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Bruckmann M, Brenet E, Boulagnon-Rombi C, Louvrier A, Mauprivez C. Effectiveness of immune checkpoint inhibitors in the treatment of kidney cancer oral metastasis. A case report. J Stomatol Oral Maxillofac Surg 2024:101913. [PMID: 38719194 DOI: 10.1016/j.jormas.2024.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024]
Abstract
Oral cavity metastasis from renal cell carcinoma is rare with poor prognosis. Recently immune checkpoint inhibitors (ICIs) have shown promising outcomes in the treatment of advanced RCC. Herein, we report a case of palatal lesion mimicking vascular tumor in a 60-year-old woman with locally advanced kidney cancer (T3aN0M0). She underwent an excisional biopsy, and histopathological examinations revealed an oral metastasis from clear cell renal cell carcinoma (ccRCC). The patient was treated with a combination of two ICIs with nivolumab, a programmed death 1 (PD-1), and ipilimumab, a cytotoxic T-lymphocyte-associated antigen 4 (CTLA4). After 3 cycles of systemic immunotherapy, the palate was completely well healed and after 13 months of follow-up, there was no evidence of recurrence. Regarding treatments, radical surgery is often recommended due to a high local control in case of solitary lesions or oligo-metastases. However, this option therapy is associated with a poor quality of life. To the best of our knowledge, this is the first case to suggest the benefits of ICIs in the treatment of oral metastases from ccRCC. Combining ICIs with conservative surgery could be another treatment option for oral metastasis in patients with renal cell carcinoma.
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Affiliation(s)
- M Bruckmann
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, F-51100 Reims, France
| | - E Brenet
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
| | - C Boulagnon-Rombi
- Université de Reims Champagne-Ardenne, UMR CNRS 7369, CHU Reims, Laboratoire de Pathologie, F-51100, Reims, France
| | - A Louvrier
- CHU Besançon, Chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, Université de Franche-Comté, SINERGIES, F-25000 Besançon, France.
| | - C Mauprivez
- Service de Chirurgie Orale, Pôle de Médecine Bucco-Dentaire, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
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Bertin E, Louvrier A, Meyer C, Weber E, Barrabé A, Pons M. An epidemiologic retrospective study of maxillofacial traumatology in the elderly. J Stomatol Oral Maxillofac Surg 2022; 123:e878-e882. [PMID: 35659531 DOI: 10.1016/j.jormas.2022.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The elderly population, which is more active than before, is increasingly suffering from trauma (loss of reflexes and systemic pathologic conditions). Surgical management may be more controversial due to the potential consequences of general anesthesia and the sometimes negligible consequences of functional management. The main objective of this study was to analyze the causes and location of facial fractures in subjects older than 65 years. The secondary objective was to evaluate the management of these fractures (surgical or functional) according to comorbidities. MATERIAL & METHODS In this retrospective study (over a five-year period), we analyzed the causes and management of facial fractures in patients aged over 65 years, and the medical history of each patient was investigated. RESULTS One hundred and nineteen patients with 198 facial fractures were included. The main cause of fractures was a fall (50%). The zygomatic region (39.9%) and mandible (27.8%) were the sites of the most frequent fractures. Comorbidities were found in 84.9% of patients, the majority of which were cardiovascular diseases (82.3%). 75.8% of fractures were treated surgically and 4.8% of patients had complications. DISCUSSION This work is a help to understanding the causes and consequences of facial trauma in the elderly population. The management of these facial fractures requires a multidisciplinary assessment, taking into account the patient's medical history and evaluating the risks and benefits of a surgical procedure with general anesthesia.
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Affiliation(s)
- E Bertin
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France.
| | - A Louvrier
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France; UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
| | - C Meyer
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France; Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - E Weber
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
| | - A Barrabé
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
| | - M Pons
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
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Pons M, Louvrier A, Bertin E, Meyer C. Intraoperative cone beam assessment after reduction of zygomatic fractures helps in taking a decision on associated orbital floor fractures. J Stomatol Oral Maxillofac Surg 2022; 123:e576-e580. [PMID: 35259490 DOI: 10.1016/j.jormas.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Orbital floor fracture (OFF) are frequently associated with zygomatic fractures (ZF). The reduction of the ZF may modify the features of the associated OFF. Intraoperative cone beam CT (CBCT) has shown diagnostic performance of OFF. The aim of our study was to evaluate how intraoperative CBCT control made after the reduction of ZF may help to take a decision on the associated OFF. MATERIAL AND METHOD Patients with a unilateral displaced ZF associated with an OFF were consecutively included during a 3-year period. Intraoperative CBCT, systematically performed after reduction of the ZF, allowed to decide if the OFF needed reconstruction. The preoperative estimation made on MDCT and the intraoperative decision regarding the OFF were compared. RESULTS Fifty-nine consecutive patients could be included in the study. Nineteen OFF were presumed to be surgical indications on the preoperative MDCT but only 16 indications were confirmed on the intraoperative CBCT, meaning that 3 OFF behaved favorably during the ZF reduction. Forty orbital floor fractures were presumed to be non-surgical on the preoperative MDCT but 6 of them worsened during ZF reduction and became surgical indications. Overall, the intraoperative CBCT control had an impact on 9 (15.3%) of the OFF. CONCLUSION Our study showed that OFF after ZF reduction may evolve favorably or, on the contrary, get worse in 15% of the cases. Surgical indication on an OFF can therefore be confirmed intraoperatively. This allows to avoid under-treatment in the patients where the OFF worsens after ZF reduction and over-treatment in the patient where the OFF reduces after ZF.
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Affiliation(s)
- M Pons
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3 Boulevard Fleming, Besançon Cedex 25030, France; INSERM, EFS BFC, UMR1098, Host-Graft Interactions/Cell and Gene Engineering, University of Bourgogne Franche-Comté, Besançon 25000, France.
