJR) and determine whether there is a higher risk of revision surgery with stock or custom-fitted prostheses (the two most current TMJR prosthesis types). A systematic review was performed, with a search of PubMed, Google Scholar, and the Cochrane Library in November 2020. Overall, 27 articles were included in this study, describing Biomet and TMJ Concepts prostheses and including postoperative data on complications requiring a return to the operating room. A total of 2247 prostheses were analysed: 1350 stock Biomet prostheses and 897 custom-fitted TMJ Concepts and custom-fitted Biomet prostheses. The global revision rate was 1.19 per 100 prosthesis-years. The most common reason for revision was heterotopic bone formation. Stock prostheses appeared to have a lower risk of revision compared to custom prostheses: rate ratio 0.52 (95% confidence interval 0.33-0.81, P-value 0.003). Regarding causes of revision, the only significant difference between the types of devices was a higher rate of heterotopic bone formation for custom-made prostheses (P = 0.001). The results of this study revealed a low revision rate post TMJR revision, with stock devices even less prone to such risk. Nevertheless, these results can be explained by the fact that custom-made prostheses are more likely to be used for cases in which the anatomy is significantly abnormal or there is a history of multiple joint surgeries, which carry a greater risk of complications and heterotopic bone formation.
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Affiliation(s)
- E Bach
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
| | - M Fauvernier
- Department of Biostatistics, Lyon Sud Hospital, University of Lyon 1, Lyon, France
| | - A-S Cousin
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
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2
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Cordier G, Sigaux N, Rasteau S, Ibrahim B, Cresseaux P. Long-term stability of basilar mandible osteotomy: Chin Wing. J Stomatol Oral Maxillofac Surg 2021; 123:337-344. [PMID: 34260981 DOI: 10.1016/j.jormas.2021.07.003] [Citation(s) in RCA: 1] [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: 05/20/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
The Chin Wing is a modified genioplasty extended along the basilar border and the angles of the mandible. This technique may be a better choice than standard genioplasty for correction of lip incompetence, retrogenia and high angle position associated with hyperdivergent cases. Our objective was to analyse the overall movement realized during surgery and the long-term stability of this procedure. Ten patients underwent a Chin Wing surgery from June 2018 to August 2019. All patients were operated on by the same surgeon. We performed a preoperative (PO), an immediate postoperative (POI), and an over 6 months postoperative (PO6) Cone Beam Computed Tomography (CBCT) for every patient. 3D reconstructions were performed for each CBCT with Proplan software. We were thus able to determine by subtractions acquired and resorbed bone volume. Some section plans were chosen in order to perform 2D measurements. The CBCT volume comparisons reveal a gain of 7.6cc between the PO and the POI, for a bone resorption of 2.5cc between POI and PO6 (33% of the volume gained). In 2D evaluation, we observe an average resorption of 1.7 mm corresponding to approximately 20% of the height gained, at the level of the mandibular angle. Given the low bone resorption we can consider Chin Wing stable over time. The important quantity of mobilized bone and the basilar rotational movement may explain over-standing aesthetic and functional outcome, compared to classical genioplasty.
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Affiliation(s)
- G Cordier
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France
| | - S Rasteau
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France
| | - B Ibrahim
- Department of surgery ORL-CCF, Faculty of Medicine, Univeristé de Montreal, Quebec, Canada
| | - P Cresseaux
- Chirurgie Maxillo-Faciale, Hôpital Privé Jean Mermoz, Lyon, France.
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Caruhel JB, Sigaux N, Crambert A, Donat N, Boddaert G, Haen P, Hoffmann C. Military gas mask to protect surgeons when performing tracheotomies on patients with COVID-19. BMJ Mil Health 2021; 167:214. [PMID: 32753542 PMCID: PMC7409952 DOI: 10.1136/bmjmilitary-2020-001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Jean-Baptiste Caruhel
- Maxillo-facial, Head and Neck Surgery Department, Hopital d'Instruction des Armees Percy, Clamart, France
| | - N Sigaux
- Maxillo-Facial Surgery Department, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - A Crambert
- Maxillo-facial, Head and Neck Surgery Department, Hopital d'Instruction des Armees Percy, Clamart, France
| | - N Donat
- Intensive Care Unit and Burn Center, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
| | - G Boddaert
- Department of Thoracic and Vascular Surgery, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
| | - P Haen
- Maxillo-Facial Surgery Department, Hopital d'Instruction des Armees Laveran, Marseille, Provence-Alpes-Côte d'Azur, France
| | - C Hoffmann
- Intensive Care Unit and Burn Center, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
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de Boutray M, Kün-Darbois JD, Sigaux N, Lutz JC, Veyssiere A, Sesque A, Savoldelli C, Dakpe S, Bertin H, Lallemant B, Llobet A, du Cailar M, Lauwers F, Davrou J, Foletti JM. Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study. Int J Oral Maxillofac Surg 2020; 50:750-755. [PMID: 33172710 PMCID: PMC7648505 DOI: 10.1016/j.ijom.2020.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/20/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
Abstract
The coronavirus disease 2019 (COVID-19) outbreak has had a major impact on medical and surgical activities. A decline in facial trauma incidence was noticed during the lockdown period. The aim of this study was to evaluate the decline in maxillofacial trauma in France during this particular period. A retrospective multicentre comparative study was initiated in 13 major French public hospital centres. The incidence of facial trauma requiring surgery during the first month of lockdown was compared to that during equivalent periods in 2018 and 2019. Differences in the types of trauma were also analysed. Thirteen maxillofacial departments participated in the study. A significant decline in maxillofacial trauma volumes was observed when compared to equivalent periods in 2018 and 2019 (106 patients compared to 318 and 296 patients, respectively), with an average reduction of 65.5% (P = 0.00087). The proportion of trauma due to sports and leisure was reduced when compared to reports in the literature. As a consequence, in the context of a pandemic, the material and human resources related to this activity could be reallocated to the management of other pathologies that cannot be postponed.
