[Towel clip reduction of zygomatic arch fracture]. / Réduction des fractures de l'arcade zygomatique par pince fixe-champ.

INTRODUCTION: Isolated fractures of the zygomatic arch (IFZA) are common in maxillofacial emergencies. They usually require a closed reduction. Several reduction techniques have been proposed. The reduction using a Ginestet-type hook is the gold standard technique. DISCUSSION: The reduction using a towel clip under local anesthesia is an economical, simple, reliable and safe alternative technique for the reduction of IFZA. We describe this procedure.

[A pediatric case of hydatid cyst in the infratemporal fossa]. / Kyste hydatique de la fosse infratemporale chez un enfant.

INTRODUCTION: Hydatid cyst or disease is an anthropozoonosis due to the development of the larval form of the taenia Echinococcus granulosus in humans. It is endemic in Morocco. The location of a hydatid cyst in the infratemporal fossa (ITF) is extremely rare. The authors report a pediatric case. OBSERVATION: An 11 year old child was admitted to hospital with a history of left latero-facial swelling gradually increasing in volume for 2 months, CT scan of the face revealed a cystic formation of 7 cm diameter sitting at the left ITF, hydatid serology was negative. A transzygomatic approach allowed the excision of the cyst. The histopathological examination of the resected specimen confirmed the diagnosis of hydatid cyst. DISCUSSION: The location at the infratemporal fossa of an expansive process such as hydatid cyst in children may have a particular impact on adjacent structures and a more meaningful clinical expression. The rate of growth of hydatid cysts is highly variable and ranges from 1 to 5 cm a year. Hydatid serology is often negative. CT examination is the gold-standard radiological examination. Surgical removal of the hydatid cyst is the most effective treatment. The transzygomatic approach allowed a sufficient access to the cyst and a good quality of excision.

[Reconstruction of the lower third of the ear with a Crikelair flap]. / Reconstruction du tiers inférieur de l'auricule par lambeau de Crikelair.

Amputation of the lower third of the ear includes full thickness earlobe defects. Earlobe reconstruction depends on the covering and scaffold technique used. The Crikelair cervical skin flap is one of the available techniques for reconstruction. We discuss its assets and drawbacks by comparing it with alternative procedures.

[Facial wounds: an epidemiological review of 850 cases]. / Plaies faciales : étude épidémiologique de 850 cas.

BACKGROUND: Facial wound are among the most frequent emergencies. They often affect a young population. We studied the epidemiological profile of facial wounds admitted in our hospital. PATIENTS AND METHODS: This prospective study was carried out in the Emergency Unit from June 2008 to June 2009. It included all patients having presented with at least one facial wound. The analysed parameters were patient, trauma, and wound characteristics. RESULTS: Eight hundred and fifty patients were included, 20% of whom were female patients. The most frequent etiologies were traffic accidents for men, assault for women, and domestic accidents for children. Alcohol abuse was involved in 12.4% of the cases. The most frequent wound localization was frontal (35.4%). A craniofacial organ (eye, brain…) was affected in 6.1% of the cases; the wound was associated to a craniofacial fracture in 9.6% of the cases, and to an extrafacial lesion in 22% of the cases. DISCUSSION: Facial wounds are a frequent emergency. They are predominant in young male patients. The high frequency of traffic accident and alcohol abuse requires an adequate prevention policy.

[Medial cleft lip: one diagnosis masking another]. / Les fentes labio-palatines médianes : un diagnostic qui en cache un autre.

UNLABELLED: Median cleft lip and palate are one of the facial manifestations of holoprosencephaly, a brain malformation resulting from a defect in the development of the prosencephalon, the embryonic precursor of the forebrain. It can occur in isolation or as part of a broader pattern of malformation in many different syndromes. The diagnosis of holoprosencephaly requires a complete malformative assessment. FIRST CASE: a newborn baby seen at birth for a median cleft lip associated with a complex craniofacial malformation. The search for malformations revealed the absence of the median cerebral structure and trisomy 13. The baby died at 48 h. SECOND CASE: A 28-day-old newborn baby consulting for a median cleft lip and palate. The brain ultrasounds showed no anomalies of the median cerebral structure. The malformative assessment revealed no other malformation. DISCUSSION: Holoprosencephaly is a complex developmental brain malformation. From the advances in neuroimaging and genetics, our understanding of the etiology and pathogenesis of this condition has advanced dramatically. This advance should lead to improved management of common medical complications and more optimal family counseling. Surgical treatment is the preferred therapy for viable malformations.