[Activity report about hospital Saint-Louis's team for taking in charge sequellae of Noma]. / Bilan d'activité des équipes de l'hôpital Saint-Louis à Niamey pour la prise en charge des séquelles de noma (médecins du Monde-Opération sourire).

A presentation of the country in which the missions have been made, the authors describe the schedule of their action and the synergy developed with associative partners allowing tacking in charge of sequelae of Noma disease. Epidemiology and clinics of Noma are shortly described. Different cases are exposed by localisations: lips, centro-facial, cheek, hemi-face. Different principles of these reconstructions are exposed and the techniques with their adaptation to the African lip and to the particularity of Noma lesion (important lose of substance of mucosae which is very important to repair). The very important points of the organisation are exposed especially for the follow up of these patients.

["Opération Smile" missions in Mongolia]. / Missions "opération sourire" en Mongolie.

We report our experience of plastic surgery of the face, limbs and burns in Mongolia. This country is three times as huge as France and has got 2,4 millions of inhabitants of whom almost one million live in the capital city Oulan-Baator, where sanitary and weather conditions are very tough for a large part of the population. The main observed and treated pathologies were sequellae of nerves and vessels lacerations, sequellae of complex hand injuries, sequellae of leg traumas, face, neck and limb burns, lips and palate clefts and pressure shores. The training of Mongol surgeons is far from good in the fields of skin coverage, digits reconstruction, treatment of nerve and vascular injuries and management of burns. Pedicled radial antebrachial, posterior interosseous, inguinal, sural, saphenous and lower limb muscular flaps were performed and taught. Microsurgery is still starting up. Thus we performed the first second toe transfer to reconstruct an amputated thumb. Some clinical cases are presented. This French-Mongolian cooperation should continue in order to match between both countries the knowledge and use of standard techniques in plastic surgery.

[Contribution of computers in reconstructive surgery missions in Third World countries]. / L'apport de l'outil informatique dans les missions de chirurgie réparatrice dans les pays du tiers-monde.

The authors analyse the possible contribution of computers to the management of patients operated as part of humanitarian reconstructive surgery missions. There are many advantages: better preparation of missions, better evaluation of follow-up, possibility of exchange of files by Internet, or even remote medical assistance.

[An auricular prosthesis attached by intra-mastoid implants. Apropos of 11 cases]. / Prothèse auriculaire fixée sur implants intramastoïdiens. A propos de 11 observations.

The use of osseointegrated implants to provide support for auricle prosthesis as been carried out by Tjellstrom. This method has provided the maxillofacial surgeon with another approach to the treatment of defect of the auricle. The principles and concepts of extra-oral osseointegrated implants are the same as those of the intra-oral application developed by Branemark 26 years ago. This simple and reliable method allow the attachment to splint bar fixated to three or two mastoid osseointegrated implants. This method represent an interesting possibility for the management of auricle defects. We report on our experience of 11 cases.

[Orbito-palpebral prosthesis and intraosseous implants]. / Epithèse orbito-palpébrales et implants intra-osseux.

Authors report their experience of the use of intraosseous implants for orbito-palpebral prosthesis. Principles are reminded and advantages discussed.

[Mandibular reconstruction by a free peroneal transfer]. / Reconstruction mandibulaire par transfert libre de péroné.

After an anatomical study of the osteo-septo-cutaneous fibular flap, we reported 4 reconstructions of segmental mandible defects by this procedure, published in 1989 by D. Hidalgo. 2 patients presented mandibular defects associated with intraoral soft- tissue loss, following resection for epidermoid carcinoma with pre or post-operative radiation. The third patient had a multirecurrent ameloblastoma associated with extraoral soft-tissue extension. The fourth patient presented a complex loss of soft tissue and mandible following a war injury. The flaps survived in all patients. The osteo-septo-cutaneous fibular flap for mandible reconstruction has presented several advantages. The flap has been elevated under a tourniquet, the distant donor site has allowed a two-team approach. The osteo-septo-cutaneous blood supply has been adequate to support a skin island for intra or extraoral soft-tissue replacement. Biomechanical properties of the fibula have allowed fixation with miniplates and no postoperative intermaxillary fixation. Osteointegrated implants (Branemark) for dental rehabilitation were done for one patient. There was no long-term donor-site morbidity.

[Sphenoid fissure syndrome in orbital fractures. Case presentation and literature review]. / Syndrome de la fente sphénoïdale au cours des fractures de l'orbite. Présentation d'un cas et revue de la littérature.

The superior orbital syndrome has been reported as a very rare complication of orbital fracture. In emergency clinical examination and computed tomography of the cranio-orbital region have provided diagnosis of the compression of the superior orbital fissure content by oedema and/or hematoma. These examinations have determined the type of cranio-orbital fractures and the absence of extra-dural haemorrhage, optical nerve damage or compression, which required emergency treatment. After surgical treatment of the cranio-orbital fracture by temporal and transconjunctival approach, the orbital fissure syndrome has required supervision. The recovery of ophthalmoplegia has taken several months. Minor after effects have been observed for the patient reported.