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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.

Helicobacter pylori (H. pylori), clasificada como carcinógeno tipo I para cáncer gástrico (CG), ha acompañado al hombre al menos desde hace 116 000 años. Los conocimientos de las fuerzas evolutivas que modulan el rol de esta bacteria en el desarrollo del espectro de enfermedades gástricas son aún escasos. Esta revisión sistemática recopila artículos que reportan un proceso de coevolución, relacionan los componentes ancestrales huésped-hospedero y describen mecanismos adaptativos de H. pylori al entorno gástrico humano, con el fin de comprender si el proceso de coevolución modula la patogenicidad de la bacteria y el desarrollo de enfermedades gástricas. Se realizó una búsqueda sistemática en las bases de datos electrónicas: MEDLINE (OvidSP), Scopus (ScienceDirect), Scielo y Tree of Science (ToS); términos de búsqueda: "stomach", "cancer", "neoplasms", "ethinicity", "evolution", "genetics", "ancestry" y "Helicobacter pylori". Idiomas: inglés y español. Los datos fueron filtrados por un revisor utilizando un formulario estándar de extracción y ulteriormente revisados por otro. El riesgo de sesgo y la calidad metodológica de los estudios fueron evaluadas con el programa: Critical Appraisal Skills Programme (CASP). Del total de 1584 estudios, 36 cumplieron los criterios de inclusión. Los factores más relevantes en el desarrollo del espectro de enfermedades asociadas con la infección por H. pylori son: la disrupción en el proceso de coevolución entre la bacteria y su huésped humano -por la transferencia horizontal de segmentos de genes que no han evolucionado con sus anfitriones-; las sustituciones de aminoácidos; la fijación y la selección positiva principalmente en las regiones hipervariables. Helicobacter pylori (H. pylori) is classified as carcinogen type I for gastric cancer (GC). Although it has accompanied man for at least 116,000 years, knowledge of the evolutionary forces that modulate the role of this bacterium within the development of the spectrum of gastric diseases is still scarce. This systematic review compiles articles that report a process of coevolution process, relate host-host ancestral components, and describe H. pylori’s mechanisms of adaptation to the human gastric environment in order to understand if coevolution has modulated the pathogenicity of these bacteria and the development of gastric diseases. A systematic search was carried out in MEDLINE (OvidSP), Scopus (ScienceDirect), Scielo and Tree of Science (ToS). The following search terms were used: "Stomach", "Cancer", "Neoplasms", "Ethinicity", "Evolution", "Genetics", "Ancestry" and "Helicobacter pylori", and searches were conducted in both English and Spanish. The data were filtered by one reviewer using a standard extraction form and then reviewed by another. The risk of bias and the methodological quality of the studies were evaluated using the Critical Appraisal Skills Program (CASP). Thirty-six of the total 1,584 studies found met the inclusion criteria. The most relevant factors in the development of the spectrum of diseases associated with H. pylori infection are amino acid substitutions, binding and positive selection mainly in the hypervariable regions, and disruption of the coevolution process between the bacteria and their human hosts as the result of horizontal transfer of gene segments that did not evolve with their host.

Resume Introduction Le cylindrome de Poncet-Spiegler (CPS) est une tumeur cutanee benigne annexielle qui siege preferentiellement au niveau du cuir chevelu, du cou et du front. Les localisations peuvent etre isolees ou multiples. Il atteint souvent l’adulte jeune. Il s’agit de lesions a croissance progressive. Lorsque le cuir chevelu est entierement envahi, il presente l’aspect de « tumeur en turban ». Le traitement est chirurgical et peut etre delicat quand la tumeur est etendue. Nous presentons la prise en charge d’une tumeur turban. Observation Une patiente de 25 ans a d’abord beneficie de l’exerese partielle de lesions nodulaires du cuir chevelu dont l’histologie mettait en evidence un CPS. Elle a ete perdue de vue. Neuf ans plus tard, elle a ete prise en charge pour un CPS en aspect de turban. Le traitement a consiste en l’exerese totale du cuir chevelu et une reconstruction secondaire par greffe cutanee. Le suivi a ete marque par une amelioration fonctionnelle et esthetique et apres deux ans de suivi, il n’y avait pas de signe de recidive. Discussion Comme la plupart des tumeurs, la taille du CPS guide la prise en charge. Un traitement chirurgical agressif doit etre envisage si la forme est etendue. En cas d’aspect en turban, une exerese complete du cuir chevelu et une reconstruction secondaire par greffe cutanee est preconisee.