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3 Boulevard Fleming, Besançon Cedex 25030, France; INSERM, EFS BFC, UMR1098, Host-Graft Interactions/Cell and Gene Engineering, University of Bourgogne Franche-Comté, Besançon 25000, France
| | - E Bertin
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3 Boulevard Fleming, Besançon Cedex 25030, France; Department of anatomy, University of Franche Comté, Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3 Boulevard Fleming, Besançon Cedex 25030, France; Nanomedicine Laboratory, Imagery and Therapeutics, EA 4662, UFR Sciences et Techniques, University of Franche-Comté, route de Gray, Besançon Cedex 25030, France
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Vernier-Mosca M, Pluvy I, Bayti T, Louvrier A, Andreoletti JB. [Abdominoplasties: Do we still need to drain in 2021?]. ANN CHIR PLAST ESTH 2021; 66:305-313. [PMID: 34023138 DOI: 10.1016/j.anplas.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study was to consider the use of drainage when performing an abdominoplasty with regards to postoperative complications for two groups of patients. PATIENTS AND METHOD From January 1st 2017 to December 31th 2019, 215 patients underwent an abdominoplasty in our institution. In this retrospective, comparative, single institution study, patients were divided into two groups: "drainage" D (n=162) when suction completed abdominoplasty, "no drainage" ND (n=53) when suction didn't completed abdominoplasty. Early and distant complications were retrieved for each group and compared. RESULTS There was no significant difference between the two groups concerning the occurrence of seroma postoperatively (8% of patients in group D and 11.3% of patients in group AD). The drainage group D experienced more seroma's punctures (2,3± 1,0) and the mean of punctured fluid was higher (386,5ml±350,4ml) compared to the no drainage group ND (1,3+- 0,5 number of punctures with a mean punctured fluid of 165,8mL± 224,2mL). The mean hospital stay was shorter for group ND (2,9± 1,8 days) than for group D (4,4+- 1,7 days), P<0,0001. CONCLUSION Performing an abdominoplasty with quilting suture but drainless doesn't seem to increase postoperative complications statistically. The authors recommend, under the guise of a quilting suture, not to systematically drain the abdominoplasties and to reserve this technique for patients at risk of complications (high BMI, significant weight loss and co-morbidities).
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Affiliation(s)
- M Vernier-Mosca
- Service de chirurgie plastique, reconstructrice et esthétique, Hôpital Nord Franche-Comté, 100, route de Moval, 90400 Trévenans.
| | - I Pluvy
- Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - T Bayti
- Service de chirurgie plastique, reconstructrice et esthétique, Hôpital Nord Franche-Comté, 100, route de Moval, 90400 Trévenans
| | - A Louvrier
- Service de chirurgie maxillo-faciale, CHRU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - J B Andreoletti
- Service de chirurgie plastique, reconstructrice et esthétique, Hôpital Nord Franche-Comté, 100, route de Moval, 90400 Trévenans
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Louvrier A, Terranova L, Meyer C, Meyer F, Euvrard E, Kroemer M, Rolin G. Which experimental models and explorations to use in regenerative endodontics? A comprehensive review on standard practices. Mol Biol Rep 2021; 48:3799-3812. [PMID: 33761086 DOI: 10.1007/s11033-021-06299-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/18/2021] [Indexed: 01/09/2023]
Abstract
Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.
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Affiliation(s)
- A Louvrier
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France.
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France.
| | - L Terranova
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - C Meyer
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - F Meyer
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - E Euvrard
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - M Kroemer
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- Pharmacie Centrale, CHU Besançon, 25000, Besançon, France
| | - G Rolin
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- INSERM CIC-1431, CHU Besançon, 25000, Besançon, France
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Kün-Darbois JD, Kahn A, Khonsari RH, Gueutier A, Baldini N, Corre P, Bertin H, Provost M, Lesclous P, Ansidei CM, Majoufre C, Louvrier A, Meyer C, Ammari H, Rougeot A, Moret A, Poisbleau D, Nicot R, Marti-Flich L, Ferri J, Lutz JC, Prevost R, Kimakhe J, Poulet V, Lauwers F, Veyssière A, Bénateau H, Pham Dang N, Barthelemy I, Foletti JM, Chossegros C, Queiros C, Laure B, Paré A, de Boutray M. Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study. J Stomatol Oral Maxillofac Surg 2021; 123:16-21. [PMID: 33596475 DOI: 10.1016/j.jormas.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.
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Affiliation(s)
- J D Kün-Darbois
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France.
| | - A Kahn
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - R H Khonsari
- Department of Maxillo-facial and Plastic surgery, Necker-Enfants Malades University Hospital, Paris, France
| | - A Gueutier
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - N Baldini
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - P Corre
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - H Bertin
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - M Provost
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - P Lesclous
- Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - C M Ansidei
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - C Majoufre
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - A Louvrier
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - C Meyer
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - H Ammari
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Rougeot
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Moret
- Department of Maxillo-facial surgery and Stomatology, Aix Hospital Centre, Aix-En-Provence, France
| | - D Poisbleau
- Department of Maxillo-facial surgery and Plastic surgery, Grenobles University Hospital, Grenoble, France
| | - R Nicot
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - L Marti-Flich
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J Ferri
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J C Lutz
- Department of Maxillo-facial surgery and Stomatology, Strasbourg University Hospital, Strasbourg, France
| | - R Prevost
- Department of Maxillo-facial surgery, La Rochelle, Ré, Aunis Hospital, La Rochelle, France
| | - J Kimakhe
- Department of Maxillo-facial surgery and Stomatology, Vendée Hospital Centre, La Roche Sur Yon, France
| | - V Poulet
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - F Lauwers
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - A Veyssière
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - H Bénateau
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - N Pham Dang
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - I Barthelemy
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - J M Foletti
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Chossegros
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Queiros
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - B Laure
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - A Paré
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - M de Boutray
- Department of Maxillo-facial surgery, Gui de Chauliac University Hospital Centre, Montpellier University, Montpellier, France
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Benhmida S, Sun R, Gherga E, Hammoud Y, Rouvier J, Mauvais O, Bockel S, Louvrier A, Lebbad A, Bontemps P, Ortholan C, Bourhis J, Lestrade L, Sun XS. Split-course hypofractionated radiotherapy for aged and frail patients with head and neck cancers. A retrospective study of 75 cases. Cancer Radiother 2020; 24:812-819. [PMID: 33144061 DOI: 10.1016/j.canrad.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the efficacy and the tolerance of a split course hypofractionated (SCH) radiotherapy (RT) protocol in head and neck cancer (HNC) for eldery and/or unfit patients (pts). PATIENTS AND METHODS Pts with HNC treated by SCH-RT in two institutions were included retrospectively. The main SCH RT regimen was two courses of 30 grays (Gy)/10 fractions separated by 2-4 weeks, without any systemic therapy. RESULTS Between February 2012 and January 2019, 75 consecutive patients were analyzed. The median age was 80 years (range: 45.7-98.2) and 53 (70.7%) were men. Sixty-one (81.3%) pts had stage III/IV disease and 54 (72%) had at least two comorbidities. All of them were treated with intensity-modulated radiotherapy. Median follow-up was 10.6 months (range: 3.1-58.3). Local control at 12 and 24 months was 72.8% IC95%[62-85.5] and 51.7% IC95%[38.1-70.1] respectively. Progression free survival (PFS) at 12 and 24 months were 47.7% IC95%[37.4-60.8] and 41% IC95%[15-36.4] respectively, with a median of 11.5 months IC95%[8.9-17]. OS at 12 and 24 months were 60.4% IC95%[50-73.1] and 41% IC95%[30.6-54.9] respectively, with a median of 19.3 months IC95%[11.9-25.8]. Acute and late grade 3 or higher toxicities occurred for 6 (8%) and 3 (4%) pts. CONCLUSION The present SCH-RT regimen seems effective, well-tolerated and could represent an alternative to palliative strategies for pts deemed unfit for standard exclusive RT.