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Affiliation(s)
- M de Boutray
- Department of Maxillofacial Surgery, Gui de Chauliac University Hospital Centre, Montpellier University, Montpellier, France.
| | - J-D Kün-Darbois
- Department of Maxillofacial and Oral Surgery, Angers University Hospital, Angers, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital Centre, Hospices Civils de Lyon, Pierre-Benite, France.
| | - J-C Lutz
- Department of Maxillofacial Surgery and Stomatology, Strasbourg University Hospital Centre, Strasbourg, France.
| | - A Veyssiere
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France.
| | - A Sesque
- Oral and Maxillofacial Surgery Department, Estaing University Hospital, Clermont Ferrand, France.
| | - C Savoldelli
- Head and Neck University Institute, Nice University Hospital, Nice, France.
| | - S Dakpe
- Department of Maxillofacial Surgery, Amiens University Hospital Centre, Amiens, France; UR CHIMERE 7516, Picardie Jules Verne University, Amiens, France.
| | - H Bertin
- Department of Oral and Maxillofacial Surgery, Nantes University Hospital, Nantes, France.
| | - B Lallemant
- Department of Head and Neck Surgery, University Hospital Centre of Nîmes, Nîmes, France.
| | - A Llobet
- Department of Maxillofacial and Oral Surgery, Perpignan Hospital Centre, Perpignan, France.
| | - M du Cailar
- Maxillofacial Surgery Unit, Purpan University Hospital, Toulouse, France.
| | - F Lauwers
- Maxillofacial Surgery Unit, Purpan University Hospital, Toulouse, France.
| | - J Davrou
- Department of Maxillofacial Surgery and Stomatology, La Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.
| | - J-M Foletti
- Aix Marseille University, APHM, IFSTTAR, LBA, La Conception University Hospital, Department of Maxillofacial Surgery, Marseille, France.
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Lacagne AS, Brumpt E, Barrabé A, Pomero E, Chatelain B, Grillet F, Weber E, Malakhia A, Pons M, Aubry S, Meyer C, Sigaux N, Louvrier A. Diagnostic performance of mobile cone beam computed tomography versus conventional multi-detector computed tomography in orbital floor fractures: a study on human specimens. Int J Oral Maxillofac Surg 2020; 50:205-211. [PMID: 32921556 DOI: 10.1016/j.ijom.2020.08.011] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the diagnostic accuracy of mobile cone beam computed tomography (MCBCT) versus multi-detector computed tomography (MDCT) in orbital floor fractures. Twenty-four fresh cadaver heads were used, and one orbital floor was fractured for each head by transconjunctival approach. MDCT and MCBCT were performed on each of the heads. The images obtained were then analysed independently by eight evaluators. The radiological characteristics of the orbital floor fractures were visualized with good interpretation agreement between the two images. The location of the fracture and enophthalmos were identified in a comparable manner with strong agreement (κ=0.93 and κ=0.85, respectively). Measurements of fatty hernias and bone defects showed a strong correlation between the two imaging modalities (Pearson coefficient between 0.64 and 0.71 and between 0.67 and 0.71, respectively). The fracture limits and the presence of bone fragments, an intrasinus fatty hernia, and a fracture of the associated medial orbital wall were visualized in both examinations with good agreement (κ=0.68, κ=0.51, κ=0.57, and κ=0.46, respectively). The soft tissue study showed superiority for MDCT, with a κ<0.0009. MCBCT showed good diagnostic performance in the study of orbital floor fracture characteristics.