Resume Introduction Nous avons evalue les reconstructions des pertes de substances partielles de l’helix par le lambeau d’Antia-Buch et nous avons compare nos resultats a ceux des autres techniques decrites dans la litterature. Materiels et methodes Entre novembre 1998 et novembre 2002, nous avons realise 19 lambeaux d’Antia-Buch : 15 cas apres exerese carcinologique et quatre cas post-traumatiques. Les pertes de substances allaient de 15 a 40 mm. Entre 30 et 40 mm, la technique chirurgicale etait modifiee selon Fata. L’evaluation a pris en compte la satisfaction des patients, l’harmonie de l’ourlet heliceen evaluee par l’equipe chirurgicale, la presence eventuelle d’une encoche a la jonction ente les deux lambeaux et l’importance de la microtie postoperatoire. Resultats Toutes les reconstructions ont pu etre menees a bien sans complication. La technique de Fata a ete necessaire chez huit patients. Tous les patients etaient satisfaits du resultat esthetique, bien que la microtie ait ete systematique. La reconstruction de l’ourlet heliceen a ete jugee bonne chez 16 patients et moyenne chez trois autres patients. Neuf patients avaient une encoche sur le bord libre de l’helix. Discussion La reconstruction par le lambeau d’Antia-Buch est une technique simple et rapide, realisable en un temps, sous anesthesie locale. Elle permet une reconstruction harmonieuse de l’helix et du pavillon de l’oreille avec un tissu de meme nature, au prix d’une rancon cicatricielle minime, d’une constante microtie et parfois d’une encoche sur le bord libre de l’helix.

Les auteurs rapportent trois observations d’epithelioma spino-cellulaire de la columelle envahissant la sous-cloison. L’exerese large de ces tumeurs a pose le probleme d’une reparation a cheval sur plusieurs sous-unites esthetiques nasales. Apres une revue chronologique des procedes de reconstruction de la columelle, les auteurs justifient le choix du lambeau nasogenien dans ces trois cas cliniques, alors qu’il n’a que rarement retenu leur attention pour les rhinopoieses partielles.

There are many lips kinetic disorders whose clinical appearances greatly differ. An acute examination directs toward the diagnosis on a neurologic, neurogenous, muscular, myogenous, medicamentous, dermatological or psychiatric etiology. The authors review the different etiologies that have to be discussed, in order to choose the appropriate further investigations and specialized examinations, before a possible surgical treatment.

Resume Introduction L’evolution intracrânienne du melanome cutane est habituellement due a des metastases. L’evolution neurotrope des tumeurs malignes vers l’endocrâne concerne principalement les nerfs trijumeau et facial. Parmi les types histologiques de tumeurs neurotropes, le melanome constitue une entite rare. Observation Un patient a presente un melanome desmoplastique palpebral inferieur. L’evolution a ete marquee par l’envahissement du sinus caverneux, puis du nerf mandibulaire a partir du nerf maxillaire. Discussion Cette evolution neurotrope doit attirer l’attention en cas de lesion tumorale a proximite d’un nerf. Une chirurgie d’exerese large doit etre preconisee dans ce type de tumeur. Dans le cadre de la surveillance d’un melanome, notamment desmoplastique, tout signe neurologique moteur ou sensitif doit faire discuter une exploration approfondie par IRM.

