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Introduction The eyelids reconstruction presents an aesthetic, but above all, a functional challenge. It must allow the good protection of the cornea. The development of perforator flaps is major in recent years and is gradually spreading to the face, which has pushed us to apply it to palpebral surgery. Material and method Since 2014, in the maxillofacial surgery department of St Etienne, four patients have benefited from a palpebral reconstruction. A temporal perforator flap, dissected on a perforator of the superficial temporal artery was performed for the anterior lamella and a palatal mucosa graft for the tarsal reconstruction. Results The results were satisfying. Functionally, this technique allowed good occlusion of the eyelid and prevented the occurrence of ocular complications. On the aesthetic view, the position of the neo-eyelids is satisfying. No patient need retouching. The perforator flap allowed a significant mobilization without distortion of neighboring tissues, and maintaining frontal contractility. Discussion This contemporary approach to flap dissection provides a good functional result, reduces the sequelae of the donor site and does not impose a secondary aesthetic gesture. However, despite these advantages, this type of dissection has the disadvantage of being technically more delicate and requires a trained operator.

Facial rehabilitation from facial epithets is part of the facial surgeon's therapeutic arsenal. The primary technique requires taking imprints on the patient, which has major drawbacks such as discomfort and difficulties for precisely recording anatomical surfaces. In this paper, we present a technical improvement in the design of facial epithesis, introducing application of a 3D printing technology. By exploiting digital data in DICOM format, it is possible to produce a digital copy of an epithesis. Based on this copy a model can be printed and then used to support the final prosthesis.

Resume Introduction La region condylienne est un site frequent de fractures, dont le traitement est debattu. La chirurgie mini-invasive endoscopique est une alternative a la chirurgie a ciel ouvert. Le but de ce travail est d’evaluer les resultats de cette technique qui, bien que classique, n’est que diversement repandue. Materiel et methodes Cette etude retrospective monocentrique a concerne les patients operes consecutivement d’une fracture du condyle, classee de II a V selon Spiessl et Schroll, par voie endobuccale assistee par endoscopie pendant une periode de 30 mois. Les resultats fonctionnels et radiographiques ainsi que la survenue d’eventuelles complications ont ete evalues. Resultats Vingt-deux patients (25 fractures) ont ete operes. Dix-sept patients (19 fractures) ont ete suivis (suivi moyen : 16,7 mois). Les valeurs moyennes etaient : ouverture de bouche de 45 mm (± 8,4) ; propulsion de 8,3 mm (± 1,9) ; lateralite homolaterale a la fracture de 8,6 mm (± 2) et controlaterale de 8,7 mm (± 4). Trois abords combines a une voie pre-auriculaire ont ete realises. La reduction etait radiologiquement bonne dans 10/19 cas et mauvaise dans 3 cas. Les complications retrouvees etaient : 3 infections et un debricolage a consolidation correcte, et lors d’abord combine, 2 paresies faciales transitoires et 2 syndromes de Frey. Discussion L’utilisation de l’endoscopie dans la chirurgie des fractures sous-condyliennes est une technique fiable, aux resultats fonctionnels satisfaisants avec un faible taux de complication specifique, notamment esthetique et de lesion du nerf facial, principaux enjeux de cette chirurgie.