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Affiliation(s)
- S Benhmida
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France.
| | - R Sun
- Department of radiotherapy, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - E Gherga
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - Y Hammoud
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - J Rouvier
- Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - O Mauvais
- Department of head and neck surgery, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France
| | - S Bockel
- Department of radiotherapy, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - A Louvrier
- Department of Maxillofacial Surgery and Stomatology, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon, France
| | - A Lebbad
- Department of head and neck surgery, Hôpital Nord Franche-Comté, 100, route de Moval, Trevenans, France
| | - P Bontemps
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - C Ortholan
- Department of radiotherapy, Centre hospitalier Princesse-Grace, 98000 Monaco, Monaco
| | - J Bourhis
- Centre Hospitalier Universitaire Vaudois, Service de Radio-oncologie, 1005 Lausanne, Switzerland
| | - L Lestrade
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
| | - X S Sun
- Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France
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Lutz JC, Schouman T, Meyer C, Savoldelli C, Louvrier A. Chin wing osteotomy using customised guide and implants: an improvement for a safer and swifter procedure: technical note. Br J Oral Maxillofac Surg 2020; 59:129-131. [PMID: 32958320 DOI: 10.1016/j.bjoms.2020.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Affiliation(s)
- J-C Lutz
- Department of Oral and Maxillofacial Surgery, University Hospital, 1, Avenue Molière, 67098 Strasbourg Cedex, France; University of Strasbourg, Department of Medicine, 8Rue Kirschleger, 67000 Strasbourg, France; Laboratory of Engineering Science, Computer Science and Imaging, CNRS, ICUBE-University of Strasbourg, FMTS, 2 Rue Boussingault, 67000 Strasbourg, France; INSERM (French National Institute of Health and Medical Research), "Regenerative Nanomedicine" Laboratory, UMR 1260, Faculty of Medicine, FMTS, 67085 Strasbourg Cedex, France.
| | - T Schouman
- Oral and Maxillofacial Surgery Department, APHP - Pitié-Salpetrière University Hospital, 47 Boulevard de l'Hôpital, 75013 Paris, France; Sorbonne University, UPMC Paris 06 University, 75005, Paris, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France; Department of Medicine, University of Franche-Comté, 19 Rue Ambroise Paré, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics, EA 4662, Department of Medicine, University of Franche-Comté, 19 Rue Ambroise Paré, 25000 Besançon, France.
| | - C Savoldelli
- Department of Oral and Maxillofacial Surgery, Head and Neck Institute, University Hospital of Nice, France.
| | - A Louvrier
- Department of Medicine, University of Franche-Comté, 19 Rue Ambroise Paré, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics, EA 4662, Department of Medicine, University of Franche-Comté, 19 Rue Ambroise Paré, 25000 Besançon, France; Host-Graft Interactions Lab - Tumor-Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1 Boulevard Fleming, 25020 Besançon, France.
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9
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Lacagne AS, Brumpt E, Barrabé A, Pomero E, Chatelain B, Grillet F, Weber E, Malakhia A, Pons M, Aubry S, Meyer C, Sigaux N, Louvrier A. Diagnostic performance of mobile cone beam computed tomography versus conventional multi-detector computed tomography in orbital floor fractures: a study on human specimens. Int J Oral Maxillofac Surg 2020; 50:205-211. [PMID: 32921556 DOI: 10.1016/j.ijom.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the diagnostic accuracy of mobile cone beam computed tomography (MCBCT) versus multi-detector computed tomography (MDCT) in orbital floor fractures. Twenty-four fresh cadaver heads were used, and one orbital floor was fractured for each head by transconjunctival approach. MDCT and MCBCT were performed on each of the heads. The images obtained were then analysed independently by eight evaluators. The radiological characteristics of the orbital floor fractures were visualized with good interpretation agreement between the two images. The location of the fracture and enophthalmos were identified in a comparable manner with strong agreement (κ=0.93 and κ=0.85, respectively). Measurements of fatty hernias and bone defects showed a strong correlation between the two imaging modalities (Pearson coefficient between 0.64 and 0.71 and between 0.67 and 0.71, respectively). The fracture limits and the presence of bone fragments, an intrasinus fatty hernia, and a fracture of the associated medial orbital wall were visualized in both examinations with good agreement (κ=0.68, κ=0.51, κ=0.57, and κ=0.46, respectively). The soft tissue study showed superiority for MDCT, with a κ<0.0009. MCBCT showed good diagnostic performance in the study of orbital floor fracture characteristics.
