Anatomical study of the variations in innervation of the orbicularis oculi by the facial nerve.

While the divisions of the facial nerve in the face are well known, the innervation of the orbicularis oculi by the different distal branches of the facial nerve is poorly described. To determine which branches of the facial nerve play a role in this innervation, the facial nerve was dissected in 30 fresh cadavers. The innervation of this muscle was in the form of two plexuses, a superior one, most often (93%) formed by the union of the temporal and superior zygomatic branches, and an inferior one, usually formed (63%) by the union of the inferior zygomatic and superior buccal branches. This new mode of innervation explains how, without damage to both plexuses, innervation of orbicularis oculi by the facial nerve remains functional. It also explains the often unsatisfactory results of treatment of primary blepharospasm, and the unusual character of palsies of this muscle in cervicofacial lifts.

[Treatment of vesicovaginal fistulas using the musculofascial flap of the levator ani muscle: 26 case reports]. / Le traitement des fistules vésicovaginales par l'utilisation du lambeau musculofascial du muscle releveur de l'anus: à propos de 26 cas.

OBJECTIVE: The authors reported the preliminary results of levator ani muscle flap in the treatment of vesicovaginal fistula. MATERIALS AND METHODS: Twenty-six patients whose age varied between 13 and 18 years (mean: 30 years) are selected. All the patients are treated by the vaginal approach using the part of superficial rectal fibers of the levator ani muscle. RESULTS: Among the 26 patients, 14 are free after the first cure of vesicovaginal fistula (54%), and 4 patients (15%), after the treatment of some complications. CONCLUSION: The musculofascial levator ani flap with its vascular pedicle and its mobilisation can successfully close the vesicovaginal fistula. The preliminary results obtained (88%) tie up with that previously described in the literature.

[Internal iliac artery: functional anastomosis value and pelvic surgery application]. / Artère iliaque interne: valeur anastomotique fonctionnelle et application chirurgicale pelvienne.

The vascularization of the intra and extra pelvic organs of adults, children and neonates (male and female) is studied in 17 pelvis, in which the vascular system has been injected with colored Altufix p10 and gelatinous india ink. The pelvic region constitute a true vascular crossroad of two anastomotic networks, one arterial, originate from the visceral and parietal branches of iliac internal and external arteries, femoral and abdominal aorta by inferior mesenteric artery; the other one, which morphology is incompletely superposable in diameter. Each organ is tributary of characteristic vascular system from adventitious to mucosa with direct or recurrential manner between striated muscle fibers and mucosal layers. This duality of two systems, vascular and anastomotic provides the anatomic direction of vascular suppliance after troncular iliac artery binding and determines the vitality of the organ.