Introduction Le chirurgie du lentigo malin (LM) necessite, du fait de la difficulte a determiner les marges, soit une intervention en plusieurs temps, soit la realisation d’une chirurgie micrographique de Mohs (CMM). La microscopie confocale ex vivo (MCEV) est proposee comme alternative a la CMM pour evaluer l’envahissement des marges et realiser une analyse extemporanee. Notre objectif etait de montrer la precision et la fiabilite de la MCEV pour l’examen extemporane des marges d’exerese du LM. Patients et methodes Nous avons compare de maniere prospective, chez 15 patients (16 LM) ne necessitant pas de reconstruction par lambeau, l’analyse par MCEV a l’examen anatomopathologique « en face » en aveugle de l’ensemble des marges laterales apres inclusion en paraffine (technique « du spaghetti »). Resultats Toutes les constatations de MCEV sont comparables avec les resultats anatomopathologiques (2 vrais positifs, 14 vrais negatifs, pas de faux positif ni faux negatif). Discussion La qualite de la MCEV semble aussi bonne que l’analyse anatomopathologique apres inclusion en paraffine, celle-ci etant de qualite superieure a la CMM. La duree de l’examen est comparable a celle d’un examen extemporane et aucune piece n’a eu une duree d’ischemie froide superieure a 1 heure. Conclusion Ces resultats suggerent que la MCEV peut etre une technique rapide et fiable d’analyse extemporanee dans la prise en charge chirurgicale du LM, mais doivent etre confirmes par une plus grande serie.

The condylar region is a frequent localization of mandibular fractures; there are various types of management. Mini-invasive endoscopic surgery is an alternative to open reduction. We had as goal to evaluate the outcome of this technique.We performed a monocentric retrospective study of patients consecutively operated for a condylar fracture (type II to V in the Spiessl and Schroll classification) with intraoral route and endoscopic assistance, during 30 months. We assessed the functional and radiological outcomes, and the complications.Twenty-two patients (25 fractures) were included. Seventeen patients (19 fractures) could be followed (mean follow-up: 16.7 months). The mean values were: interincisal opening, 45mm (±8.4); protrusion, 8.3mm (±1.9); ipsilateral excursion of the jaw: 8.6mm (±2); contralateral excursion: 8.7mm (±4). Three routes were used combined with a preauricular approach. The fracture reduction was good for 10 of the 19 fractures and poor for 3. The complications were: 3 cases of infection, 1 case of fixation failure with good consolidation; for combined approaches: 2 cases of temporary facial palsy and 2 cases of Frey syndrome.Endoscopic assistance for the surgical management of the fracture of mandibular condyle is a reliable technique, with a good functional outcome, and a low rate of specific complications, especially for facial nerve lesion or esthetic outcome.

The major complications of free flap surgery are anastomotic obstructions. The coupler, mechanical anastomosis using a double ring eversion system, yields higher venous patency rates than sutured anastomoses, and requires less operating time. We present our initial experience with this coupler in free flap surgery.We conducted this retrospective study between November 2011 and June 2012. We focused on complications having occurred in the first 10 patients having undergone free flap reconstruction (11 flaps) with end-to-end venous anastomosis using this coupler. Five flaps were used to fill cervico-facial defects in carcinologic surgery: one for mandibular osteoradionecrosis, one for cranioplasty coverage, one for cranial base reconstruction, two for skin defects in lower limb (heel, leg). One was an antebrachial radial flap, four anterolateral thigh flaps, five fibular flaps, and one latissimus dorsi flap. Fifteen veins were anastomosed. The diameters of the couplers used were 2.5 mm (3/15), 3 mm (6/15), and 3.5 mm (6/15).There were no venous complications. One flap failed because of arterial ischemia.The coupler is a fast and reliable alternative to usual sutures in free flap reconstructions, for head and neck as well as for limbs.

