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Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lips repair cannot be considered until the characteristics of the loss of substance which are given by its aetiology, has been carefully determined. Traumatic aetiologies remain dominated by accidents on the public roads associated more often with adjacent damage. Dog bites remain the burden of children and always raise the problem of their septicity. For burns there is a need to wait for the organism to delimit its own viable tissues. Ballistic traumatisms will lead to major damage where functional repair to the lips can often be very difficult. Tumours of the lips, essentially malignant, lead to wide exeresis, where the margins are dictated by histological findings. They, of course, pose the problem of eventual neck node dissection and are dominated by squamous cell carcinomas. [Copyright &y& Elsevier]

Introduction: Chronic maxillary atelectasis refers to a persistent volume decrease of the maxillary sinus by inward bowing of its walls. When associated with hypoglobus or enophthalmos, some authors use the term “silent sinus syndrome”. We aimed to report a case of accidental diagnosis of chronic maxillary atelectasis while investigating and treating a recurrent oroantral fistula. Observation: CT imaging showed a large bone defect and stage II chronic maxillary atelectasis. Closure of the oroantral fistula was performed with a combined surgical approach: functional endoscopic surgery and buccal fat pad flap. The follow up at 2 months showed no signs of recurrent oroantral fistula. Commentaries: Chronic maxillary atelectasis is separated into three stages, membranous deformity (stage I), bony deformity (stage II), and clinical deformity (stage III). The term silent sinus syndrome should be abandoned for stage III chronic maxillary atelectasis to allow for better collaboration between medical practitioners. Recurrent oroantral fistulas should be treated with a combined approach including endoscopic antrostomy and local flap. Conclusion: The association of functional endoscopic surgery and buccal fat pad flap were the key to success in this case allowing for oroantral fistula closure and treatment of chronic maxillary atelectasis.

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Cervicofacial cellulitis resulting from common odontogenic infections is rare but serious, with life-threatening complications and potential general or local complications. Observation: Two cases are discussed here. The first observed case concerned a 32-year-old patient, affected by gangrenous cellulitis, following the avulsion of teeth number 38. The second observed case was of a chronic periapical infection being left untreated. The urgency of these two cases required the coordination of medical and surgical specialist teams to ensure a stable and successful treatment, involving surgical treatment, drug therapy, and reanimation. Discussion: The inadequate treatment or chronic dental infections, associated with immunosuppression and some cofactors (tobacco, alcohol, drugs, pregnancy, etc.), can lead to severe case of cellulitis. Medical and surgical management should be carried out as soon as possible to prevent the onset of serious complications such as mediastinitis, septic shock, and thrombophlebitis.

Purpose: The gluteal region is a key element of beauty balance and sexual appearance. However, there is no clear anatomical description of the infragluteal fold, nor any classification exists allowing standardizing treatment of this area in case of jeopardisation. The purpose of this study was to perform an anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone level. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1.5 T) of the pelvic region. T1 Vibe Morpho T2, Sag Space 3D, and Millimetric slices were performed in order to obtain a more detailed selection of the gluteal landmark. Trabecular connective tissue of the region was analyzed using Horos® ROI (region of interest) segmentation function. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. Results: The infragluteal fold is a connectival fibrous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the apex of the sacrum (for a length of 13 ± 2 and 11 mm ± 2), and the coccyx (for a length of 19 mm ± 2 and 20 mm ± 2, all measures referring to volunteers and cadavers, respectively) reaching superficially the dermis of the medial one-third of the cutaneous fold. No significant difference was found between volunteer and cadaver group in MRI measurement of bony origins, or between MRI and cadaveric dissection measurements. Conclusion: Knowledge of this structure will define novel surgical techniques in infragluteal fold restoration. [ABSTRACT FROM AUTHOR]

