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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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Hammoutene S, Nihous H, Foletti JM, Collet C, Lan R. Ossifying fasciitis of the chin: A case report. J Stomatol Oral Maxillofac Surg 2021; 122:524-526. [PMID: 33429067 DOI: 10.1016/j.jormas.2021.01.004] [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] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Affiliation(s)
- S Hammoutene
- Aix Marseille Univ, APHM, Timone Hospital, Odontology Department, Functional Unit of Oral Surgery, Marseille, France.
| | - H Nihous
- Aix Marseille Univ, APHM, INSERMS, MMG, Timone Hospital, Pathology Department, Marseille, France
| | - J M Foletti
- Aix Marseille Univ, APHM, LBA, Conception Hospital, Maxillo-Facial Surgery Department, Marseille, France
| | - C Collet
- Sainte Musse Hospital, Maxillo-Facial Department, Toulon, France
| | - R Lan
- Aix Marseille Univ, APHM, Timone Hospital, Odontology Department, Functional Unit of Oral Surgery, Marseille, France
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Levy N, Benzaquen M, Le Roux MK, Arnaud M, Graillon N, Foletti JM. Self‐injection of a solution intended for topical use containing hyaluronic acid and vitamin B5. Clin Exp Dermatol 2020; 45:600. [DOI: 10.1111/ced.14168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- N. Levy
- Department of Maxillofacial Surgery Aix Marseille University APHM Hôpital de la Conception Marseille France
- Departments of Department of Ophthalmology Aix Marseille University APHM Hôpital Nord Marseille France
| | - M. Benzaquen
- Department of Dermatology Aix Marseille University APHM Hôpital Nord Marseille France
| | - M. K. Le Roux
- Department of Maxillofacial Surgery Aix Marseille University APHM Hôpital de la Conception Marseille France
| | - M. Arnaud
- Department of Maxillofacial Surgery Aix Marseille University APHM Hôpital de la Conception Marseille France
| | - N. Graillon
- Department of Maxillofacial Surgery Aix Marseille University APHM Hôpital de la Conception Marseille France
| | - J. M. Foletti
- Department of Maxillofacial Surgery Aix Marseille University APHM Hôpital de la Conception Marseille France
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Haen P, Laversanne S, Graillon N, Foletti JM. Facial necrotising fasciitis following rhytidectomy. Br J Oral Maxillofac Surg 2019; 57:685-687. [PMID: 31204188 DOI: 10.1016/j.bjoms.2019.05.016] [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: 12/27/2018] [Accepted: 05/28/2019] [Indexed: 11/24/2022]
Abstract
Rhytidectomy is the most common surgical procedure used to rejuvenate the appearance of the aging face and neck. Necrotising fasciitis is a rapidly progressing, life-threatening, bacterial infection of the skin, the subcutaneous tissue, and the fascia. We report a case of necrotising fasciitis of the face caused by a group A streptococcal infection after rhytidectomy on a healthy female patient. An abscess on her hand that had been caused by an infection related to a venous catheter had provided a potential entry for the pathogen, and treatment combined both surgical debridement and antibiotics. The operation had resulted in large tissue losses around the ears, which we treated by healing by second intention.
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Affiliation(s)
- P Haen
- Department of Oral and Maxillofacial Surgery, Hôpital d'Instruction des Armées Laveran, Boulevard Laveran, 13013 Marseille, France.