The Poncet-Spiegler cylindroma (PSC) is a benign annexal cutaneous tumor which preferentially develops on the scalp, neck, or forehead. Localizations may be isolated or multiple and often affect the young adult. The lesions grow progressively. When the scalp is completely involved, it presents as a "turban tumor". Treatment is surgery and may be difficult when the tumor is extended. We report the management of turban tumor.A 25 year-old female patient was first treated by partial scalp nodule exeresis and histology documented a PSC. She was lost to follow-up. But 9 years later, she was managed for a turban like PSC. The treatment was a complete scalp exeresis and secondary reconstruction with a skin graft. Follow-up was uneventful with a progressive functional and cosmetic improvement and after 2 years, there was no relapse.As for most tumors, management depends on the size of the PSC. An aggressive surgical treatment must be considered if the PSC is extended. In case of turban tumor, total scalp exeresis and secondary reconstruction with a skin graft is recommended.

A pneumomediastinum was discovered fortuitously on a CT scan prescribed to a patient for facial and cranial trauma. Emphysema was attributed secondarily to an anterolateral maxillary wall fracture. The evolution was favorable after simple clinical and radiological surveillance.The observation of a pneumomediastinum should first be related to a tracheal or esophageal wound with a severe prognosis. Endoscopy under general anesthesia was not necessary for our patient thanks to CT scan with 3D reconstruction. There is no consensus for systematic antibioprophylaxis.

The intracranial evolution of cutaneous melanoma is usually due to metastases. Neurotropic invasion mainly concerns the trigeminal and the facial nerves. The melanoma is a rare entity among neurotropic tumors.A patient presented with a desmoplastic melanoma of the lower lid, complicated by a perineural extension to the cavernous sinus and the mandibular nerve via the maxillary nerve.This neurotropic evolution should be carefully monitored when close to a nerve. Extensive surgical excision including peripheral nerves in the vicinity of such tumors is recommended. MRI should be performed when a motor or sensitive disorder appears in the course of a desmoplastic melanoma.

The aim of this study was to evaluate the results of ear defect reconstruction using the Antia-Buch flap technique and to compare it to other techniques described in international literature.We performed 19 Antia-Buch flaps between November 1998 and November 2002: 15 cases after neoplastic treatment and four post-traumatic cases. Defect ranged between 15 and 40 mm. Between 30 and 40 mm, we used Fata's modification. The final assessment took into account patient satisfaction, cosmetic aspect of reconstruction assessed by the medical team, the presence of a notch at the helical rim and the degree of microtia.All ear reconstructions were successful. No complications were reported. Fata's modification was used for eight patients. All the patients were satisfied with the result in spite of a systematic microtia. The cosmetic aspect was considered as good for 16 patients, average for three. Nine patients presented with a notch at the helical rim.Reconstruction using the Antia-Buch flap is a simple and fast operative technique performed in a single operation under local anesthesia. It allows for a harmonious reconstruction of the helix and auricle with a tissue of same nature, and only a tiny cicatricial ransom, systematic microtia and frequent notch on the helical rim.

Introduction La pemphigoide cicatricielle (PC) est une dermatose auto-immune dont le diagnostic repose sur la caracterisation par IFI d’Ac anti-BP180 et moins souvent anti-BP230, l’etude histologique des bulles et l’IFD de la zone peri bulleuse. Les biopsies doivent souvent etre realisees sur les muqueuses notamment oculaires avec un risque d’aggravation locale du decollement bulleux. Nous avons realise chez 6 patients un examen en microscopie confocale in vivo des muqueuses oculaire ou buccale chez des malades atteints de PC sans atteinte cutanee associee. Observations Il s’agissait de 4 hommes et 2 femmes d’âge moyen 76 ans ayant beneficie d’un EMCIV des faces externes des gencives et des culs de sacs conjonctivaux oculaires. Resultats Une atteinte buccale etait presente chez 3 patients sous la forme d’une gingivite desquamative. Un decollement bulleux sous-muqueux en microscopie confocale au moyen de la camera Vivascope 3000 etait mis en evidence dans les 3 cas. Quatre patients presentaient des manifestations oculaires, inflammatoires 2 fois, cicatricielles 2 fois. Dans les 2 cas d’atteinte inflammatoire etait mis en evidence un decollement bulleux sous-muqueux. Discussion La realisation de biopsie des culs de sac conjonctivaux expose les malades atteints de PC a un risque d’aggravation des lesions locales de PC et de brides conjonctivales. Par ailleurs, en l’absence de bulles cliniquement visibles, il s’agit d’une biopsie non ciblee ce qui augmente le risque de faux negatif. L’examen de la totalite du cul de sac conjonctival ou de la gencive inflammatoire nous a permis de voir que les bulles infracliniques etaient, outre leur petite taille, peu nombreuses et reparties sur l’ensemble de la muqueuse inflammatoire, tres a distance les unes des autres. Ainsi, la possibilite de caracteriser un decollement bulleux de maniere fiable et non invasive est un element utile au diagnostic chez ces patients souvent âges et douloureux. Conclusion Il s’agit des 2 premiers cas rapportes d’examen en MCIV visualisant de maniere formelle les bulles des culs de sacs conjonctivaux. Un cas a deja ete rapporte mais la qualite plus que mediocre des images ne permettait pas de visualiser le decollement bulleux sur les images de cet article. Enfin, un seul type de camera a permis l’examen des lesions buccales et oculaires.