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Affiliation(s)
- A S Lacagne
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France.
| | - E Brumpt
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Pomero
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - F Grillet
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Malakhia
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - M Pons
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
| | - S Aubry
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - N Sigaux
- Hospices Civils de Lyon, University Claude Bernard Lyon 1, Maxillofacial and Stomatology, Lyon-Sud Hospital Centre, Pierre-Benite, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
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6
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Cordier G, Sigaux N, Giai J, Ibrahim B, Cresseaux P. Assessing the incidence of nerve injuries according to different mandibular osteotomies including Wing osteotomies. Journal of Stomatology, Oral and Maxillofacial Surgery 2020; 122:472-476. [DOI: 10.1016/j.jormas.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/23/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
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7
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Devoti JF, Sigaux N, Zirganos N, Meyer C, Louvrier A. A maxillary tumor with an atypical radiological presentation. J Stomatol Oral Maxillofac Surg 2020; 122:219-220. [PMID: 32659409 DOI: 10.1016/j.jormas.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Affiliation(s)
- J-F Devoti
- Department of plastic and maxillofacial surgery, Central hospital, CHRU Nancy, 54000 Nancy, France; Department of oral and maxillofacial surgery, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - N Sigaux
- Hospices civils de Lyon, Claude-Bernard Lyon 1 University, 69310 Pierre-Bénite, France
| | - N Zirganos
- Department of pathology, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Department of oral and maxillofacial surgery, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine lab imagery and therapeutics (EA 4662), university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - A Louvrier
- Nanomedicine lab imagery and therapeutics (EA 4662), university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; Host-graft interactions lab - tumor - cell and tissue engineering (UMR 1098 Inserm/UFC/EFS), university of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France.
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Gagnieur P, Rasteau S, Caruhel JB, Louvrier A, Sigaux N. De l’histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 4 : la rhinoplastie. ANN CHIR PLAST ESTH 2020; 65:271-276. [PMID: 32595064 DOI: 10.1016/j.anplas.2020.05.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022]
Abstract
Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This fourth original article will focus on the inventors of rhinoplasty instruments: Joseph, Killian, Aufricht, Cottle and Claoué.
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Affiliation(s)
- P Gagnieur
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - S Rasteau
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - J B Caruhel
- Chirurgie maxillo-faciale, hôpital universitaire Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Louvrier
- Chirurgie maxillo-faciale et stomatologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France
| | - N Sigaux
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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9
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Assouline SL, Meyer C, Weber E, Chatelain B, Barrabe A, Sigaux N, Louvrier A. How useful is intraoperative cone beam computed tomography in maxillofacial surgery? An overview of the current literature. Int J Oral Maxillofac Surg 2020; 50:198-204. [PMID: 32605822 DOI: 10.1016/j.ijom.2020.05.006] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Intraoperative imaging is increasingly used by surgeons and has become an integral part of many surgical procedures. This study was performed to provide an overview of the current literature on the intraoperative use of cone beam computed tomography (CBCT) imaging in maxillofacial surgery. A bibliographic search of PubMed was conducted in March 2020, without time limitation, using "intraoperative imaging" AND "maxillofacial surgery" AND "cone beam computed tomography" as key words. Ninety-one articles were found; after complete reading, 16 articles met the eligibility criteria and were analysed. The results showed that the majority of the indications were related to maxillofacial trauma, particularly zygomaticomaxillary complex fractures. Final verification with intraoperative CBCT before wound closure was the most common use of this device. However, innovative uses of intraoperative CBCT are expanding, such as CBCT coupling with mirror computational planning, and even the combined use of initial intraoperative CBCT acquisition with navigation. Immediate, fast, and easy evaluation of bone repositioning to avoid the need for further surgical revision is the main advantage of this technique. Imaging quality is comparable to that of multi-slice computed tomography, but with lower radiation exposure. Nevertheless, CBCT is still not widely available in maxillofacial centres, probably because of its cost, and perhaps because not everyone is aware of its advantages and versatility, which are reported in this review.
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Affiliation(s)
- S L Assouline
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Department of Oral and Maxillofacial Surgery, University Hospital of Strasbourg, Strasbourg, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; NanomedicineLab, Imagery and Therapeutics, EA 4662, Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Barrabe
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre-Bénite, France; 3d.FAB platform, ICBMS, CNRS 5246 Claude-Bernard Lyon 1 University, Villeurbanne, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; University of Bourgogne Franche- Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon- Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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10
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Pons M, Lutz JC, Sigaux N, Tavernier L, Graillon N, Louvrier A. Surgical reconstruction of the foramen tympanicum: What is known and how we do it. J Stomatol Oral Maxillofac Surg 2020; 121:545-549. [PMID: 32360752 DOI: 10.1016/j.jormas.2020.04.005] [Citation(s) in RCA: 3] [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: 04/02/2020] [Accepted: 04/20/2020] [Indexed: 11/17/2022]
Abstract
Defects affecting the anterior wall of the tympanal bone can result from trauma, infection, neoplasm or previous local surgery. An anatomic variation, namely the persistence of the foramen tympanicum, can also be encountered. When symptomatic, surgical reconstruction may be indicated. The aim of this study was to identify the surgical treatments of symptomatic foramen tympanicum found in the literature and detail our innovative reconstruction technique. A bibliographic research was conducted in PubMed database in March 2020, without time limitation. Papers dealing with surgical management of a foramen tympanicum were included. Data collected were the publication date, the number of patients, their age and gender, the symptoms and the surgical treatment performed. We report, in addition, the case of a symptomatic persistent foramen tympanicum in a 30-year-old man with a follow-up of 18-months. A total of 17 studies (n=23 patients) were included for analysis. The main reconstruction techniques were, in equal proportion, cartilage graft (30%) and insertion of a titanium mesh (30%). We carried out an iliac crest bone graft using a preauricular approach on a patient suffering from chronic tinnitus and fullness in the left ear resulting from a persistent foramen tympanicum, confirmed by clinical and radiological examinations. It allowed the complete resolution of symptoms and no complication such as temporomandibular ankylosis occurred. Based on the review of the literature, we believe this technique has the advantage of providing durable reconstruction thanks to osseointegration.