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Affiliation(s)
- A S Lacagne
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France.
| | - E Brumpt
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Pomero
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - F Grillet
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Malakhia
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France
| | - M Pons
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
| | - S Aubry
- Medical Faculty, University of Franche-Comté, Besançon, France; Department of Radiology, University Hospital of Besançon, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Nanomedicine Laboratory - Imagery and Therapeutics (EA 4662), University of Franche-Comté, Besançon, France
| | - N Sigaux
- Hospices Civils de Lyon, University Claude Bernard Lyon 1, Maxillofacial and Stomatology, Lyon-Sud Hospital Centre, Pierre-Benite, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Medical Faculty, University of Franche-Comté, Besançon, France; Host-Graft Interactions Laboratory - Tumour-Cell and Tissue Engineering (UMR 1098 INSERM/UFC/EFS), Besançon, France
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10
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Devoti JF, Sigaux N, Zirganos N, Meyer C, Louvrier A. A maxillary tumor with an atypical radiological presentation. J Stomatol Oral Maxillofac Surg 2020; 122:219-220. [PMID: 32659409 DOI: 10.1016/j.jormas.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Affiliation(s)
- J-F Devoti
- Department of plastic and maxillofacial surgery, Central hospital, CHRU Nancy, 54000 Nancy, France; Department of oral and maxillofacial surgery, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - N Sigaux
- Hospices civils de Lyon, Claude-Bernard Lyon 1 University, 69310 Pierre-Bénite, France
| | - N Zirganos
- Department of pathology, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Department of oral and maxillofacial surgery, university hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine lab imagery and therapeutics (EA 4662), university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - A Louvrier
- Nanomedicine lab imagery and therapeutics (EA 4662), university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; Host-graft interactions lab - tumor - cell and tissue engineering (UMR 1098 Inserm/UFC/EFS), university of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France.
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11
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Gagnieur P, Rasteau S, Caruhel JB, Louvrier A, Sigaux N. De l’histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 4 : la rhinoplastie. ANN CHIR PLAST ESTH 2020; 65:271-276. [PMID: 32595064 DOI: 10.1016/j.anplas.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022]
Abstract
Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This fourth original article will focus on the inventors of rhinoplasty instruments: Joseph, Killian, Aufricht, Cottle and Claoué.
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Affiliation(s)
- P Gagnieur
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - S Rasteau
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - J B Caruhel
- Chirurgie maxillo-faciale, hôpital universitaire Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Louvrier
- Chirurgie maxillo-faciale et stomatologie, centre hospitalier régional universitaire Jean-Minjoz, 25000 Besançon, France
| | - N Sigaux
- Chirurgie maxillo-faciale, stomatologie, chirurgie orale et chirurgie plastique de la face, hospices civils de Lyon, hôpital Lyon-Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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12
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Courtot R, Devoize L, Louvrier A, Pereira B, Caillet J, Meyer C, Barthélémy I, Depeyre A. Surgical approach of ectopic maxillary third molar avulsion: Systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2020; 122:77-82. [PMID: 32621999 DOI: 10.1016/j.jormas.2020.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Abstract
Ectopic maxillary third molars (EMTM) are extracted mainly by the Caldwell-Luc technique but also by nasal endoscopy. There is currently no consensus on the treatment of this eruption and its management is heterogeneous and multidisciplinary. Two literature searches were performed with no time restrictions via Pubmed. In the first, we used the keywords "ectopic AND third molar" and in the second the keywords "dentigerous cyst AND ectopic third molar". For both articles, epidemiological, symptomatic, radiological and surgical data were recorded. Overall, 33 eligible articles were identified involving 39 cases of EMTM. 79% of patients were symptomatic. 87% of the teeth were associated with a dental cyst. In only 13% of cases was the location of the tooth in the sinus specified in the three planes of the space. Surgery was performed in 77% of patients by the Caldwell-Luc technique, by nasal endoscopy in 10% and by the Le Fort I approach in 3%. The indications for avulsion of EMTM are symptomatic patients or asymptomatic patients with an associated cyst. The intra-sinusal location of the tooth is not a factor in the choice of technique used, which depends rather on the individual skills of the surgeon. Although for a trained operator the Le Fort I osteotomy is an easy procedure, its interest in the treatment of EMTM is limited owing to the rare but potentially severe complications involved.
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Affiliation(s)
- R Courtot
- Oral and maxillofacial department, Estaing hospital, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Faculty of medicine, université d'Auvergne, 63001 Clermont-Ferrand, France
| | - L Devoize
- Oral and maxillofacial department, Estaing hospital, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Faculty of dental surgery, université d'Auvergne, 63100 Clermont-Ferrand, France; Inserm U1107 neuro-dol, trigeminal pain and migraine, faculty of dental surgery, 63100 Clermont-Ferrand, France
| | - A Louvrier
- Department of oral and maxillofacial surgery, university hospital of Besançon, boulevard Fleming, 25030 Besançon cedex, France; Faculty of medicine, university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; Inserm, EFS BFC, UMR1098, interactions hôte-greffon-tumeur/ingénierie cellulaire et génique, university of Bourgogne Franche-Comté, 25000 Besançon, France
| | - B Pereira
- Clermont-Ferrand, Biostatistics unit (clinical research and Innovation Direction), Clermont-Ferrand, France
| | - J Caillet
- Oral and maxillofacial department, Estaing hospital, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Faculty of medicine, université d'Auvergne, 63001 Clermont-Ferrand, France
| | - C Meyer
- Department of oral and maxillofacial surgery, university hospital of Besançon, boulevard Fleming, 25030 Besançon cedex, France; Faculty of medicine, university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; EA 4662, medical faculty, nanomedicine lab, imagery and therapeutics, university of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - I Barthélémy
- Oral and maxillofacial department, Estaing hospital, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Faculty of medicine, université d'Auvergne, 63001 Clermont-Ferrand, France; Inserm U1107 neuro-dol, trigeminal pain and migraine, faculty of dental surgery, 63100 Clermont-Ferrand, France
| | - A Depeyre
- Oral and maxillofacial department, Estaing hospital, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Faculty of medicine, université d'Auvergne, 63001 Clermont-Ferrand, France; Laboratoire CROC EA 3847, faculty of dental surgery, université d'Auvergne, 63100 Clermont-Ferrand, France; Inserm, U1008 - controlled drug delivery systems and biomaterials, university Lille, CHU Lille, 59000 Lille, France; Cabinet maxillo-facial privé de Saint-Étienne, hôpital privé de la Loire, Ramsay GDS, 39, boulevard de la Palle, 42100 Saint-Étienne, France.
