Squamous cell carcinoma of the pyriform sinus: retrospective study of 351 cases treated at the Institut Gustave-Roussy.

The first part of the study was devoted to 199 tumors treated by surgery, either conservative for the smallest tumors (18 cases) or radical (181 cases), with systematic postoperative radiotherapy. The 3-year survival rate was 48% and the 5-year, 33%, with a 12% local recurrence rate, a 7.5% neck recurrence rate, and 27.6% rate distant metastases. Histologic correlations were developed. The second part of the study reported 152 cases treated by external radiotherapy alone either as a variant of our treatment protocol for the small-sized tumors (31 cases) or, for the major part (121 cases), as a result of surgical inoperability or patient refusal. The former subgroup had a variable survival rate (65% at 3 years and 40% at 5 years) equivalent to similarly staged patients treated with conservation laryngeal surgery, whereas the prognosis of the latter subgroup was poor. The two main causes of failure were the inability to apply the curative treatment protocol in 35% of patients ineligible for a surgery and the high risk of distant metastases in the 65% of patients able to undergo the usual management.

[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.

[Labial incompetence and maxillodental dysmorphosis]. / Incompétence labiale et dysmorphose maxillo-dentaire.

A definition of labial incompetence is given and emptrasis placed on the fact that this is a symptom of maxillodental dysmorphism (MDD) and not of nasal dyspermeability. Pathogenic features are discussed, the relevant clinical and paraclinical diagnostic features of MDD outlined, and the different alveolodental and/or bony (maxillary or mandibular) dysmorphias responsible for labial incompetence described. Principles of orthodontic and surgical treatment are centered on re-establishment of a correct articulation and therefore labial competence.

[Mucoceles of the maxillary sinus. Diagnostic and therapeutic problems. Apropos of 5 cases]. / Mucocèles du sinus maxillaire. Problèmes diagnostiques et thérapeutiques. A propos de 5 cas.

Five cases of the rarely observed maxillary sinus mucocele are reported, one patient with bilateral lesions presenting primary dilatation of the bronchi. A previous history of surgery or injury to sinuses was obtained in all cases, the diagnosis being confirmed by computed tomography imaging. Recovery is usually complete after the Caldwell-Luc operation. One case with exclusion of the sinus is described and the literature reviewed.