| | - S Laversanne
- Department of Oral and Maxillofacial Surgery, Hôpital d'Instruction des Armées Laveran, Boulevard Laveran, 13013 Marseille, France
| | - N Graillon
- Department of Oral and Maxillofacial Surgery, Assistance Publique des Hôpitaux de Marseille, Hôpital de la Conception, Boulevard Baille, 13005 Marseille, France
| | - J M Foletti
- Department of Oral and Maxillofacial Surgery, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Chemin des Bourrely, 13326 Marseille, France
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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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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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Foletti JM, Martinez V, Haen P, Godio-Raboutet Y, Guyot L, Thollon L. Finite element analysis of the human orbit. Behavior of titanium mesh for orbital floor reconstruction in case of trauma recurrence. J Stomatol Oral Maxillofac Surg 2018; 120:91-94. [PMID: 30453103 DOI: 10.1016/j.jormas.2018.11.003] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/22/2018] [Accepted: 11/11/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The authors' main purpose was to simulate the behavior of a titanium mesh implant (TMI) used to reconstruct the orbital floor under the stress of a blunt trauma. MATERIALS AND METHODS The orbital floor of a previously validated finite element model (FEM) of the human orbit was numerically fractured and reconstructed by a simplified TMI. Data from a CT scan of the head were computed with MICMICS (Materialise, Louvain, Belgium) software to re-create the skull's geometry. The meshing production, the model's properties management and the simulations of blunt traumas of the orbit were conducted on HYPERWORKS® software (Altair Engineering, Detroit, MI, USA). Some of the elements of the orbital floor were selected and removed to model the fracture; these elements were duplicated, their characteristics being changed by those of titanium to create a TMI covering this fracture. A 3D FEM composed of 640,000 elements was used to perform 21 blunt trauma simulations on the reconstructed orbit. RESULTS In 90.4% (19/21) of the tests conducted, the TMI, whether free from any bony attachment or screwed to the orbital rim, has tended to move in the orbit and/or to deform. DISCUSSION In the event of traumatic recurrence, which is not rare, TMIs may deform in a "blow-in" motion and threaten intra-orbital structures.
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Affiliation(s)
- J M Foletti
- Aix Marseille université, AP-HM, IFSTTAR, LBA, hôpital de la Conception, service de chirurgie maxillo-faciale, 13015 Marseille, France.
| | - V Martinez
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
| | - P Haen
- Aix Marseille université, HIA Laveran, service de chirurgie maxillo-faciale, 13013 Marseille, France.
| | - Y Godio-Raboutet
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
| | - L Guyot
- AP-HM, CNRS, EFS, hôpital de la Conception, service de chirurgie maxillo-faciale, 13015 Marseille, France.
| | - L Thollon
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
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Graillon N, Foletti JM, Le Roux MK, Alessandrini M, Benzaquen M, Guyot L. Impact of antithrombotic treatment in orbital haematoma. J Stomatol Oral Maxillofac Surg 2018; 119:489-492. [PMID: 29792939 DOI: 10.1016/j.jormas.2018.05.004] [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] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/27/2018] [Accepted: 05/11/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Orbital haematomas threaten the visual prognosis, but no treatment guidelines have been proposed. Antithrombotics could affect their prognosis and treatment. This study aimed to evaluate the effect of antithrombotics in the management of orbital haematomas and to suggest a standardised protocol. MATERIAL AND METHODS We conducted a retrospective study by sending a standardised questionnaire to 20 French maxillofacial surgery university departments to collect all the cases of orbital haematoma. RESULTS Twenty-five cases from 10 centres were collected, including five patients treated with anticoagulant and one patient treated with dual antiplatelet. Antithrombotics increased the risk of amaurosis and ocular disorders significantly. Surgery was performed for 66.7% of patients treated with antithrombotic and for 89.5% of other patients. Surgical delay was longer in patients treated with antithrombotic. Surgical drainage was used in most of the cases, whereas canthotomy with inferior cantholysis was the least-used technique. CONCLUSION Antithrombotics appear to worsen the functional prognosis of orbital haematomas. A surgical management of orbital haematoma in patients treated with antithrombotics is not contraindicated. Surgical delay must be shortened as much as possible. A lateral canthotomy with inferior cantholysis seems to be an appropriate solution.
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Affiliation(s)
- N Graillon
- Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France.
| | - J M Foletti
- Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - M K Le Roux
- Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - M Alessandrini
- Aix Marseille Université, SPMC EA 3279, 27, boulevard Jean-Moulin, 13385 Marseille, France
| | - M Benzaquen
- Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - L Guyot
- Oral and Maxillofacial surgery department, North hospital, assistance publique hôpitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, 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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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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12
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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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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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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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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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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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Foletti JM, Guyot L, Brignol L, Bertrand B, Thiéry G. [Mandible dislocation: diagnosis and reduction technique "in the field"]. Med Trop (Mars) 2010; 70:219-220. [PMID: 20734586] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Diagnosis of temporomandibular joint dislocation can be achieved based on clinical findings. No complementary studies are required. Reduction can be performed without specific equipment in remote areas.
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Affiliation(s)
- J M Foletti
- Service de chirurgie maxillo-faciale, stomatologie, et plastique de la face, Hôpital d'instruction des armées Laveran, Marseille
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