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13
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Assouline SL, Meyer C, Weber E, Chatelain B, Barrabe A, Sigaux N, Louvrier A. How useful is intraoperative cone beam computed tomography in maxillofacial surgery? An overview of the current literature. Int J Oral Maxillofac Surg 2020; 50:198-204. [PMID: 32605822 DOI: 10.1016/j.ijom.2020.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Intraoperative imaging is increasingly used by surgeons and has become an integral part of many surgical procedures. This study was performed to provide an overview of the current literature on the intraoperative use of cone beam computed tomography (CBCT) imaging in maxillofacial surgery. A bibliographic search of PubMed was conducted in March 2020, without time limitation, using "intraoperative imaging" AND "maxillofacial surgery" AND "cone beam computed tomography" as key words. Ninety-one articles were found; after complete reading, 16 articles met the eligibility criteria and were analysed. The results showed that the majority of the indications were related to maxillofacial trauma, particularly zygomaticomaxillary complex fractures. Final verification with intraoperative CBCT before wound closure was the most common use of this device. However, innovative uses of intraoperative CBCT are expanding, such as CBCT coupling with mirror computational planning, and even the combined use of initial intraoperative CBCT acquisition with navigation. Immediate, fast, and easy evaluation of bone repositioning to avoid the need for further surgical revision is the main advantage of this technique. Imaging quality is comparable to that of multi-slice computed tomography, but with lower radiation exposure. Nevertheless, CBCT is still not widely available in maxillofacial centres, probably because of its cost, and perhaps because not everyone is aware of its advantages and versatility, which are reported in this review.
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Affiliation(s)
- S L Assouline
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Department of Oral and Maxillofacial Surgery, University Hospital of Strasbourg, Strasbourg, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; NanomedicineLab, Imagery and Therapeutics, EA 4662, Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Barrabe
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre-Bénite, France; 3d.FAB platform, ICBMS, CNRS 5246 Claude-Bernard Lyon 1 University, Villeurbanne, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; University of Bourgogne Franche- Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon- Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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Pons M, Lutz JC, Sigaux N, Tavernier L, Graillon N, Louvrier A. Surgical reconstruction of the foramen tympanicum: What is known and how we do it. J Stomatol Oral Maxillofac Surg 2020; 121:545-549. [PMID: 32360752 DOI: 10.1016/j.jormas.2020.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/20/2020] [Indexed: 11/17/2022]
Abstract
Defects affecting the anterior wall of the tympanal bone can result from trauma, infection, neoplasm or previous local surgery. An anatomic variation, namely the persistence of the foramen tympanicum, can also be encountered. When symptomatic, surgical reconstruction may be indicated. The aim of this study was to identify the surgical treatments of symptomatic foramen tympanicum found in the literature and detail our innovative reconstruction technique. A bibliographic research was conducted in PubMed database in March 2020, without time limitation. Papers dealing with surgical management of a foramen tympanicum were included. Data collected were the publication date, the number of patients, their age and gender, the symptoms and the surgical treatment performed. We report, in addition, the case of a symptomatic persistent foramen tympanicum in a 30-year-old man with a follow-up of 18-months. A total of 17 studies (n=23 patients) were included for analysis. The main reconstruction techniques were, in equal proportion, cartilage graft (30%) and insertion of a titanium mesh (30%). We carried out an iliac crest bone graft using a preauricular approach on a patient suffering from chronic tinnitus and fullness in the left ear resulting from a persistent foramen tympanicum, confirmed by clinical and radiological examinations. It allowed the complete resolution of symptoms and no complication such as temporomandibular ankylosis occurred. Based on the review of the literature, we believe this technique has the advantage of providing durable reconstruction thanks to osseointegration.
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Affiliation(s)
- M Pons
- Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, University of Bourgogne Franche-Comté, Besançon, France.
| | - J-C Lutz
- Inserm, Regenerative Nanomedicine Laboratory, UMR 1260, Laboratory of Engineering Science, Computer Science and Imaging, CNRS, Department of Maxillofacial and Plastic Surgery, Faculty of Medicine, ICUBE University of Strasbourg, University Hospital and UFR Medicine of Strasbourg, Strasbourg, France.
| | - N Sigaux
- Department of Maxillofacial and Stomatology, Lyon-Sud Hospital Center, Pierre-Bénite, France.
| | - L Tavernier
- Otorhinolaryngology, University Hospital of Besançon, Besançon, France.
| | - N Graillon
- IFSTTAR, LBA UMR T24, Department of Oral and Maxillofacial Surgery, Aix-Marseille University, CHU Conception, AP-HM, Marseille, France.
| | - A Louvrier
- Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Department of Oral and Maxillofacial Surgery, Medical Faculty, University of Franche-Comté, University Hospital of Besançon, Besançon, France.
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Quenot J, Sigaux N, Hugot E, Meyer C, Louvrier A. Gingival Mucosa-Associated Lymphoid Tissue (MALT) lymphoma developed around a mandibular extraosseous dental root canal overfilling: A case report. J Stomatol Oral Maxillofac Surg 2020; 121:743-745. [PMID: 32360488 DOI: 10.1016/j.jormas.2020.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/22/2020] [Indexed: 11/25/2022]
Abstract
Lymphomas are rare pathologies in the oral cavity, representing only 3.5% of malignant tumors. Their typical topography is Waldeyer's lymphatic ring and approximately 8% of all non-Hodgkin lymphomas are mucosa associated lymphoid tissue (MALT) lymphomas. The authors report a rare case of mandibular gingival MALT lymphoma, which developed around an extraosseous dental root canal overfill. This atypical, case of lymphoma indicates that practitioners have to be vigilant and perform a biopsy every time they are confronted with a suspicious chronic lesion in the oral cavity.
