Double palatal flap for oro-nasal fistula closure.

INTRODUCTION: The management of oral fistula to the nose depends on its etiology, its size and its location. Here, we describe a simple technique, inspired by the ones initially developed by Bardach for cleft palates repair. The surgical alternatives are discussed. TECHNICAL NOTE: The double palatal flap is a simple technique, allowing closure in a single session of a central or centro-lateral palate fistula. The key of this technique is the dissection between nasal and palate mucous layers, providing a sufficient amount of laxity to close the defect without tension. DISCUSSION: The double palatal flap can cover centro-lateral palate mucosal fistulae. It provides both aesthetic and functional results in a single stage. Reliability, simplicity and quickness are its main advantages. Outcomes are usually simple; Velar insufficiency may occur, that can be corrected by speech therapy.

Chin wing: Technical note.

The chin may be concerned by morphological abnormalities in its various dimensions. Classical genioplasty techniques can be used to correct these but have some disadvantages. The "chin wing", described by Triaca, is a technique of genioplasty extended to the mandibular angles, considering the mandibular basilar border as an anatomical unit, thus achieving a better harmonious functional and aesthetic result. The preoperative assessment included a mandibular Cone Beam to evaluate the position of the inferior alveolar nerve. The procedure was performed under general anesthesia. The periosteal dissection was limited to the osteotomy area and mental nerves were protected. The osteotomy observed a modification of its orientation in front of the mental foramen to become parallel to the basilar border, which was interrupted at the level of the mandibular angle. The spaces created were filled with bone grafts and maintained by a symphysary plate. Chin wing genioplasty both improves the function and aesthetic of the face because it considers the mandibular basilar border as an entire anatomical unit. It can be performed independently of any procedure to modify the bone bases. Nowadays, chin wing remains a challenging technique hardly performed.

[Plunging ranula. Review]. / Ranulas à expression cervicale. Mise au point.

INTRODUCTION: Ranula is a pseudocyst of the sublingual gland, often of unknown etiology. In few cases, it can extend to the neck when passing through the mylohyoid muscle. Diagnosis is not always easy as other cervical cystic lesions may have the same clinical aspect. Some ranulas recur after removal. The aim of our study was to conduct a review about plunging ranulas, with a focus on the most useful paraclinical exams and the most effective treatment. MATERIAL AND METHODS: A review of the literature has been conducted in the PubMed database between 2015 and 2010 using following keywords: plunging ranula, recurrent plunging ranula. RESULTS: Thirteen articles reporting 37 cases of plunging ranulas have been selected. Among these cases, 3 recurred. Paraclinical exams consisted in US, CT scan and MRI. Main reported treatment was sublingual gland removal, sometime associated with marsupialization. DISCUSSION: The most useful paraclinical exam is CT scan. Total sublingual gland removal is the most efficient treatment.