ABSTRACT
Surgical management of obstructive sleep apnea remains a surgical challenge. Multidisciplinary collaboration is a fundamental element. We report the principles of management as proposed to the patient and preliminary results obtained in a series of 26 patients treated in the phase I of the Stanford protocol. Cure rate after this phase was 50%. Different research projects in this area are discussed.
Subject(s)
Sleep Apnea Syndromes/surgery , Adult , Aged , Airway Obstruction/surgery , Facial Muscles/surgery , Female , Follow-Up Studies , Humans , Male , Methods , Middle Aged , Nose/surgery , Palate, Soft/surgery , Polysomnography , Positive-Pressure Respiration , Sleep Apnea Syndromes/etiology , Sleep Apnea Syndromes/physiopathology , Sleep Apnea Syndromes/therapyABSTRACT
Several questions concerning the material to be used for surgical repair of fractures of the orbit are still under debate. Surgeons may choose between autologous or heterologous grafts or different biomaterials. We conducted a retrospective analysis of 137 patients treated in our unit for fractures of the floor of the orbit over the last 20 years who received a silastic implant. After 20 years, the rate of complications requiring removal of the implant was 13.8%. Complications observed were dacryocystitis, implant migration to the skin and the maxillary sinus, skin fistula, persistent diplopia, communication between the orbit and the sinus, periorbit cellulitis.
Subject(s)
Orbital Fractures/surgery , Prostheses and Implants/adverse effects , Silicone Elastomers/adverse effects , Biocompatible Materials/adverse effects , Bone Transplantation , Cellulitis/etiology , Cutaneous Fistula/etiology , Dacryocystitis/etiology , Diplopia/etiology , Fistula/etiology , Follow-Up Studies , Foreign-Body Migration/etiology , Humans , Maxillary Sinus/pathology , Orbital Diseases/etiology , Paranasal Sinus Diseases/etiology , Prosthesis Failure , Retrospective Studies , Skin/pathology , Transplantation, Autologous , Transplantation, HeterologousABSTRACT
Fractures of the orbital floor still raise unresolved therapeutic problems concerning the operative indication or the type of material to be used during repair. For this purpose, surgeons have the choice between heterologous or autologous grafts, implants and numerous biomaterials. The authors conducted a retrospective study with a follow-up of 20 years of 137 patients treated in the department for a fracture of the orbital floor using a Silastic implant. The reoperation rate to remove the implant was 13.8%. Various complications were observed: dacryocystitis, migration of the implant to the skin and maxillary sinus, cutaneous fistula, persistent diplopia, orbito-sinus communication, periorbital cellulitis. In view of these complications, it appears preferable to modify the therapeutic approach and propose autotransplantation of the concha for defects less than 1.5 cm2 and autologous parietal bone graft for larger defects.
Subject(s)
Orbital Fractures/surgery , Prosthesis Implantation/methods , Adult , Biocompatible Materials , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/diagnosis , Retrospective StudiesABSTRACT
The authors describe the clinical and anatomical appearance of orbital fractures operated on in their centre, based on an analysis of a homogeneous series of 105 cases. They define their indications, operative technique and results.
Subject(s)
Orbital Fractures/epidemiology , Adolescent , Adult , Child , Female , France/epidemiology , Humans , Male , Orbital Fractures/complications , Orbital Fractures/surgery , PrognosisABSTRACT
Gingival ameloblastoma is a rare odontogenic tumor which shares the same histology as endo-osseous ameloblastoma but from which it differs in terms of its course by the absence of "local malignancy". There would appear to be two probable origins concerning this lesion: Serre debris and the epithelium of the gingival mucosa. However, the etiopathogenesis remains controversial, raising problems of pathological distinction from gingival basal cell carcinoma.
Subject(s)
Ameloblastoma/pathology , Gingival Neoplasms/pathology , Aged , Aged, 80 and over , Female , Humans , MandibleSubject(s)
Zygomatic Fractures/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Fracture Fixation , Humans , Middle Aged , Zygomatic Fractures/diagnosisABSTRACT
The authors advise the carrying out of total partiodectomy with conservation of the facial nerve in all parotid tumors and supply a method of obtaining a truely radical parotidectomy by pre-operative vital staining.
