[Ketanserin and random skin flaps. An experimental study in the rat]. / Kétansérine et lambeaux cutanés au hasard étude expérimentale chez le rat.

This prospective randomised study in a rodent model was designed to analyse the value of a serotonin antagonist, ketanserin, on the survival of random skin flaps in Wistar rats. Our study demonstrates the statistical value of this molecule. The surface of skin necrosis was statistically lower in the group of rats treated with pre and post operative subcutaneous injection of ketanserin.

[Surgical indications in angiomas of the face]. / Indications chirurgicales dans les angiomes de face.

Hemangiomas are common vascular tumors of children. They always regress. Surgery takes place for late sequelae, such as cutaneous scarring and distortion of the facial structures. Early surgery is beneficial for the nasal cyrano hemangioma, of for some eyelid hemangiomas. Venous malformations need to be manage from childhood to adulthood as they slowly worsen. Percutaneous embolization with Ethibloc and surgery are performed in order to minimize, or to improve the skin, muscle and bone distortion. Arteriovenous malformations are the most dangerous vascular anomalies of the face. Superselective arterial embolization prepares the surgical excision of the nidus. Difficulties in covering the excised area are frequently solved by flaps or cutaneous expansion.

[Surgical indications in angioma of the face]. / Indications chirurgicales dans les angiomes de face.

Hemangiomas are common vascular tumors of children. They always regress. Surgery takes place for late sequelae, such as cutaneous scarring and distortion of the facial structures. Early surgery is beneficial for the nasal cryano hemangioma, or for some eyelid hemangiomas. Venous malformations need to be manage from childhood to adulthood as they slowly worsen. Percutaneous embolization with Ethibloc and surgery are performed in order to minimize, or to improve the skin, muscle and bone distortion. Arteriovenous malformations are the most dangerous vascular anomalies of the face. Superselective arterial embolization prepares the surgical excision of the nidus. Difficulties in covering the excised area are frequently solved by flaps or cutaneous expansion.

[Surgical landmarks of the temporo-frontal branch of the facial nerve]. / Repères chirurgicaux du rameau temporo-frontal du nerf facial.

The temporal branches of the facial nerve, and in particular the rami for the frontalis muscle, have been the subject of many studies with the main objective of avoiding injury. The usual reference points, sometimes difficult to localise, anatomical variations in their branching and anastomoses are the main points of our investigation. This anatomical dissection study of 30 cadavres, with easy reference points available both superficially and in the depths allow a simple, non complicated localisation of the frontal branch and its anastomosis in a precise way on the mandibular condyle, the zygomatic arch and the temporal region. The distances described a, b, c, are useful in common surgical practice: temporo-mandibular joint surgery, facial lifting, temporal and temporo-parietal fascia flaps, and contralateral neurotomy for frontal symmetrization among others.

[Esthetic impact of the Le Fort I type osteotomy]. / Répercussions esthétiques de l'ostéotomie de type LE FORT I.

The study of a population treated according to orthodontico-surgical process with only a LE FORT I osteotomy allowed us to determinate the moderate influence on each element of curtain profile (nose, lips and chin). The comparison between relative moving of maxillary and the one of each cutaneous structures enable us to define the sagittal and vertical displacement's ratios of curtain profile.

[Progression toward bimaxillary surgery]. / Evolution vers la chirurgie bimaxillaire.

The authors explain the different reflexions which drive maxillo-facial surgery to a bimaxillary surgery. They describe this surgery relatively to Class II and Class III malocclusions with facial diseases in the vertical dimension. Surgical procedures seem to be directed by aesthetic (better facial balance) and functional problems, in spite of the ideal is not yet reached on this last point.

[The tip correction phase in esthetic reduction rhinoplasty]. / Le temps de correction de pointe dans la rhinoplastie esthétique de réduction.

The tip correction phase in reduction rhinoplasty cannot and must not be performed according to the same protocol in all patients. Simple clinical examination can determine the predominant element in projection of the tip: lateral crus, medial crus, the septum, which may participate to varying degrees in this projection. Precise procedures are performed on the basis of the elements observed on clinical examination.

[Fibrous dysplasia and ossifying fibroma of the base of the skull. Apropos of 6 cases]. / Dysplasie fibreuse et fibrome ossifiant de la base du crane. A propos de 6 cas.

The authors report 6 cases of fibrous dysplasia (F.D.) of the base of the skull and review the literature. They confirm the impossibility of histological differentiation between ossifying fibroma and monostic dysplasia with cranio-facial sites. They stress the value of CAT scan in the assessment of spread and that of dynamic isotope scan in the differential diagnosis with plaque-shaped hyperostotic meningioma, in the diagnosis of polyostotic forms and in postoperative surveillance. They stress the risk of visual sensorial impairment: visual by stenosis of the optic canals and auditory by stenosis of the E.A.M. Operative indications are influenced by this risk, thereby explaining the need for prolonged surveillance.

[Capillary-venous angioma of the temporo-masseteric region]. / Les angiomes capillaro-veineux temporo-massétérins.

Angioma of temporomasseteric region is a capillariovenous malformation in the temporomasseteric groove which can extend into adjacent facial zones. It forms a well defined clinicopathological entity. Clinically these angiomas present typical signs of a slow output capillariovenous angioma. Several patients were investigated by standard radiology, tomography and scan imaging, allowing detection of bony, particularly maxillary deformities, and by preoperative laboratory examinations. Treatment is by first stage embolization in situ of the angioma using sclerosing agents to reduce risk of perioperative bleeding and disseminated intravascular coagulation. The second surgical stage varies with the size and site of the lesion. Treatment should be carried out fairly early in childhood to avoid facial skeletal and muscular deformities. This hopefully allows harmonious growth of face with preservation of functions that risk alteration by the temporomasseteric angioma.

[Nonsurgical treatment of cystic lymphangioma]. / Traitement non chirurgical des lymphangiomes kystiques.

Capillary lymphangiomas present of birth, and which have very little tendency to regress, must be distinguished from true cystic lymphangiomas developing after birth which are probably due to lymph blockade and are not true congenital malformations. This probably explains why the latter lesions regress either spontaneously or more rapidly after treatment with products such as Ethibloc. In the latter case, the efficacy of Ethibloc therapy appears to be equal to that of surgery without the formation of a scar and should therefore be tried initially before surgery.

[The transfacial flap in surgery of tumors of the middle and posterior 3d of the face and base of the skull. Its use as a means of approach and reconstruction]. / Le volet transfacial dans la chirurgie des tumeurs des tiers moyen et postérieur de la face et de la base du crâne. Son utilisation comme moyen d'abord et comme moyen de reconstruction.

A transfacial approach and the use of a bone flap allows exeresis of large tumors of middle and posterior third of face and of base of skull. The procedure can be used alone or associated with a neurosurgical approach to the lesions. This wide surgical approach increases the possibility of a complete excision under conditions of strict hemostasis. Replacement of the bone flap at the end of surgery restores skeletal reliefs ad integrum with excellent esthetic results. The technique is described in detail and several examples of its use outtined.