Introduction La delimitation des marges du lentigo malin (LM) est difficile et le taux de recidive important. La Societe francaise de dermatologie preconise de realiser des marges a 1 cm, qui peuvent etre ramenees a 0,5 cm avec un controle strict des berges dans les zones a forte rancon cicatricielle. La microscopie confocale in ivo ou in vivo reflectance confocal microscopy (RCM in vivo) est utilisee pour ameliorer la precision des marges pour eviter toute exerese inutile et assurer une exerese maximale. L’objectif de notre etude etait d’evaluer l’interet du reperage par RCM in vivo des marges du LM sur l’epargne tissulaire par rapport aux marges cliniques de 0,5 et 1 cm. Materiel et methodes Vingt-six LM prouves histologiquement ont beneficie d’une delimitation prealable au stylo dermographique des marges cliniques a 5 et 10 mm, suivie d’un reperage des marges par RCM in vivo. Des photographies 3D ont ete realisees avec 3D LifeViz™. Le logiciel Dermapix ® etait utilise pour le traitement des images afin de connaitre la surface d’exerese avec chacune des marges. Les mesures ont ete realisees en aveugle par 2 operateurs differents (variabilite inter-observateurs), avec repetition des mesures a distance pour l’un des deux (variabilite intra-observateur). Resultats La surface moyenne delimitee par la RCM in vivo etait de 193 mm 2 . Le gain relatif etait de 31,1 % et 70,4 % entre les marges en RCM in vivo et respectivement celles a 5 et 10 mm. Des cellules tumorales ont ete trouvees au-dela de la marge clinique de 5 mm sur une (6 cas), voire deux (4 cas) zones. Dans un cas, la marge a 1 cm etait depassee. Les resultats etaient comparables en inter- et intra-observateurs. Discussion Nous avons pu montrer que la RCM in vivo permettait une reduction drastique de la surface d’exerese, ce qui dans une zone aussi critique que la face peut faire une difference d’importance dans la technique chirurgicale. Par ailleurs, nous avons pu observer que la marge de 5 mm expose a la reprise (chirurgie par etapes ou de Mohs) avant reconstruction, mais aussi que la marge de 1 cm n’est pas une securite absolue. Conclusion Notre travail conforte la place importante de la RCM in vivo dans la prise en charge moderne du LM.

A 23 year-old girl was admitted for a facial tumefaction, fixed to the mandible. The X-rays showed a fuzzy osteolytic lesion of the mandibular angle. The CT-scan confirmed the rupture of the cortical bone and the extension to the soft tissue. Biopsy provided the diagnosis of granulocytic monoblastic sarcoma (chloroma). Chemotherapy was efficient.Mandibular localizations of chloroma are rare. Granulocytic monoblastic sarcoma is a localized tumor made of extramedullar immature granulocytes, in general associated (or more rarely preceded by) with leukemia. Early diagnosis is important because high dose chemotherapy induction may completely cure leukemia.