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Affiliation(s)
- M Pons
- Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, University of Bourgogne Franche-Comté, Besançon, France.
| | - J-C Lutz
- Inserm, Regenerative Nanomedicine Laboratory, UMR 1260, Laboratory of Engineering Science, Computer Science and Imaging, CNRS, Department of Maxillofacial and Plastic Surgery, Faculty of Medicine, ICUBE University of Strasbourg, University Hospital and UFR Medicine of Strasbourg, Strasbourg, France.
| | - N Sigaux
- Department of Maxillofacial and Stomatology, Lyon-Sud Hospital Center, Pierre-Bénite, France.
| | - L Tavernier
- Otorhinolaryngology, University Hospital of Besançon, Besançon, France.
| | - N Graillon
- IFSTTAR, LBA UMR T24, Department of Oral and Maxillofacial Surgery, Aix-Marseille University, CHU Conception, AP-HM, Marseille, France.
| | - A Louvrier
- Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Department of Oral and Maxillofacial Surgery, Medical Faculty, University of Franche-Comté, University Hospital of Besançon, Besançon, France.
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11
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Quenot J, Sigaux N, Hugot E, Meyer C, Louvrier A. Gingival Mucosa-Associated Lymphoid Tissue (MALT) lymphoma developed around a mandibular extraosseous dental root canal overfilling: A case report. J Stomatol Oral Maxillofac Surg 2020; 121:743-745. [PMID: 32360488 DOI: 10.1016/j.jormas.2020.04.007] [Citation(s) in RCA: 1] [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: 03/24/2020] [Accepted: 04/22/2020] [Indexed: 11/25/2022]
Abstract
Lymphomas are rare pathologies in the oral cavity, representing only 3.5% of malignant tumors. Their typical topography is Waldeyer's lymphatic ring and approximately 8% of all non-Hodgkin lymphomas are mucosa associated lymphoid tissue (MALT) lymphomas. The authors report a rare case of mandibular gingival MALT lymphoma, which developed around an extraosseous dental root canal overfill. This atypical, case of lymphoma indicates that practitioners have to be vigilant and perform a biopsy every time they are confronted with a suspicious chronic lesion in the oral cavity.
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Affiliation(s)
- J Quenot
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - N Sigaux
- Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - E Hugot
- Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; Host-Graft Interactions Lab-Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France
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Louvrier A, Barrabé A, Weber E, Chatelain B, Sigaux N, Meyer C. The high sub-mandibular approach: Our experience about 496 procedures. J Stomatol Oral Maxillofac Surg 2020; 121:626-633. [PMID: 32205300 DOI: 10.1016/j.jormas.2020.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The potential drawbacks of surgical approaches to neck and base fractures of the mandibular condyle (visible scare, facial nerve injury) are still considered by many surgeons as a brake for open reduction and internal fixation. The aim of our study was to analyze the results in terms of access, scare quality and complications that could be noticed in a 12 years period of time with the use of the high sub-mandibular approach (HSMA) we first described in 2006 for the surgical treatment of neck and base fractures. MATERIAL AND METHOD All the files of patients operated on for condylar neck and base fractures approached by mean of a HSMA between January 2006 and December 2018 in our department and containing information concerning age, sex, type of fracture, kind of osteosynthesis material, operating time, name of the surgeon, postoperative complication linked to the approach, scare quality at 6 months follow-up at least were included. The skin incision and the dissection planes followed the original publication of Meyer et al. in 2006. RESULTS 434 patients (sex ratio: 2.06, mean age: 32, 496 approaches) met the inclusion criteria. Following the AO classification, 21.2% of the fractures were classified as neck fractures and 78.8% as base fractures. 97.6% of all fractures were stabilized by mean of a 3D plate (TCP® plate, Medartis, Basel-CH), the remaining ones by mean of a combination of 1.2, 1.5 and 2.0 straight plates. Mean operating time was 40minutes per side. Patients were operated on by senior surgeons in 71.7% of the cases and by trainees under supervision for the others. Concerning the complications linked to the approach, we noticed 11 (2.2%) temporary (0 definitive) paresis of the facial nerve, 1 (0.2%) hematoma and 1 (0.2%) abscess that both needed revision. Scare was hypertrophic or considered as unaesthetic by the patient in 5 cases (1%). DISCUSSION The HSMA, if performed as initially described, is a safe and quick procedure compared to other cutaneous approaches. It gives access to all base fractures and to most of neck fractures. The very low rate of facial nerve complications is mainly explained by the plane by plane dissection making it very easy to avoid the facial nerve branches or to check them when encountered. The HSMA is particularly suited to the use of TCP plates as the upper holes of these plates, placed horizontally, are easy to reach from below. The HSMA is therefore still our preferred cutaneous approach to the condylar process.