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Affiliation(s)
- J Quenot
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - N Sigaux
- Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - E Hugot
- Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Department of Maxillofacial Surgery and Plastic Facial Surgery, Claude-Bernard Lyon 1 University, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Department of Pathology, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France; Host-Graft Interactions Lab-Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France
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Louvrier A, Barrabé A, Weber E, Chatelain B, Sigaux N, Meyer C. The high sub-mandibular approach: Our experience about 496 procedures. J Stomatol Oral Maxillofac Surg 2020; 121:626-633. [PMID: 32205300 DOI: 10.1016/j.jormas.2020.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The potential drawbacks of surgical approaches to neck and base fractures of the mandibular condyle (visible scare, facial nerve injury) are still considered by many surgeons as a brake for open reduction and internal fixation. The aim of our study was to analyze the results in terms of access, scare quality and complications that could be noticed in a 12 years period of time with the use of the high sub-mandibular approach (HSMA) we first described in 2006 for the surgical treatment of neck and base fractures. MATERIAL AND METHOD All the files of patients operated on for condylar neck and base fractures approached by mean of a HSMA between January 2006 and December 2018 in our department and containing information concerning age, sex, type of fracture, kind of osteosynthesis material, operating time, name of the surgeon, postoperative complication linked to the approach, scare quality at 6 months follow-up at least were included. The skin incision and the dissection planes followed the original publication of Meyer et al. in 2006. RESULTS 434 patients (sex ratio: 2.06, mean age: 32, 496 approaches) met the inclusion criteria. Following the AO classification, 21.2% of the fractures were classified as neck fractures and 78.8% as base fractures. 97.6% of all fractures were stabilized by mean of a 3D plate (TCP® plate, Medartis, Basel-CH), the remaining ones by mean of a combination of 1.2, 1.5 and 2.0 straight plates. Mean operating time was 40minutes per side. Patients were operated on by senior surgeons in 71.7% of the cases and by trainees under supervision for the others. Concerning the complications linked to the approach, we noticed 11 (2.2%) temporary (0 definitive) paresis of the facial nerve, 1 (0.2%) hematoma and 1 (0.2%) abscess that both needed revision. Scare was hypertrophic or considered as unaesthetic by the patient in 5 cases (1%). DISCUSSION The HSMA, if performed as initially described, is a safe and quick procedure compared to other cutaneous approaches. It gives access to all base fractures and to most of neck fractures. The very low rate of facial nerve complications is mainly explained by the plane by plane dissection making it very easy to avoid the facial nerve branches or to check them when encountered. The HSMA is particularly suited to the use of TCP plates as the upper holes of these plates, placed horizontally, are easy to reach from below. The HSMA is therefore still our preferred cutaneous approach to the condylar process.
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Affiliation(s)
- A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Host-Graft Interactions Lab-Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, 1, boulevard Fleming, 25020 Besançon cedex, France.
| | - A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - N Sigaux
- Department of Maxillofacial Surgery and Plastic Facial Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, 69310 Pierre-Bénite, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab Imagery and Therapeutics (EA 4662), University of Franche-Comté, 19, rue Ambroise-Paré, 25000 Besançon, France.
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Barrabé A, Louvrier A, Allary R, Moussa M, Boutros M, Bénateau H. Infantile and adult mortality in precarious conditions. Journal of Stomatology, Oral and Maxillofacial Surgery 2020; 121:49-52. [DOI: 10.1016/j.jormas.2019.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/16/2019] [Accepted: 04/21/2019] [Indexed: 10/26/2022]
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Delarue M, Berceanu A, Laude MC, Louvrier A. Giant Blisters. J Stomatol Oral Maxillofac Surg 2019; 120:497-498. [PMID: 30664956 DOI: 10.1016/j.jormas.2019.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/30/2018] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Affiliation(s)
- M Delarue
- Centre Hospitalier Universitaire de Besançon, Service de chirurgie maxillo-faciale, 25030, Besançon, France.
| | - A Berceanu
- Centre Hospitalier Universitaire de Besançon, Service de Soins Intensifs Hématologie, 25030, Besançon, France
| | - M-C Laude
- Centre Hospitalier Universitaire de Besançon, Service de Soins Intensifs Hématologie, 25030, Besançon, France
| | - A Louvrier
- Centre Hospitalier Universitaire de Besançon, Service de chirurgie maxillo-faciale, 25030, Besançon, France; INSERM, EFS BFC, UMR 1098, Interactions hôte-greffon-tumeur - Ingénierie cellulaire et génique, Université de Bourgogne Franche-Comté, Besançon, France
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Starch-Jensen T, Rodríguez-Santamarta T, de Vicente JC, Snäll J, Thorén H, Aničić B, Konstantinovic VS, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Goguet Q, Anquetil M, Louvrier A, Meyer C, Dovšak T, Vozlič D, Birk A, Tarle M, Dediol E. Epidemiology of maxillofacial trauma in the elderly: A European multicenter study. J Stomatol Oral Maxillofac Surg 2019; 121:330-338. [PMID: 31533064 DOI: 10.1016/j.jormas.2019.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). MATERIALS AND METHODS The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). RESULTS A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (P<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (P<.05) and a high FISS score (P<.005) were associated with concomitant body injuries too. CONCLUSIONS This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.
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Affiliation(s)
- M Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - P Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - I Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - C Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - A Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - M Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - T Rodríguez-Santamarta
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J C de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Finland; Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - B Aničić
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - V S Konstantinovic
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - P Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - N Pavlov
- Private practice of oral surgery, Plovdiv, Bulgaria
| | - H Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - I Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - K Kelemith
- Department of maxillofacial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - T Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - A Kopchak
- Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine
| | - I Shumynskyi
- Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine
| | - P Corre
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - H Bertin
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - Q Goguet
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - M Anquetil
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery-Hospital Dentistry Unit, University Hospital of Besançon, 3 boulevard Alexandre-Fleming, 25000 Besançon, France; University of Bourgogne-Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, 25000 Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery-Hospital Dentistry Unit, University Hospital of Besançon, 3 boulevard Alexandre-Fleming, 25000 Besançon, France; University of Bourgogne-Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, 25000 Besançon, France
| | - T Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - D Vozlič
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - A Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - M Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
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Sigaux N, Pourchet L, Breton P, Brosset S, Louvrier A, Marquette CA. 3D Bioprinting:principles, fantasies and prospects. Journal of Stomatology, Oral and Maxillofacial Surgery 2019; 120:128-132. [DOI: 10.1016/j.jormas.2018.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/12/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022]