We report three cases of squamous cell carcinoma of the columella invading the sub-partitions. Wide resection raised the problem of several nasal esthetics sub-units. A chronological review of columella reconstruction procedures explained why the nasolabial fragment rarely used for partial rhinopoiesis, was appropriate in these three patients.

Lengthening temporalis myoplasty is indicated in long-standing and congenital facial paralysis. Its principle is the transfer of the coronoid tendinous insertions onto the lip and the nasolabial fold. Knowledge of the anatomy of this strong and wide tendon is necessary for successful use of its anatomic advantages. A study on 10 cadavers (20 temporalis muscles) confirmed the surgical anatomy found during lengthening temporalis myoplasty procedures: the strong tendon, when freed from the coronoid process, is 4-6 cm wide.

We describe a case of branchial cyst from the first branchial cleft in an 8-year-old patient, emphasizing the diagnostic difficulties of this type of lesion and the clinical aspects as well as the details of surgical treatment. The embryogenic origin and the anatomic relation with the facial nerve is recalled. Surgical treatment is indicated.

There are many lips kinetic disorders whose clinical appearances greatly differ. An acute examination directs toward the diagnosis on a neurologic, neurogenous, muscular, myogenous, medicamentous, dermatological or psychiatric etiology. The authors review the different etiologies that have to be discussed, in order to choose the appropriate further investigations and specialized examinations, before a possible surgical treatment.

The Chinese or radial forearm flap, first described by Yang et al. (1981), is useful both as a free or a pedicle flap. This flap has proved to be one of the safest and most versatile flap in widely differing clinical situations. It is generally classified as a fasciocutaneous flap, but can also be used together with a segment of radius as a composite flap. However, the most common objection to this flap is the donor-site morbidity. The donor defect is significant, with a poor graft take over the exposed tendons. Inclusion of bone in the flap leads to a greater contour defect and to a risk of fracture. Many suggestions are given to minimize the complications on the donor-site defect. The surgical technique, the advantages, the disadvantages, and at least the indications of this flap are detailed.

Recommended treatment for head and neck cancer associates surgery and radiotherapy. Indication for bone-anchored epitheses in irradiated patients is also a common situation. The outcome of the implant appears to be improved with a special protocol for hyperbaric oxygen therapy, antibiotic therapy and calcitherapy. The problem of radiotherapy in patients with titanium osseointegrated implants is also discussed.

Resume Observation Un pneumomediastin a ete decouvert fortuitement sur un scanner prescrit dans un contexte de traumatisme crânien et facial. L’emphyseme a ete secondairement rapporte a une fracture de la paroi anterolaterale du maxillaire. L’evolution a ete favorable apres une simple surveillance clinique et radiographique. Discussion La decouverte d’un pneumomediastin doit en premier lieu faire evoquer une plaie tracheale ou œsophagienne, dont le pronostic est grave. Le scanner en coupes axiales avec reconstructions tridimensionnelles nous a permis d’eviter une endoscopie sous anesthesie generale. L’antibioprophylaxie systematique est discutable.

Objectifs pedagogiques Rappeler les variations anatomiques des sinus de la face. Preciser les variantes favorisant les pathologies de confinement. Decrire les variantes a risque chirurgical lorsqu’une chirurgie endonasale est envisagee. Illustrer chacune de ces variantes par une iconographie caracteristique. Messages a retenir Les variantes anatomiques des sinus de la face sont importantes a connaitre et a preciser dans le compte rendu radiologique (importance medico-legale). Mecanismes favorisant les phenomenes de retention : retrecissement du meat moyen et de l’infundibulum. Structures a risque de lesions per-operatoires : orbite, nerf optique, artere carotide interne, dure-mere et endocrâne.

