[ Mc Kissock breast reduction]

Breast hypertrophy is an excessive volume of breasts compared to the morphology of the woman. Among the many existing surgical techniques to treat it the Mc Kissock technique has widely recognized benefits. This is a 36 years old patient who has breasts hypertrophy, pain, postural changes with an impact on the static spine. The technique of breast reduction used is a vertical bipedicle flap. The postoperative course is simple and the patient is very satisfied with of the results with a decline of 6 months. This technique can be used for all types of hypertrophy. It is characterized by the ease and reproducibility of preoperative design, the simplicity of gesture and high vascular safety. The disadvantages are large inframammary scars and the difficulty of adequately plicaturing the double pedicle in large hypertrophy and ptosis. The Mc Kissock Breast reduction gives good functional and aesthetic results, it is a technique of choice in the treatment of breast hypertrophy

[Care of a gigantomasty]

This is a rare, benign and of unknown etiology illness that is characterized by abnormal and excessive development of the breasts. It occurs most often during puberty or during pregnancy. Its physical and psychological impacts requires a quick and efficient care. This is a 15 years old patient who received a breast reduction called Thorek. This technique is particularly suitable for the treatment of advanced gigantomasty. The intervention was successful in removing more than 4 kgs in each of two breasts. The postoperative course is simple and the patient is very satisfied with the result with a decline of 18 months. The disease is defined by a breast volume superior to 1500 cm3. This results in a psychological distress and physical discomfort. Its treatment is surgical and involves the reduction mammoplasty that can be either conservative or radical. The most common techniques used are the Mc Kissock and Thorek. Our preference goes to the Thorek because it respects the viability of the areola and minimizes the risk of local complications: oedema, ulceration, necrosis, infection. The technique of Thorek used to treat the gigantomasty of our patient gave satisfactory results in terms of function and aesthetics. However, she remains under regular survey because of recurrences that are common and may require reoperation

[Reconstruction of the lower lip by the Karapandzic flap]

The main etiology of the defects of the face is the excision of skin tumors. Lip reconstruction or cheiloplasty can use several techniques. Karapandzic flap provides good coverage of these losses of substances with good aesthetic and functional results. A 67 years old patient presents a spinocellular carcinoma of the lower lip measuring 4.5 cm × 4 cm. Resection repects a margin of 1cm. A bilateral rotation flap wich incisions are parallel to the free edges of the lips and equal to the height of the defect was performed. A back cut on the mucosal side allows better advancement of the flaps. They are sutured to each other. The postoperative course is simple. The aesthetic and functional results are very satisfactory with a decline of 6 months. This is an excellent technique because it bends to the principles that are functional, morphological and aesthetic. It respects vessels: coronary facial artery, sensory and motor branches of the myocutaneous flap to obtain a buccal sphincter effective immediately. The mouth opening is satisfactory due to the elasticity of the tissue flap. Secondary commissuroplasty is not systematic. Most often, the incision seat in the nasolabial fold and goes higher or lower depending on the size of the defect. The upper limit of the incision is a few millimeters below the nostril. The Karapandzic flap used to the lower lip reconstruction after tumor resection gave good functional, morphological and aesthetic results

Intraventricular cavernoma

Intraventricular cavernoma is rare; only 45 cases have been reported in the literature. Magnetic resonance imaging has wildly contributed in the diagnosis and the surgical approach. Case file: We report a 45-year-old man presenting with syndrome of intracranial hypertesion and retrograde amnesia for one year. CT scan and MRI revealed an intraventricular tumour, which was responsible for active hydrocephalus. A ventriculo-peritoneal shunt was performed and a stereotactic biopsy allowed the diagnosis of cavernoma. Post operative follow-up was uneventful, the patient rests asymptomatic. Ventricular cavernoma is rare and should be suspected in atypical localisations in order to chosse the best surgical approach. The author attack the attention to that rare localisation of cavernoma and for its hemorrhagic risles