Nasal cocaine abuse and centrofacial destructive process: report of three cases including treatment.

We report 3 new cases of a centrofacial destructive process associated with chronic nasal abuse of cocaine. This complex first described in 1988 is a rare entity involving sinonasal tract necrosis after cocaine abuse. Of special interest in this report is a male patient with columella and lip involvement instead of the more usual rhinopalatal destruction. This cocaine abuse complex should be included in the differential diagnosis of centrofacial midline destructive processes in young patients as the first diagnostic possibility. We suggest a management strategy for these patients.

Survival evaluation of treatment modality in squamous cell carcinoma of the oral cavity and oropharynx.

The treatment of squamous cell carcinoma of the mouth and oropharynx continues to change. In this primary report, we compared the results obtained by combined surgery and radiation therapy, or either modality alone. Other methods such as brachytherapy, or hyperfractionated radiotherapy, were not included in our protocols. A statistical analysis of the 3- and 5-year survival rates in relation to location and size of the primary tumour, stage at initial presentation, treatment modality and recurrence, was carried out in 88 patients with squamous cell carcinoma of the oral cavity or oropharynx. The overall survival rate was 73.8% at 3 years and 66.3% at 5 years. Size of tumour and stage at presentation were significant when P value was adjusted by site. Survival was significantly associated with type of treatment (combined approach obtained superior results), location of primary tumour, and recurrence. The type of neck dissection did not show any effect. Therapeutic modality used, stage, and location of primary tumour significantly influenced survival. A more selective combined initial treatment according to site and stage (distribution) is recommended.

[Oral, mandibular and oropharyngeal reconstruction with a pedicled trapezius flap]. / Reconstruction orale, mandibulaire et de l'oropharynx avec le lambeau pédiculé de trapezius.

Reconstruction of large defects of the oral cavity (with or without jaw defects) and the oropharynx is one of the most important challenges in reconstructive maxillofacial surgery. Many reconstruction techniques have been proposed although none has provided total satisfaction. For each patient, accurate evaluation is required to choose the optimal solution. In this study, we reviewed our indications and results with the trapezius flap (with or without spina scapulae for lower jaw reconstruction). We review suggested indications, the technique we applied and results obtained over the past five years after an initial experience of fifteen years. The advantages and disadvantages of this technique are evaluated an indications suggested.

Clear cell ameloblastoma or odontogenic carcinoma. A case report.

An ameloblastoma of the right maxilla with a biphasic pattern of folicular ameloblastoma and clear cells, with an aggressive clinical behaviour in a 71-year-old male is reported. A literature review of clear cell ameloblastomas is made, focussing the discussion on the convenience of considering this type of ameloblastoma to be a low-grade odontogenic carcinoma.

Parotidectomy technique in the treatment of parotid tumours (an analysis of 70 cases).

A study of seventy different cases of parotid tumours, using subtotal as opposed to total parotidectomy in the treatment of benign tumours. In malignant tumours total parotidectomy was used, together with postoperative radiotherapy, as a standard procedure. The accurate meaning of subtotal parotidectomy is defined, comparing its indications as opposed to total parotidectomy. Preoperative biopsy is performed as a diagnostic procedure, and as a reference for the surgical decision. A new dissecting retractor is presented.