Introduction: Long-term enophthalmos and diplopia resulting from orbital bone loss pose significant challenges in reconstructive surgery. This study evaluated the effectiveness of patient-specific porous titanium implants (PSIs) for addressing these conditions., Materials and Methods: This retrospective study involved 12 patients treated at Croix-Rousse Hospital, Lyon, from April 2015 to April 2022 who underwent late reconstruction via PSI for unilateral complex orbital bone loss. These implants were customized via 3D mirroring techniques on the basis of high-resolution computed tomography (CT) scans of the patients' unaffected orbits., Results: All 12 patients presented with significant preoperative enophthalmos, with an average displacement of 3.24 mm, which was effectively corrected postoperatively to an average of 0.17 mm (p < 0.001). Orbital volume notably improved from a preoperative average of 3.38 mL to 0.37 mL postsurgery (p < 0.001). Functional improvements were evident as both enophthalmos and diplopia resolved completely. The Lancaster test revealed an improvement in the visual field, with 83.3 % of patients achieving normal results postoperatively., Discussion: By ensuring anatomical accuracy, patient-specific porous titanium implants, tailored from patient-specific imaging and fabricated via advanced 3D printing technology, provide a precise, effective, and reliable solution for reconstructing complex orbital defects and performing complicated revision surgeries., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Purpose: The foramen tympanicum (FT) is an anatomical variation of the tympanic part of the temporal bone located in the anteroinferior part of the external auditory pore (EAP) and posteromedial to the temporomandibular joint (TMJ). The FT is most often asymptomatic, but it can be symptomatic in rare cases. The prevalence of FT varies widely in the literature. The aim of our study was to determine the radiological prevalence in a European population., Methods: We retrospectively analyzed the presence of FT in all patients who underwent brain or rock scans from January 2021 to July 2022 in University Hospital. Demographic characteristics such as age and gender were collected. Morphometric measurements on the FT were also carried out manually: axial, sagittal and area calculation. Binomial test, Pearson's Chi2 test or Student's T test were carried out according to the type of analysis., Results: A total of 2040 patients were included. 145 patients with FT were identified, giving a prevalence of 7.11%. FT were unilateral in 39% and bilateral in 61% of cases (p = 0.008). Women were statistically more likely to have one (p = 0.00002). Higher age was correlated with an increase in the prevalence of FT (p = 0.03). The morphometric measurements did not reveal any differences depending on the side., Conclusion: This study is the largest series of Computed Tomography (CT) scans on the prevalence of foramen tympanicum. Although rare, every surgeon must keep in mind this anatomical entity to limit the risk during a surgical procedure., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

To answer the increased demand for augmentation rhinoplasty, particularly in Asian demographics, a shift from autogenous materials to synthetic implants like silicone and expanded polytetrafluoroethylene has been witnessed. These materials present an increased risk of complications like infection, extrusion, capsular contracture, and dissatisfaction. This study focuses on a case of revision rhinoplasty in a 48-year-old patient with a previous silicone implant and propose an innovative approach in managing the implant capsule. The use of the existing capsule as a mechanical and biological support structure for the diced cartilage graft in dorsal reconstruction showcases a promising method to mitigate risks and improve outcomes in revision surgeries. The capsule around the silicone is biologically active and provides a good environment for the cartilage graft to survive and improve the healing process. This approach tends to minimize the dissection to avoid potential revision complications like skin necrosis, fibrotic tissue, and infections., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Introduction: Failure to adequately secure the skin graft to the lower limbs recipient bed can result in loss of the graft. Our objective was to compare the healing of split-thickness skin grafts three weeks postoperatively, using either negative pressure wound therapy (NPWT) or conventional compression bandaging., Methods: In this multicenter randomized controlled study, patients with tissue loss ranging from 50 cm 2 to 600 cm 2 on the lower limbs and treated with split-thickness skin grafts were included in three French hospitals. A digital photographic evaluation was performed at 3 weeks., Results: During 9 years, 70 patients were included in the study and allocated to a treatment group. The grafted area was similar in both groups. Loss of graft was significantly reduced in the NPWT group with 14.6 cm2 compared to 29 cm2 in the control group ( p  = 0.0003). The hospital stay was also significantly reduced in the NPWT group, at 4 days versus 6.5 days in the control group ( p  = 0.0284). In the NPWT group, 60% reported pain compared to 22.9% in the control group ( p  = 0.0048)., Conclusions: The use of NPWT dressings improves skin graft take by reducing necrosis, improving the graft's adherence to the recipient site, and reducing hospital length-of-stay.