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Affiliation(s)
- A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Host-Graft Interactions Lab-Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France.
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - N Sigaux
- Department of Maxillofacial Surgery and Plastic Facial Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 69310 Pierre-Bénite, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France.
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Ibrahim B, Guillemaud A, Sigaux N, Pouzet C, Gormand F, Bouletreau P. The sleep board: impact of a multidisciplinary assessment model in CPAP failing OSA patients. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.455] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cordier G, Sigaux N, Ibrahim B, Cresseaux P. The intermediate length BSSO: Finding the balance between the classical and short designs. J Stomatol Oral Maxillofac Surg 2019; 121:70-73. [PMID: 31479765 DOI: 10.1016/j.jormas.2019.08.003] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/25/2019] [Indexed: 11/17/2022]
Abstract
Bilateral Sagittal Split Osteotomy (BSSO) is performed in orthognathic surgery to treat cases of dento-skeletal malformation. We present a shorter BSSO variant that allows for the realization of all orthognathic movements. This line respects the basilar rim and allows to modify the position of the mandibular angles. The splitting is more natural, separating the mandible into two anatomical subunits: the rising branch and the horizontal branch. This variant layout may also be associated with Chin Wing genioplasty.
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Affiliation(s)
- G Cordier
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - B Ibrahim
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - P Cresseaux
- Chirurgie Maxillo-Faciale, Hôpital Privé Jean Mermoz, 55, avenue Jean Mermoz, 69008 Lyon, France.
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Sigaux N, Pourchet L, Breton P, Brosset S, Louvrier A, Marquette CA. 3D Bioprinting:principles, fantasies and prospects. Journal of Stomatology, Oral and Maxillofacial Surgery 2019; 120:128-132. [DOI: 10.1016/j.jormas.2018.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/12/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022]
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Chauvel-Picard J, Pierrefeu A, Harou O, Breton P, Sigaux N. Unusual cystic lesion of the eyebrow: A case report of malignant chondroid syringoma. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:232-235. [DOI: 10.1016/j.jormas.2018.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/14/2018] [Indexed: 10/18/2022]
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Barrabé A, Meyer C, Bonomi H, Weber E, Sigaux N, Louvrier A. Surgically assisted rapid palatal expansion in class III malocclusion: Our experience. J Stomatol Oral Maxillofac Surg 2018; 119:384-388. [PMID: 29753777 DOI: 10.1016/j.jormas.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 05/06/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Maxillary transverse deficiency (MTD) is a common facial disharmony that may need surgical assisted rapid palatal expansion (SARPE). The aim of this study was to present our SARPE technique and to report about our experience. MATERIEL AND METHOD Medical records of all class III patients who underwent SARPE in our department from 2010 to 2015 and for whom a follow-up of at least 1year was available, were included in a retrospective study. The technique consisted, after short orthodontic preparation allowing for divergence of the upper central incisors, in a complete Le Fort I osteotomy without down fracture, and medial sagittal submucosal separation of the hard palate under general anesthesia in an inpatient procedure. Teeth-supported distracters were sealed preoperatively while bone-supported devices were inserted peroperatively. Activation of the distracter was allowed from day 2 at the rate of 2×0.25 per day during 4days and 2×0.5mm per day the following days. Distracters were left in place for about 4months. Orthodontic treatment resumption was allowed from the second month. The initial malocclusion, the amount and type (parallel or angular) of distraction that was needed, the type of distracter used, the amount of distraction obtained, the per- and postoperative complications and the clinical stability of the end result were analyzed. RESULTS The records of 23 patients (18 women, 5 men - average age: 25.4years, extremes: 16-55years) could be included. MTD was isolated in 6 cases, associated with a maxillary retrognathism in 5 cases, with a mandibular prognathism in 6 cases, and with both in 6 cases. The average amount of distraction needed was 7.2mm (range: 4-12), parallel in 20 cases and angular in 3 cases. The distracters were bone-supported (Rapid Palatal Expander®, KLS Martin Group, Tuttlingen, Germany) in 3 patients and custom-made tooth-supported in 20 patients. The average amount of distraction obtained at the level of the distracter cylinder was 7.7mm (range: 5-13). We noted 2 cases of palatal fibromucosa perforations, 1 case of posterior excess of distraction, 1 case of nasal septum deviation, 1 case of iatrogenic necrosis of tooth No.°11, 1 case of naso-genial sulcus hematoma, 1 case of intraoperative mobility of tooth No.°21, 5 cases of asymmetric distraction. Seventeen patients needed a second orthognathic procedure and 22 had stable Class I occlusion after removal of appliances at 18 months follow-up on average. DISCUSSION SARPE is a quite safe procedure that allows for transverse coordination without dental extraction. Transverse discrepancies greater than 4mm are for us clear indications for SARPE. When a sagittal discrepancy is associated, we prefer performing SARPE first and correcting the sagittal plane in a second operation. The recent development of Le Fort I sliding osteosynthesis plates opens the way to one time correction and the development of double-action distracters fitted out with 2 cylinders will be helpful for performing angular distractions.