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Barrabé A, Meyer C, Bonomi H, Weber E, Sigaux N, Louvrier A. Surgically assisted rapid palatal expansion in class III malocclusion: Our experience. J Stomatol Oral Maxillofac Surg 2018; 119:384-388. [PMID: 29753777 DOI: 10.1016/j.jormas.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 05/06/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Maxillary transverse deficiency (MTD) is a common facial disharmony that may need surgical assisted rapid palatal expansion (SARPE). The aim of this study was to present our SARPE technique and to report about our experience. MATERIEL AND METHOD Medical records of all class III patients who underwent SARPE in our department from 2010 to 2015 and for whom a follow-up of at least 1year was available, were included in a retrospective study. The technique consisted, after short orthodontic preparation allowing for divergence of the upper central incisors, in a complete Le Fort I osteotomy without down fracture, and medial sagittal submucosal separation of the hard palate under general anesthesia in an inpatient procedure. Teeth-supported distracters were sealed preoperatively while bone-supported devices were inserted peroperatively. Activation of the distracter was allowed from day 2 at the rate of 2×0.25 per day during 4days and 2×0.5mm per day the following days. Distracters were left in place for about 4months. Orthodontic treatment resumption was allowed from the second month. The initial malocclusion, the amount and type (parallel or angular) of distraction that was needed, the type of distracter used, the amount of distraction obtained, the per- and postoperative complications and the clinical stability of the end result were analyzed. RESULTS The records of 23 patients (18 women, 5 men - average age: 25.4years, extremes: 16-55years) could be included. MTD was isolated in 6 cases, associated with a maxillary retrognathism in 5 cases, with a mandibular prognathism in 6 cases, and with both in 6 cases. The average amount of distraction needed was 7.2mm (range: 4-12), parallel in 20 cases and angular in 3 cases. The distracters were bone-supported (Rapid Palatal Expander®, KLS Martin Group, Tuttlingen, Germany) in 3 patients and custom-made tooth-supported in 20 patients. The average amount of distraction obtained at the level of the distracter cylinder was 7.7mm (range: 5-13). We noted 2 cases of palatal fibromucosa perforations, 1 case of posterior excess of distraction, 1 case of nasal septum deviation, 1 case of iatrogenic necrosis of tooth No.°11, 1 case of naso-genial sulcus hematoma, 1 case of intraoperative mobility of tooth No.°21, 5 cases of asymmetric distraction. Seventeen patients needed a second orthognathic procedure and 22 had stable Class I occlusion after removal of appliances at 18 months follow-up on average. DISCUSSION SARPE is a quite safe procedure that allows for transverse coordination without dental extraction. Transverse discrepancies greater than 4mm are for us clear indications for SARPE. When a sagittal discrepancy is associated, we prefer performing SARPE first and correcting the sagittal plane in a second operation. The recent development of Le Fort I sliding osteosynthesis plates opens the way to one time correction and the development of double-action distracters fitted out with 2 cylinders will be helpful for performing angular distractions.
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Affiliation(s)
- A Barrabé
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics, EA 4662, UFR Sciences et Techniques, University of Franche-Comté Route de Gray, 25030 Besançon cedex, France
| | - H Bonomi
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; Department of orthodontics, Dental School, Univeristy Hospital of Strasbourg, 67091 Strasbourg, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
| | - N Sigaux
- Department of Maxillofacial, Plastic, Reconstructive and Esthetic Surgery, Lyon-Sud University Hospital, 69495 Lyon, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, 3, Boulevard Fleming, 25030 Besançon cedex, France; University of Franche-Comté UFR SMP, 19, rue Ambroise-Paré, 25000 Besançon, France
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Louvrier A, Marty P, Barrabé A, Euvrard E, Chatelain B, Weber E, Meyer C. How useful is 3D printing in maxillofacial surgery? Journal of Stomatology, Oral and Maxillofacial Surgery 2017; 118:206-212. [DOI: 10.1016/j.jormas.2017.07.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 12/20/2022]
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Martin R, Louvrier A, Weber E, Chatelain B, Meyer C. [Consequences of impacted wisdom teeth extraction on the periodontal environment of second molars. A pilot study]. J Stomatol Oral Maxillofac Surg 2017; 118:78-83. [PMID: 28343833 DOI: 10.1016/j.jormas.2016.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/17/2016] [Accepted: 10/26/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Wisdom teeth extraction is a common procedure, generally considered as safe by patients. However, complications are possible, especially periodontal ones. The aim of this study was to evaluate the frequency and the consequences of periodontal complications at the level the 2nd molars after extraction of the wisdom teeth. MATERIAL AND METHODS A single-center retrospective observational multi-operator study was conducted at the university hospital of Besançon - France. The files of all the adult patients who underwent extraction of four impacted wisdom teeth by mean of a standardized surgical technique between November 2012 and November 2014 and who could be followed 1 year postoperatively at least and that precisely mentioned the periodontal status of the surgical sites were included. Postoperative complications, gingival and plaque indexes according to Loë and Silness, periodontal attachment level and periodontal second molar probing were recorded. The main judgment criterion was the occurrence of a periodontal complication in the second molar areas. RESULTS The files of 20 patients (15 women - 5 men), operated on by five different surgeons, met the inclusion criteria. Two patients suffered from dry socket at one of the avulsion sites. No patient had a gingival or plaque index greater than 2. No gingival recession or periodontal pocket over 4mm was found. DISCUSSION Extraction of impacted third molars in young healthy adults didn't have any impact on the second molars periodontal environment in our study. Literature suggests that surgical technique greatly influences the occurrence and the extent of periodontal sequelae.
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Affiliation(s)
- R Martin
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
| | - A Louvrier
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, hôpital Jean-Minjoz, centre hospitalier régional universitaire de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Nanomedicine Lab, EA 4662, université de Franche-Comté, Besançon, France
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Berquet A, Louvrier A, Denis F, Bornert F, Weber E, Meyer C. [Evaluation of healing time of osteochemonecrosis of the jaw after surgery: Single-center retrospective study and review of the literature]. J Stomatol Oral Maxillofac Surg 2017; 118:11-19. [PMID: 28330568 DOI: 10.1016/j.jormas.2016.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 10/17/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Osteochemonecrosis of the jaw (ONJ) is a chronic ischemic bone exposure. It has an increasing incidence. ONJ is mainly related to bisphosphonate and denosumab therapies in oncologic settings. Healing is considered uncertain ad as occurring slowly. International recommendations suggest to treat ONJ symptomatically in a first attempt. A surgical procedure, potentially aggressive, should be carefully weight up in patients in poor condition and whose life expectancy is often limited. However, surgical treatment seems to allow for a high rate of clinical remission. Postoperative remission periods, when mentioned in the studies, are disparate. The aim of our study was to clarify the remission period of ONJ after surgical management. METHOD A retrospective study was conducted on all patients operated for an ONJ at stage 2 and 3 in the Department for Oral and Maxillofacial Surgery - University Hospital of Besançon (France) from January 2006 to September 2015. Healing was defined as complete mucosal closure and asymptomatic site. Stage of the disease, the number and the type of surgery and the time between the last operation and the healing was noticed. These data were compared to an exhaustive review of the literature on PubMed with the following key-words: "osteonecrosis" AND "jaw" AND "surgery" AND "management". Only the articles giving the healing period were included. RESULTS Regarding the single-center retrospective study, the files of 23 patients could be included. Fifteen percent of the patients benefited from several procedures under general anesthesia. Twenty percent had a stage 3 ONJ and 80 % had a stage 2 ONJ. Twenty-five interventions were performed on 23 sites in 20 patients. Immediate healing after surgery occurred in 35 % of the patients. At 6 months after surgery, 57 % of the treated areas were healed. Twenty percent of the patients had died. The healing rate did not improve further after 6 months postoperatively. Regarding the review of the literature, 7 articles could be included. The mean postoperative healing period was 60.7 % at 6 months, 71.1 % at 12 months and 69.5 % at 18 months. DISCUSSION Our study shows that the postoperative healing rate of ONJ lies between 57 and 66.7 % at 6 months and that this rate was optimized in the order of 10 % to 12months and stable at 18months postoperatively. The ONJ of our series were partially or fully linked to other drugs than bisphosphonates in 70 % of the cases: 50 % were related to denosumab, alone or in combination and 35 % were related to an association with antiangiogenics, bevacizumab mainly.