Introduction: Nerve autograft is the gold standard for reconstruction of peripheral nerve loss. The alternative is the interposition of a synthetic regeneration conduit. The purpose of the study was to evaluate the in vivo feasibility and interest of Adipose-Derived Stem Cells (ADSCs) using the Nanofat technique and chitosan conduit for peripheral nerve defect repair., Material and Methods: In vivo, after the creation of a 10 mm defect of the sciatic nerve, 2 groups were defined according to the nerve repair in rats: "chitosan" group (n = 10) and "chitosan and ADSCs" group (n = 10) with a clinical and paraclinical evaluation at 7 weeks., Results: The in vivo results seem to show that the adjunction of ADSCs was favorable clinically, histologically and functionally compare to a chitosan reconstruction alone., Discussion: Peripheral nerve repair with defect using a chitosan conduit associated with ADSCs would constitute a surgical alternative in a single surgical step., Competing Interests: Declaration of Competing Interest No conflict of interest., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Objectives: This study assessed return to work and prosthesis survival after trapeziometacarpal prosthesis surgery., Material and Methods: A multicenter retrospective study was carried out on patients operated on between 2002 and 2020. All working patients who had undergone trapeziometacarpal prosthesis surgery were included. Return to work was defined as resuming the same full-time position. Postoperative events and their specific treatment and failure to return to work were reported., Results: 240 prostheses in 211 patients were included. The complications rate was 7.5%, with 97% prosthesis survival. 94.3% of patients returned to work, at a mean 48 days (range, 29-210 days; SD, 22.7 days), with no significant difference according to age. Twelve patients did not return to work, half of whom because of prosthetic complications., Conclusion: Trapeziometacarpal arthroplasty enables most patients to return to work within 6 weeks. In this series, the prosthetic survival rate was 97%., (Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Backgrounds: Necrotizing fasciitis is a severe bacterial infection characterized by involvement of all skin's layers, including the superficial fascia. Diagnosis and treatment must be as quick as possible. Once suspected, extensive surgical debridement is required., Methods: All necrotizing fasciitis, managed in our hospital in Dijon, during the period from January 2011 to May 2021, were retrospectively analyzed. Demographics characteristics of patients, biological parameters, and type of bacteria were collected. Statistical analysis was performed on the cost of hospitalization, as well as on the death rate between type I and II NF and the speed of management. Student's t-test and Chi 2 test were performed with a significant level P<0.05., Findings: A total of 65 patients were included over the period. The mean age was 68.8 years. The average length of stay was 32.4 days, with an average cost of 79,305 €. The main locations were the lower limbs (57%) and the perineum (35%). Cost of hospitalization did not differ between type I and II (P=0.21), unlike mortality rate (P=0.003). Furthermore, the mortality rate according to the speed of management did not vary in our series (P=0.45)., Conclusion: Necrotizing fasciitis is quickly fatal if left untreated. Early diagnosis, combined with surgical debridement and probabilistic antibiotic therapy are required. Our study shows the impact of necrotizing fasciitis in terms of cost to society and the importance of prevention of certain risk factors. A global management of the patient is necessary to increase the survival rate., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Medication-related osteonecrosis of the jaw (MRONJ) is a complication caused by anti-resorptive agents and anti-angiogenesis drugs. Since we wanted to write a protocol for a randomized clinical trial (RCT), we reviewed the literature for the essential information needed to estimate the size of the active patient population and measure the effects of therapeutics. At the same time, we designed a questionnaire intended for clinicians to collect detailed information about their practices. Twelve essential criteria and seven additional items were identified and compiled from 43 selected articles. Some of these criteria were incorporated in the questionnaire coupled with data on clinical practices. Our review found extensive missing data and a lack of consensus. For example, the success rate often combined MRONJ stages, diseases, and drug treatments. The occurrence date and evaluation methods were not harmonized or quantitative enough. The primary and secondary endpoints, failure definition, and date coupled to bone measurements were not well established. This information is critical for writing a RCT protocol. With this review article, we aim to encourage authors to contribute all their findings in the field to bridge the current knowledge gap and provide a stronger database for the coming years.

A deep dissecting hematoma is the most serious complication of dermatoporosis, consisting of a rapidly expanding blood collection that splits the hypodermis from the muscle fascia. A several-week time lapse between a minor trauma-induced superficial hematoma and its sudden evolution into a rapidly spreading deep dissecting hematoma is unusual. We report the case of a 70-year-old woman with long-term oral anticoagulation and dermatoporosis who suddenly developed a rapidly spreading right-leg deep dissecting hematoma 1 month after minor trauma, for which a surgical debridement and drainage were performed. Only local care and absorbent dressings were used to manage the post-operative wound, and within 4 months, the wound had healed. In this report, we emphasize the importance of preventing deep dissecting hematoma in patients who are at risk as well as the need to weigh the benefits and risks of anticoagulants when dermatoporosis cutaneous signs are present. A limb-threatening deep dissecting hematoma may develop suddenly, even weeks after a minor impact. In order to prevent skin necrosis from occurring, caregivers, patients, and carers must be able to identify this condition early on., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Basal cell carcinoma (BCC) is locally aggressive and its prognosis depends on the risk of recurrence. The initial location of the tumor is a key criterion for calculating the risk of recurrence. The aim of this study was to evaluate the sites that appear to be most at risk of recurrence of BCC. All cases of BCC analyzed at the anatomopathology laboratory of the University Hospital of Montpellier for 1 year were retrospectively included. In case of recurrence on the same site, only carcinomas that had previously been completely removed were analyzed. Among 803 BCC, 37 (4.6%) were confirmed as recurrent, including 34 (92%) on the head. The locations statistically at higher risk of recurrence were the temporal and frontal/temporal areas (32.4%), the medial canthus and lower eyelid area (18.9%), the ala and tip of the nose (16.2%), and the ears (8.1%). The frontal/temporal regions appear to be an area of major interest in this series. A high risk of recurrence was confirmed in the periorificial locations for the ear, the nose, and periorbital area, but not for the perioral area. In addition, the entire nose did not appear to be at risk, only the tip and the ala., Competing Interests: Conflict of Interest None, (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Background: Bacterial biofilm can occur on all medical implanted devices and lead to infection and/or dysfunction of the device. In this study, artificial biofilm was formed on four different medical implants (silicone, piccline, peripheral venous catheter and endotracheal tube) of interest for our daily clinical and/or research practice. We investigated the best conventional technic to dislodge the biofilm on the implants and quantified the number of bacteria. Staphylococcus epidermidis previously isolated from a breast implant capsular contracture on a patient in the university hospital of Dijon was selected for its ability to produce biofilm on the implants. Different technics (sonication, Digest-EUR®, mechanized bead mill, combination of sonication plus Digest-EUR®) were tested and compared to detach the biofilm before quantifying viable bacteria by colony counting., Results: For all treatments, the optical and scanning electron microscope images showed substantial less biofilm biomass remaining on the silicone implant compared to non-treated implant. This study demonstrated that the US procedure was statistically superior to the other physical treatment: beads, Digest-EUR® alone and Digest-EUR® + US (p < 0.001) for the flexible materials (picc-line, PIV, and silicone). The number of bacteria released by the US is significantly higher with a difference of 1 log on each material. The result for a rigid endotracheal tube were different with superiority for the chemical treatment dithiothreitol: Digest-EUR®. Surprisingly the combination of the US plus Digest-EUR® treatment was consistently inferior for the four materials., Conclusions: Depending on the materials used, the biofilm dislodging technique must be adapted. The US procedure was the best technic to dislodge S. epidermidis biofilm on silicone, piccline, peripheral venous catheter but not endotracheal tube. This suggested that scientists should compare themselves different methods before designing a protocol of biofilm study on a given material., (© 2022. The Author(s).)