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Affiliation(s)
- A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics, EA 4662, UFR Sciences et Techniques, University of Franche-Comté Route de Gray, 25030 Besançon cedex, France
| | - H Bonomi
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; Department of orthodontics, Dental School, Univeristy Hospital of Strasbourg, 67091 Strasbourg, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - N Sigaux
- Department of Maxillofacial, Plastic, Reconstructive and Esthetic Surgery, Lyon-Sud University Hospital, 69495 Lyon, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
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Séblain D, Bourlet J, Sigaux N, Khonsari RH, Chauvel Picard J, Gleizal A. Minimally invasive versus standard approach in LeFort 1 osteotomy in patients with history of cleft lip and palate. J Stomatol Oral Maxillofac Surg 2018; 119:187-191. [PMID: 29408322 DOI: 10.1016/j.jormas.2018.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/09/2018] [Accepted: 01/29/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Compare literature-reported efficiency and complications of the standard maxillary advancement surgery with those of a minimally invasive mucosal approach in patients with CL/P requiring Le Fort 1 osteotomy. DESIGN Meta-analysis vs. retrospective analysis of 18 consecutive cases. SETTING Department of maxillofacial surgery at a tertiary-level public general hospital. PARTICIPANTS The meta-analysis encompassed Medline, Embase and Cochrane, years 1990 to 2014, inclusive. The local series concerned all squeletally mature adolescents with non-syndromic CL/P who underwent orthognathic surgery between 30 April 2004 and 27 January 2012. INTERVENTIONS Minimally invasive approach and perioperative orthodontics including intermaxillary fixation for 3 months after surgery. MAIN OUTCOME MEASURE(S) Assessment of complications. Standard lateral cephalograms were taken before surgery, then <1 week and 12 months after surgery. Delaire's cephalometric analysis was performed and the position of the maxilla was recorded. RESULTS There were no significant differences between the literature and our series regarding sex and type of deformity (P=0.634 and 0.779, respectively). The mean horizontal and vertical relapse rates were 0.61 and 1.17mm (vs. 1.29 and 1.48mm in the meta-analysis) and the overall complication rate was 22.2% (vs. 12.76% but P=0.271). There was a significant difference regarding the palatal fistula rate (0 here vs. 21.43% in meta-analysis, P=0.028). CONCLUSIONS The minimally invasive approach showed trends toward less relapse and less complications than conventional approaches. This technique seems adapted to the management of patients with CL/P sequelae. Other benefiting groups are underway.
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Affiliation(s)
- D Séblain
- Service de chirurgie maxillofaciale, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Service de chirurgie maxillofaciale, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, bouleverd Pinel, 69677 Bron, France.
| | - J Bourlet
- Service de chirurgie maxillofaciale, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Service de chirurgie maxillofaciale, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, bouleverd Pinel, 69677 Bron, France
| | - N Sigaux
- Service de chirurgie maxillofaciale, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - R H Khonsari
- Service de chirurgie maxillofaciale et plastique, hôpital universitaire Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèves, 75015 Paris, France; CRMR MAFACE, 149, rue de Sèves, 75015 Paris, France; Université Paris-Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France
| | - J Chauvel Picard
- Service de chirurgie maxillofaciale, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - A Gleizal
- Service de chirurgie maxillofaciale, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Université de Lyon 1, Claude-Bernard, 69100 Villeurbanne, France; Service de chirurgie maxillofaciale, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, bouleverd Pinel, 69677 Bron, France
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Julien Saint Amand M, Sigaux N, Gleizal A, Bouletreau P, Breton P. Chronic osteomyelitis of the mandible: A comparative study of 10 cases with primary chronic osteomyelitis and 12 cases with secondary chronic osteomyelitis. Journal of Stomatology, Oral and Maxillofacial Surgery 2017; 118:342-348. [DOI: 10.1016/j.jormas.2017.08.006] [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] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 06/02/2017] [Accepted: 08/08/2017] [Indexed: 11/26/2022]
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Sigaux N, Amiel M, Piotrovitch d'Orlik S, Breton P. [Alberic Pont, the great war and the "broken faces"]. ANN CHIR PLAST ESTH 2017; 62:601-608. [PMID: 29030028 DOI: 10.1016/j.anplas.2017.07.009] [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: 06/12/2017] [Accepted: 07/17/2017] [Indexed: 11/18/2022]
Abstract
The First World War and the number of facial injuries made specialized trauma centers necessary. Alberic Pont was trained both in medicine and dentistry. He founded in Lyon one of the first French specialized wards, which received more than 7000 soldiers overall. Through his charisma, his skills, his creativity and his generosity, he must be considered as a symbol among the pioneers of maxillo-facial surgery, which was then at its early stage. The centenary of World War I is the occasion to shed light on this man who dedicated his career to those who were renamed "broken faces".