Introduction Il est interessant de remarquer le contraste entre la connaissance de nombreuses possibilites d’utilisation en lambeau du muscle temporal, de ses fascias et de l’os temporal en chirurgie reconstructrice, et le flou existant sur l’anatomie topographique et chirurgicale de la region. Le perioste de la region temporale est differemment situe selon les auteurs : soit au contact du plan osseux sous-jacent comme partout ailleurs dans l’organisme, soit entre fascia temporal profond et superficiel. Les auteurs font le point par des travaux anatomiques et histologiques, ainsi que par une revue de la litterature sur l’anatomie de la region temporale. Les applications chirurgicales sont degagees. Materiel et methode Il s’agit d’une etude anatomique et histologique realisee sur cadavres frais congeles comportant huit enfants morts nes et quatre adultes. Resultats Anatomiques : nos differents travaux de dissection montrent l’existence au contact du plan osseux calvarial d’une continuite anatomique entre le plan perioste temporal et le perioste parietal, notamment au niveau de la crete temporale. Histologiques : le perioste crânien se separe a partir de la ligne courbe temporale superieure en 2 lames : une lame profonde s’etalant sur le squelette de la fosse temporale au contact de l’os et correspondant au veritable perioste temporal ; une lame superficielle s’etalant sur le muscle temporal et se terminant sur l’arcade zygomatique. Cette derniere lame correspond histologiquement non pas au perioste mais plutot a une lame fibreuse de type aponevrotique. Il s’agit du fascia temporal superficiel. Conclusion A l’issu de ce travail, les auteurs situent le perioste temporal au contact du plan osseux de la fosse temporale, aussi bien chez l’adulte que chez l’enfant. Le perioste qui s’affine avec l’âge est plus difficilement individualisable chez l’adulte du fait de nombreuses insertions directes du muscle temporal sur l’os. L’existence de ce plan continu perioste parietal-perioste temporal permet la realisation d’un decollement sous perioste parietal puis temporal, notamment dans la chirurgie des craniostenoses chez le jeune enfant, ainsi qu’en traumatologie, dans l’abord des tumeurs de l’orbite, et dans la realisation des volets pterionnaux chez l’adulte.

International audience; For a long time, contingent staffing was considered as the responsability of the Human Resource department. The high needs of workforce flexibility combined with disseminated agencies have led some companies to a great number of labor suppliers. This situation has produced important cost variation, poor quality of service, and important risk due to the mistunderstanding by local managers of legal considerations. To face this situation, companies have started to move from a HR consideration to a purchasing one. This paper deal with the problem of sourcing contingent workers as a supply chain mangement issue: to secure and optimise the sourcing of non permanent workers, companies need to involve different departments within the organisation and to develop an optimise business process with some prefered suppliers. A case study developped with Wincanton finally illustrates the benefit of identifying the needs and outsourcing to a unique service provider such a sourcing process.

The topic of Performance Measurement and Management has been investigated for more than twenty five years leading to more than thirty five methods around the world, developed either by researchers or more pragmatically by practitioners, in order to define and implement indicators. Most of them are more oriented for the definition and few for the implementation. Other are simply a list of recommended PI’s. Several studies have been done to compare some of these methods and to explain the reasons of PI’s implementation failures. The objectives of this paper is to go deeper in detail in the comparison and in a second time to define a generic framework that could help to detect what should contain a generic method for Performance Indicator System definition and implementation and what is the knowledge that must be included in this kind of method to be more efficient.

International audience; This paper presents and discusses an analysis of the industrialization and manufacturing steps within the Product Life cycle Management (PLM) context. Initially, PLM was focused almost exclusively on the product design, but nowadays, it tends to cover all the stages of the product life cycle. In the same time, the industrialization and the manufacturing are not sufficiently integrated into the PLM solutions. Actually, there is much to be gained by extending the coverage of PLM to production stage in order to lead to interaction. This coverage depends on several features (for instance the frequency of product data modification). It also leads to an information exchange then to a classification of these information into categories. The main purpose of this paper is to study how to extend the PLM coverage of the life cycle stages by defining a mapping between information categories and the Information Systems (IS), which manages product manufacturing, for each feature.