Background: Pectoral plane blocks are routinely used in analgesia for patients undergoing dual-plane breast augmentation with implants. Local anesthetic infiltration is a simple alternative technique with the same aim. The authors evaluated both techniques., Methods: In this single-center retrospective study, patients received pectoral plane block (ropivacaine 0.2%, 10 ml for pectoral plane I; 20 ml for pectoral plane II) or local anesthetic infiltration. The primary outcome measure was pain, according to the visual analogue scale, at 24 hours after surgery. Secondary outcomes included the measure of pain at 1, 2, 6, and 12 hours after surgery; total opioid consumption at 24 hours; and opioid side effects., Results: Eighty-one patients were finally recruited: 37 in the pectoral plane group and 44 in the local anesthetic infiltration group. Patient characteristics were comparable between the two groups. At 24 hours after surgery, the local anesthetic infiltration group showed a decrease in pain, with a visual analogue scale score of 0.7 versus 1.5 in the pectoral plane group ( p = 0.007). There was no difference in visual analogue scale score between the two groups at 1, 2, 6, or 12 hours after surgery. The duration of anesthesia was increased in the pectoral plane group, with 153 minutes versus 120 minutes in the local anesthetic infiltration group ( p < 0.001). There was no difference in rescue morphine consumption between the two groups., Conclusions: The authors found that local anesthetic infiltration had a superior analgesic effect at 24 hours after surgery for dual-plane breast implant augmentation compared with pectoral plane block. These findings are a good indication that the local anesthetic infiltration technique is at least as effective as pectoral plane block while being safe, fast, and easy to use., Clinical Question/level of Evidence: Therapeutic, III., (Copyright © 2022 by the American Society of Plastic Surgeons.)

Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low immunogenicity and exerts anti-inflammatory, antifibrotic, antimicrobial, antiviral, and analgesic effects. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with suitable mechanical properties (permeability, stability, elasticity, flexibility, and resorbability) to prevent the proliferation of fibrous tissue and promote early neovascularization at the surgical site. In oral surgery, hAM stimulates healing and facilitates the proliferation and differentiation of epithelial cells in the oral mucosa and therefore its regeneration. We proposed using cryopreserved hAM to eight patients suffering from cancer (11 lesions) with stage 2-3 MRONJ on a compassionate use basis. A collagen sponge was added in some cases to facilitate hAM grafting. One or three hAMs were applied and one patient had a reapplication. Three patients had complete closure of the surgical site with proper epithelialization at 2 weeks, and two of them maintained it until the last follow-up. At 1 week after surgery, three patients had partial wound dehiscence with partial healing 3 months later and two patients had complete wound dehiscence. hAM reapplication led to complete healing. All patients remained asymptomatic with excellent immediate significant pain relief, no infections, and a truly positive impact on the patients' quality of life. No adverse events occurred. At 6 months of follow-up, 80% of lesions had complete or partial wound healing (30 and 50%, respectively), while 62.5% of patients were in stage 3. Radiological evaluations found that 85.7% of patients had stable bone lesions ( n = 5) or new bone formation ( n = 1). One patient had a worsening MRONJ but remained asymptomatic. One patient did not attend his follow-up radiological examination. For the first time, this prospective pilot study extensively illustrates both the handling and surgical application of hAM in MRONJ, its possible association with a collagen sponge scaffold, its outcome at the site, the application of multiple hAM patches at the same time, and its reapplication., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Odet, Meyer, Gaudet, Weber, Quenot, Derruau, Laurence, Bompy, Girodon, Chatelain, Mauprivez, Brenet, Kerdjoudj, Zwetyenga, Marchetti, Hatzfeld, Toubeau, Pouthier, Lafarge, Redl, Fenelon, Fricain, Di Pietro, Ledouble, Gualdi, Parmentier, Louvrier and Gindraux.)

Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Odet, Louvrier, Meyer, Nicolas, Hofman, Chatelain, Mauprivez, Laurence, Kerdjoudj, Zwetyenga, Fricain, Lafarge, Pouthier, Marchetti, Gauthier, Fenelon and Gindraux.)

Introduction and Importance: Osteopetrosis is a poorly known and probably underdiagnosed pathology. It is caused by various genetic abnormalities resulting in osteoclast dysfunction. Functional and aesthetic consequences have a major impact on the patient's quality of life. Ten percent of osteopetrosis cases develop osteomyelitis that usually involves the mandible. Management of this complication remains complex and often unsatisfactory., Case Presentation: We report a case of a 62-year-old woman with osteopetrosis, complicated by mandibular osteomyelitis with intra-oral bone exposure and submental fistulas. Management was performed with antibiotic therapy and surgical necrotic resection. This cured the fistulas but the bone exposure persisted., Discussion: This case report highlights the difficulty of achieving complete healing of osteomyelitis in osteopetrosis. Antibiotic therapy, surgical management, or even hyperbaric oxygen therapy are required, but must be adapted to the case. A free flap procedure is undesirable but, when it is necessary, a bone marrow transplant could be considered to restore osteoclast function., Conclusion: The management of mandibular osteomyelitis in patients with osteopetrosis must adapt to the situation and severity. To avoid most cases of osteomyelitic complications in patients suffering from osteopetrosis, we propose that a preventive strategy of better dental care should be considered., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Pancreatic cancer is a public health problem because its mortality rate is close to its incidence rate. If it were possible to detect this cancer before the onset of symptoms, 5-year survival could reach 75%. Numerous studies have attempted to accelerate the diagnosis to improve survival. Saliva presents interesting characteristics as a fluid for screening and diagnosis. Its many components provide a promising source of constitutive biomarkers with a specific signature of the disease. The aim of this work was to determine the interest of studying the metabolome, the transcriptome and the microbiome of saliva in screening for pancreatic cancer., Materials and Methods: A review of the literature was conducted using the PubMed search engine. The last search was conducted in July 2017., Results: Nine references, all original studies, published between 2010 and 2017 were included., Discussion: Different combinations of metabolites, RNA and bacteria were found. Analysis of the saliva transcriptome and metabolome seems to be the most promising avenue., Conclusion: The identification of an early salivary signature of pancreatic cancer is still in its infancy and the results obtained here must be confirmed in larger prospective multicentre studies., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Amputation of the hand is a rare and extremely intense trauma. Replanting and allografting after this type of injury require a major reorganization of the brain. Brain plasticity, though better known in the context of disorders of the central nervous system, is just as indispensable when the extremities are damaged., Materials and Methods: A 17-year-old patient underwent replantation of the nondominant hand after transmetaphyseal amputation after traumatic injury. After 18 days in hospital and subsequent treatment in a physical rehabilitation center, the patient attended clinical and radiology follow-up sessions over the next 2 years., Results: The management of this patient led to an excellent functional outcome in conjunction with successful social and professional reintegration. Electromyography at 18 months confirmed nerve regrowth. Functional magnetic resonance imaging was done at 2 years to evaluate cerebral plasticity. Motor function, largely dependent on the primary motor area, is aided by the addition of secondary and accessory motor areas for both simple and complex movements. A change in sensory information is stimulation in its own right hemisphere and increases solicitation of the contralateral precentral and postcentral gyrus., Conclusions: There seems to be a real reversible dynamic plasticity under the balance of inhibitory and excitatory influences exerted on the cortical neurons. Any disruption of this balance requires the brain to adapt to the new circumstances to reestablish the hand as a functioning part of the body.