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Affiliation(s)
- N Sigaux
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, centre hospitalier Lyon-Sud, université Claude-Bernard-Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - M Amiel
- Université Claude-Bernard-Lyon 1, Pierre-Bénite, France
| | - S Piotrovitch d'Orlik
- Conservateur du musée des hospices civils de Lyon, 3, quai des Célestins, 69229 Lyon cedex 02, France
| | - P Breton
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, centre hospitalier Lyon-Sud, université Claude-Bernard-Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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Sigaux N, Philouze P, Boucher F, Jacquemart M, Frobert P, Breton P. Efficacy of the postoperative management after microsurgical free tissue transfer. J Stomatol Oral Maxillofac Surg 2017; 118:173-177. [PMID: 28391079 DOI: 10.1016/j.jormas.2017.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/06/2017] [Accepted: 03/29/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The physical and medical postoperative measures after free flap reconstruction vary substantially between surgical units. The objective of this review was to identify the postoperative measures which proved a significant positive effect on free flap survival. METHOD A review was conducted in the MEDLINE database on the English and French literature. RESULTS AND DISCUSSION Twenty-eight articles were retained. A meta-analysis of 4984 patients who were given antithrombotics (viz. antiplatelets and anticoagulants) postoperatively found that these treatments were of no significant benefit to free flap survival and increased the risk of postoperative hematoma. Postoperative transfusions did not favor free flap survival and were associated with a higher incidence of medical complications. Preoperative anemia was a risk factor for free flap failure. Blood pressure control, vasodilators, antioxidants, corticotherapy, oxygen therapy, and prolonged immobilization were of no proven benefit. CONCLUSION No postoperative therapy, whether drug-based or not, has been shown to have a significant positive effect on free flap survival.
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Affiliation(s)
- N Sigaux
- Department of Maxillofacial Surgery, Stomatology and Facial Plastic Surgery, Hospices Civils de Lyon - Claude-Bernard-Lyon 1 University, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
| | - P Philouze
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospices Civils de Lyon - Claude-Bernard-Lyon 1 University, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - F Boucher
- Department of Plastic, Reconstructive and Esthetic Surgery - Croix Rousse Hospital, Hospices Civils de Lyon - Claude-Bernard-Lyon 1 University, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - M Jacquemart
- Department of Maxillofacial Surgery, Stomatology and Facial Plastic Surgery, Hospices Civils de Lyon - Claude-Bernard-Lyon 1 University, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - P Frobert
- Department of Plastic, Reconstructive and Esthetic Surgery, Centre Léon-Bérard - Cancer Treatment Center, 28 rue Laënnec, 69008 Lyon, France
| | - P Breton
- Department of Maxillofacial Surgery, Stomatology and Facial Plastic Surgery, Hospices Civils de Lyon - Claude-Bernard-Lyon 1 University, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
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Sigaux N, Lahon M, Maucort-Boulch D, Bouletreau P. Posterior mandibular widening secondary to advancement sagittal split osteotomy: A retrospective study. ACTA ACUST UNITED AC 2016; 117:77-83. [PMID: 26947811 DOI: 10.1016/j.revsto.2016.01.012] [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: 09/09/2015] [Revised: 12/28/2015] [Accepted: 01/18/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Patients sometimes spontaneously report a modification of the width of their lower face after an advancement bilateral sagittal split osteotomy (ABSSO). The main goal of our study was to assess the variation of the bigonial distance (BGD) before and after ABSSO in a group of patients. The second goal was to look for a possible relation between the variation of BGD and the amount of mandibular advancement. MATERIALS AND METHODS We conducted a retrospective radiological study on patients who underwent an isolated ABSSO (Obwegeser-Dal Pont II type osteotomy) for a class II malocclusion in our department over a 26 months period. The measures were made on standardized frontal and lateral teleradiographies taken before, one day and one year postoperatively. RESULTS Fifty patients (36 females, 14 males; mean age: 24) could be included. BGD was significantly increased one day (+9.8mm, P<10(-3)) and one year after surgery (+4mm, P<10(-3)). There was no relation between the amount of mandibular advancement and the increase of BGD. DISCUSSION Our results suggest that ABSSO is responsible for posterior mandibular enlargement which must be taken into account during the aesthetic preoperative assessment. Further studies are mandatory to identify the risk factors for this phenomenon.
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Affiliation(s)
- N Sigaux
- Department of maxillofacial surgery, hospices civils de Lyon, hôpital Lyon-Sud, Claude-Bernard Lyon I university, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - M Lahon
- Department of maxillofacial surgery, hospices civils de Lyon, hôpital Lyon-Sud, Claude-Bernard Lyon I university, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - D Maucort-Boulch
- Biostatistics, hospices civils de Lyon, National Center for Scientific Research (CNRS - UMR 5558), Claude-Bernard Lyon I university, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - P Bouletreau
- Department of maxillofacial surgery, hospices civils de Lyon, hôpital Lyon-Sud, Claude-Bernard Lyon I university, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
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Sigaux N, Viremouneix L, Guibaud L, Breton P. [Head and neck superficial venous malformations]. ACTA ACUST UNITED AC 2015; 116:201-8. [PMID: 26296277 DOI: 10.1016/j.revsto.2015.07.002] [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: 07/17/2015] [Accepted: 07/22/2015] [Indexed: 10/23/2022]
Abstract
Management of vascular malformations and vascular tumors has recently been maximized by the establishment of an accurate clinical and histological classification and by the development of multidisciplinary expert consultations. Head and neck localizations of venous malformations are common, thus maxillo-facial surgeons should be aware of the characteristics of this pathology and the principles of its management. Diagnosis is mainly clinical and must be certified by Doppler-ultrasonography and contrast enhanced magnetic resonance imaging with T2 fat-saturation sequence. Therapeutic decision depends on the volume of the lesion, and on functional, cosmetic and psychological complaints. Sclerotherapy is now the preferred treatment of head and neck venous malformations. It is performed in specialized interventional radiology units by intralesional injections of sclerosing solution under fluoroscopic guidance. Surgery is useful in some cases, either on its own or following sclerotherapy. In case of bulky lesion, it is necessary to search for and prevent a severe coagulopathy before planning any intervention.
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Affiliation(s)
- N Sigaux
- Chirurgie maxillo-faciale et stomatologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard Lyon 1, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - L Viremouneix
- Imagerie médicale pédiatrique, centre de traitement des angiomes, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - L Guibaud
- Imagerie médicale pédiatrique, centre de traitement des angiomes, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - P Breton
- Chirurgie maxillo-faciale et stomatologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard Lyon 1, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
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Wargnier A, Legros-Maïda S, Bourge J, Soulié A, Israël-Biet D, Sigaux N, Paul P, Sasportes M. Monitoring of transplanted patients using granzyme B and perforin. Hum Immunol 1994. [DOI: 10.1016/0198-8859(94)90146-5] [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: 11/29/2022]
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Legros-Maïda S, Soulié A, Benvenuti C, Wargnier A, Vallée N, Berthou C, Guillet J, Sasportes M, Sigaux N. Granzyme B and perforin can be used as predictive markers of acute rejection in heart transplantation. Eur J Immunol 1994; 24:229-33. [PMID: 8020560 DOI: 10.1002/eji.1830240136] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We have investigated perforin and granzyme B expression in graft-infiltrating lymphocytes of patients who underwent heart transplantation. Those proteins are commonly present in the cytoplasmic granules of cytotoxic T lymphocytes and are released upon effector-target cell interaction. From 28 patients 103 endomyocardial biopsies were obtained and examined by histology and immunocytochemical analysis using relevant monoclonal antibodies. We found that "high" biopsy histological grades were associated with perforin and granzyme B expression in graft-infiltrating lymphocytes of patients with acute severe rejection crisis. In contrast, these markers were not detected in patients without rejection or during graft stabilization. Interestingly, in patients with mild rejection and "low" histological grades, two groups could be distinguished with a differential expression of the two intracytoplasmic proteins. The presence of perforin and granzyme B-expressing cells was found to be predictive of rapid progression to severe rejection, so that this situation required additional treatment; in contrast, their absence seemed to correlate with a good graft outcome without additional treatment. Moreover, perforin and granzyme B expression seemed to be down-regulated by immunosuppressive drugs, which coincided with graft stabilization. In conclusion, our data suggest that detection of granzyme B and perforin in graft-infiltrating lymphocytes might be helpful for routinely monitoring heart transplant patients.
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Clément MV, Haddad P, Soulié A, Benvenuti C, Lichtenheld MG, Podack ER, Sigaux N, Sasportes M. Perforin and granzyme B as markers for acute rejection in heart transplantation. Int Immunol 1991; 3:1175-81. [PMID: 1760412 DOI: 10.1093/intimm/3.11.1175] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Histological analysis of endomyocardial biopsies (EMB) is regarded as the most satisfactory technique for monitoring crisis of rejection in heart transplanted patients. In this study, 42 biopsies from 14 patients who underwent heart transplantation were examined. Three patients did not present any rejection crisis at the date of the biopsy analysis, six were examined during an early rejection crisis (day 7-70 post-graft), and five were examined during a late rejection crisis (day 74-960 post-graft). Since granzyme B and perforin are proteins associated with cell lysis histological grading and cell phenotype analysis, in situ hybridization using granzyme B and perforin [35S]RNA probes was performed on 30 EMB to characterize the cytolytic activation of heart infiltrating cells. Our data suggest that granzyme B and perforin could be used as predictive markers for acute rejection in patients with early rejection crisis. Their detection might be an indication to administrate corticoids to resolve an acute rejection crisis. In contrast, their absence in patients with late rejection crisis appears as a good prognostic factor for the outcome of rejection and raises the question of the necessity to treat such patients with additional corticoid treatment.
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Affiliation(s)
- M V Clément
- INSERM U 93, Hôpital St Louis, Paris, France
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