Introduction: Pedicled flaps and free-tissue transfer flaps are used routinely to reconstruct hard and soft tissue defects in head and neck, limb, hand, thoracic and abdominopelvic reconstructive surgery. But failure remains a constant concern, particularly in free-tissue transfers. Usually failure is due to blood supply compromise. Indocyanine green (ICG), a fluorescent dye is a suitable tracer for vessel perfusion. The objective of this study is to evaluate the fluorescent indocyanine green angiography (FA ICG) in free flaps procedures., Materiel and Methods: Patients who had microsurgical flap reconstruction were included during the study period in a single center. The FA ICG was used at specific times. Intra-veinous injections of 0.1mg/kg of INFRACYANINE ® (concentration 2.5mg/mL) were done intraoperatively. The Fluobeam ® device programmed on sensitivity and mapping to interpret the data, was used. These different injections allowed to checked skin paddle perforators vessels, osseous perforators vessels, arterial and venous patency after anastomosis and the cutaneous, muscular and osseous perfusion., Results: A total of 12 patients enrolled were 10 males and 1 female. Their mean age was 54.5 years (range 25-75 years). Of the 12 flaps, 8 were free flaps with 4 fibular flaps (3 for mandibular reconstruction and one for femur reconstruction); 2 radial forearm flaps for maxillary reconstruction; one latissimus free flap for tibia skin coverage and one retroauricular fasciocutaneous free flap for thumb skin coverage. We got to modify specific steps during surgery with 8 patients by using the FA ICG to anticipate potential complications: modifying the draw of the skin paddle, recut of this paddle, modifying the osteotomies, re-doing the anastomosis or modifying the position of the pivot point., Discussion: Evaluation of microvascular flap perfusion is still based on subjective clinical features. Clinical monitoring is observer-dependent and does not allow information sharing, test reproducibility, and consistent postoperative follow-up. The successful of salvage rate is linked to the delay between the onset of ischemia and its clinical assessment. FA ICG could be a reliable method for monitoring free-tissue transfers. This technique is objective, non invasive and facilitate a complex reconstructive procedure to augment is liability. This technique may be used such a pedagogical tool for young practitioners in their first microsurgery procedures., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: The submental flap is a pedicled island flap with excellent color match for facial reconstruction. The flap can be raised with muscle, submandibular gland, or bone and can be transposed to reach defects up to two-thirds of the face. The authors report the primary author's (D.M.) experience of 25 years using the submental flap from its original description to most recent technical evolutions in both Europe and Africa., Methods: This is a retrospective study including all patients with facial defects who underwent reconstruction using a submental flap between 1991 and 2016. This study included the use of all four variations of the submental flap: platysmal, digastric, extended, and superextended. The authors report technical adaptations and complications encountered., Results: The authors performed 311 facial reconstructions using submental flaps: 32 platysmal, 133 digastric, 91 extended, and 45 superextended variations. In conjunction with these reconstructions, the authors performed 10 osteocutaneous submental flaps and two free flaps. The authors report two cases of total flap necrosis (0.6 percent) and 28 minor complications, including 23 cases of distal skin necrosis (7 percent), one reversible mandibular facial nerve palsy (0.3 percent), and three hematomas (1 percent)., Conclusions: The submental flap has proven to be a reliable flap for head and neck reconstruction. The four technical modifications described use varying amounts of soft tissue to replace tissue lost and can include vascularized bone from the mandibular margin. This flap exemplifies Gillies' principle of "replacing like with like" and should be discussed as an alternative to free tissue transfer in facial reconstruction, especially in settings where resources are limited., Clinical Question/level of Evidence: Therapeutic, IV.

The cervicofacial lift is a frequently performed procedure in plastic surgery. It is the reference technique for facial rejuvenation and restoration of the oval form of the face and it is essential to treat excess skin. One of the most frequent complications of this procedure is the formation of haematomas. The aim of this article is to analyse the incidence of bleeding in the standard cervicofacial lift carried out under pure local anaesthesia. The entire operation, including liposuction and tightening of the SMAS, can be done under local anaesthesia. A total of 1500 patients, who have undergone cervicofacial lift under pure local anaesthesia between November 1995 and January 2016, were included in the study. The incidence of early bleeding (in the first 15 days following the operation) was recorded and analysed. Pre- intra- and post-operative monitoring of the arterial blood pressure revealed stable pressure in the peri‑operative period. The mean difference in blood pressure when comparing the intra-operative to the post-operative periods was 7 mmHg for the systolic BP [range from 3 to 25] and 4 mmHg [range from 2 to 12] for the diastolic BP, with lower mean values in the post-operative period. We identified nine bleeding events in 1500 patients (0.6%). The cervicofacial lift under pure local anaesthesia does not radically modify the surgical technique. It allows better control of arterial blood pressure of patients throughout the surgical procedure and avoids fluctuations in blood pressure, which is one of the main causes of bleeding and haematoma formation. The infiltration of xylocaine adrenaline combined with the absence of hypotensive general anaesthesia diminishes the incidence of haematoma and ensures an early return home for the patients., (Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Exclusive breastfeeding is highly recommended by the World Health Organization during the first 6 months of life. In parallel, breast augmentation with implants is one of the most performed operations in aesthetic surgery., Objective: The goal of our study was therefore to analyze the potential impact of aesthetic breast implants on breastfeeding., Study Design: A retrospective study was carried out in 3 French university hospitals. The main inclusion criterion was adult women of childbearing age (18-50 years old) with bilateral breast hypoplasia. Some features of the surgery, such as the operative indication, the surgical approach, the implant position against the pectoral muscle, and implants features (material, volume, profile), were collected. We conducted a survey by phone about childbirth after the procedure. If the women had children after surgery, we asked them if they breastfed and the characteristics of breastfeeding., Results: In total, 1316 patients received breast implants in the 3 centers from January 2011 to October 2016 and met our inclusion criteria. We included 1073 patients; 998 women had breast implants with no pregnancy. Among the 75 patients (7%) who gave birth after the surgery, 51 wanted to breastfeed (68%). The patients with a retroglandular implant were significantly less able to breastfeed compared with the patients with retromuscular implants (P = 0.0005). No difference was found for age, the type of surgery, the surgical approach, and the shape or type of implant between the successful breastfeeding group and failed breastfeeding group., Conclusion: A woman with aesthetic breast implants has a 75% chance of breastfeeding if desired, regardless of the type and the volume of the implant and the surgical approach. She has an 82% probability of breastfeeding with retromuscular implants and 17% with retroglandular implants.

Introduction: Rheumatoid arthritis (RA) is a frequent and co-morbid condition. One of the main complications is induced osteoporosis. Treatments related to this complication significantly modify oral and implant management. Affected patients represent a population at intermediate risk of osteonecrosis of the jaw (ONJ). The objective was to search the literature for durations of treatment with bisphosphonates at the time of ONJ occurrence in patients with RA in order to obtain an average duration., Materials and Methods: A bibliographic search in the PubMed/Medline database was carried out using the following equation "(osteonecrosis and jaw) and rheumatoid arthritis" with no time limitation. The primary study endpoint was the duration of treatment with bisphosphonates (BP) at the time of ONJ onset in patients with RA., Results: Twelve articles accounting for 50 patients were included. Patients had had a median of 46.8 months of treatment with BP before ONJ occurred. Mean, minimum and maximum treatment times were 48.68, 6 and 120 months, respectively. The standard deviation was 27.77 months., Discussion: The median treatment duration in our cohort of patients with RA was less than that reported for osteoporosis. We therefore, recommend that practitioners take additional precautions regarding oral surgery or implant procedures, particularly in patients with RA who have been treated with BP for more than 4 years., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: In surgery, certain defects require reconstruction with a microsurgical flap. The free flap failure rate varies between 2% and 5%. Vascular thrombosis is the most frequent complication and represents 15% to 73% of failures. The success rate of salvage therapy is greater when salvage surgery is early. Currently, clinical monitoring is the criterion standard but many noninvasive or minimally invasive techniques have been developed to improve early diagnosis of complications of vascular thrombosis. The aim of our experimental study was to compare clinical assessments with measurements of capillary glycemia and lactatemia during the monitoring of free flaps., Materials and Methods: Myocutaneous latissimus dorsi flaps with skin paddles were created in pigs under general anesthesia. For each animal, 2 flaps were created (right and left) using the same technique. Four groups were made: group 1 (no flap ligation: control group), group 2 (flap with permanent ligation of the artery), group 3 (flap with permanent ligation of the two veins), group 4 (flap with transient ligation of the artery and 2 veins for 1 hour). The postoperative monitoring protocol consisted of monitoring the clinical, biological (glucose and lactate), and histological parameters., Results: Eight animals were operated on and sixteen flaps were created. Each flap was clinically and biologically tested 25 times. Clinical, biological, and histological monitoring showed significant variations between the groups. The analysis of variance of capillary glycemia and lactatemia showed statistically significant difference between control group and group 2 (P < 0,0001), group 3 (P < 0,0001), or group 4 (P < 0,0001). There were no histological abnormalities after transient ligature at different times contrary to permanent ligature., Discussion-Conclusion: Measuring capillary levels of lactate and glucose associated with clinical monitoring may shorten the time to diagnosis of flap failure. Ultimately, this will save lives and achieve better functional and aesthetic results.

Previous clinical studies have shown the efficacy of a two-stage surgical procedure - the induced membrane (IM) technique - for reconstruction of large bone defects or bone non-union. The first stage involves radical debridement and insertion of a cement spacer into the bone defect. The second stage, performed weeks to months later, consists of removing the spacer while leaving the foreign body membrane induced by the cement in place, and then filling the cavity with bone autograft. The IM has been shown to (1) act as a protective physical barrier by preventing bone autograft resorption and (2) act as a bioreactor by promoting healing through revascularisation and growth factor secretion, and by concentrating mesenchymal stem cells (MSC) with osteogenic properties. New solutions to reduce this surgical procedure to a single step are being explored, for example by using an IM-like bioactive and protective barrier inserted into the bone defect at the same time as bone graft., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Malignant intraosseous odontogenic tumors (MIOT) of the jaws are very rare. The diagnosis is difficult. Clinical, paraclinical and histological diagnostic criteria, strict are well established. But the International Union Against Cancer (UICC) does not provide TNM classification that will allow harmonization of the treatment. Indeed, despite their location, they cannot be classified as primary tumors of the oral cavity because of their localization in the bone marrow, making them systematically classified as T4. We propose a classification taking into account the clinical and radiological data., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

The human amniotic membrane (hAM) has been successfully used as a natural carrier containing amniotic mesenchymal stromal cells, epithelial cells and growth factors. It has a little or no immunogenicity, and possesses useful anti-microbial, anti-inflammatory, anti-fibrotic and analgesic properties. It has been used for many years in several indications for soft tissue repair. We previously reported that hAM represents a natural and preformed sheet containing highly potent stem cells, and could thus be used for bone repair. Indeed, native hAM possesses pre-osteoblastic potential that can easily be stimulated, even as far as mineralization, by means of in vitro osteogenic culture. However, cell culture induces damage to the tissue, as well as to cell phenotype and function. The aim of this study was to evaluate new bone formation by fresh and in vitro osteodifferentiated hAM, alone or associated with an additional scaffold presenting osteoinductive properties. Moreover, we also aimed to determine the effect of in vitro hAM pre-osteodifferentiation on its in vivo biocompatibility/tissue degradation. Results showed that neither fresh nor osteodifferentiated hAM induced ectopic bone formation, whether or not it was associated with the osteoinductive scaffold. Secondly, fresh and osteodifferentiated hAM presented similar in vivo tissue degradation, suggesting that in vitro hAM pre-osteodifferentiation did not influence its in vivo biocompatibility.

Introduction: Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures., Case: A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved., Discussion: Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Regulatory T (Treg) cells are important to induce and maintain immunological self-tolerance. Although the progress accomplished in understanding the functional mechanism of Treg cells, intracellular molecules that control the mechanisms of their suppressive capacity are still on investigation. The present study showed that peroxisome proliferator-activated receptor-alpha deficiency impaired the suppressive activity of Treg cells on CD4 + CD25 - and CD8 + T cell proliferation. In Treg cells, PPARα gene deletion also induced a decrease of migratory abilities, and downregulated the expression of chemokine receptors (CCR-4, CCR-8 and CXCR-4) and p27 KIP1 mRNA. Treg cells from PPARα -/- mice also lost their anergic property. Since low Treg activity, as observed in PPARα -/- mice, is known to be associated with the inhibition of tumor growth, we inoculated these mice with B16 melanoma cells and assessed tumor proliferation. In PPARα -/- mice, cancer growth was significantly curtailed, and it was correlated with high expression of granzyme B and perforin mRNA in tumor bed. Degranulation of cytolytic molecules by CD8 + T cells, assessed by a perforin-release marker CD107a expression, was higher in PPARα -/- mice than that in wild-type mice. Tumor-infiltrating lymphocytes (TIL) in melanoma tumors in PPARα -/- mice exhibited high pro-inflammatory Th1 phenotype. Consistently, adoptive transfer into lymphopenic RAG2 -/- mice of total PPARα -/- splenic T cells inhibited more the growth rate of B16 tumor than the wild type splenic T cells. Our findings suggest that PPARα deficiency, by diminishing Treg cell functions and upregulating pro-inflammatory T cell phenotype, exerts an in vivo anti-cancer properties., (Copyright © 2016 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.)

Introduction: Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful., Material and Methods: A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction. Mean follow-up was 47.4 months. Pain intensity, swelling and occurrence of infectious episodes were evaluated immediately and after middle-term and long-term follow-up (up to 36 months)., Results: The best results were obtained for anterior lithiasis, with an 87.5% immediate success rate. Morbidity was low with 2 transient facial nerve upper buccal branch palsies and 2 post-operative stenoses., Discussion: TSDA is an easy-to-perform and safe technique that can be recommended in cases of sialendoscopy or lithotripsy failure for anterior-third parotid duct lithiasis. Even if this technique has shown limitations for more posterior lithiases, or other causes of obstruction (stenosis, megaduct), it requires no specific material and may be useful. It may avoid an external combined approach or a parotidectomy., (Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)