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Affiliation(s)
- A Berquet
- Département d'odontologie et de chirurgie orale, CHU François Mitterrand, Dijon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France.
| | - A Louvrier
- Faculté de médecine, université de Franche-Comté, Besançon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France
| | - F Denis
- Département de chirurgie orale, service d'odontologie, hôpital de la Maison-Blanche, université Champagne-Ardennes, Reims, France; EA 481 neurosciences intégratives et cliniques, Besançon, France; Centre hospitalier La Chartreuse, 21033 Dijon, France
| | - F Bornert
- Inserm (French National Institute of Health and Medical Research), "Osteoarticular and Dental Regenerative Nanomedicine" laboratory, UMR 1109, faculté de médecine, FMTS, 67085 Strasbourg cedex, France; Université de Strasbourg, faculté de chirurgie dentaire, Strasbourg, France; Pôle de médecine et de chirurgie bucco-dentaires, unité de pathologie-chirurgie buccale, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - E Weber
- Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; EA 4662 Nanomedicine Lab, université de Franche-Comté, 25000 Besançon, France
| | - C Meyer
- Département d'odontologie et de chirurgie orale, CHU François Mitterrand, Dijon, France; Département de chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, CHRU Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; EA 4662 Nanomedicine Lab, université de Franche-Comté, 25000 Besançon, France
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Louvrier A, Euvrard E, Nicod L, Rolin G, Gindraux F, Pazart L, Houdayer C, Risold PY, Meyer F, Meyer C. Odontoblastic differentiation of dental pulp stem cells from healthy and carious teeth on an original PCL-based 3D scaffold. Int Endod J 2017; 51 Suppl 4:e252-e263. [PMID: 28109162 DOI: 10.1111/iej.12746] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 01/17/2017] [Indexed: 01/09/2023]
Abstract
AIMS To isolate and characterize dental pulp stem cells (DPSCs) obtained from carious and healthy mature teeth extracted when conservative treatment was not possible or for orthodontic reasons; to evaluate the ability of DPSCs to colonize, proliferate and differentiate into functional odontoblast-like cells when cultured onto a polycaprolactone cone made by jet-spraying and prototyped into a design similar to a gutta-percha cone. METHODOLOGY DPSCs were obtained from nine carious and 12 healthy mature teeth. Then cells were characterized by flow cytometry and submitted to multidifferentiation to confirm their multipotency. These DPSCs were then cultured on a polycaprolactone cone in an odontoblastic differentiation medium. Cell proliferation, colonization of the biomaterial and functional differentiation of cells were histologically assessed. For the characterization, a t-Student test was used to compare the two groups. RESULTS In all cell cultures, characterization highlighted a mesenchymal stem cell phenotype (CD105+, CD90+, CD73+, CD11b-, CD34-, CD45-, HLA-DR-). No significant differences were found between cultures obtained from carious and healthy mature teeth. DPSCs from both origins were able to differentiate into osteocytes, adipocytes and chondrocytes. Cell colonization was observed both on the surface and in the thickness of polycaprolactone cones as well as a mineralized pericellular matrix deposit composed of type I collagen, alkaline phosphatase, osteocalcin and dentin sialophosphoprotein. CONCLUSIONS DPSCs were isolated from both carious and healthy mature teeth. They were able to colonize and proliferate within a polycaprolactone cone and could be differentiated into functional odontoblast-like cells.
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Affiliation(s)
- A Louvrier
- Service de Chirurgie Maxillo-faciale, Stomatologie et Odontologie Hospitalière, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - E Euvrard
- Service de Chirurgie Maxillo-faciale, Stomatologie et Odontologie Hospitalière, Centre Hospitalier Universitaire de Besançon, Besançon, France.,Nanomédecinelab, EA 4662, UFR SMP, Université de Franche-Comté, Besançon, France
| | - L Nicod
- Nanomédecinelab, EA 4662, UFR SMP, Université de Franche-Comté, Besançon, France
| | - G Rolin
- Centre d'Investigation Clinique de Besançon, INSERM 1431, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - F Gindraux
- Nanomédecinelab, EA 4662, UFR SMP, Université de Franche-Comté, Besançon, France.,Service de Chirurgie Orthopédique, Traumatologique et Plastique, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - L Pazart
- Centre d'Investigation Clinique de Besançon, INSERM 1431, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - C Houdayer
- Estrogènes, Expression Génique et Pathologies du Système Nerveux Central, EA3922, UFR ST, Université de Franche-Comté, Besançon, France
| | - P Y Risold
- Estrogènes, Expression Génique et Pathologies du Système Nerveux Central, EA3922, UFR ST, Université de Franche-Comté, Besançon, France
| | - F Meyer
- Inserm UMR 1121 Biomaterials and Bioengineering, FMTS, Université de Strasbourg, Strasbourg, France.,Institut Hospitalo Universitaire, Pôle de médecine et chirurgie bucco-dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - C Meyer
- Service de Chirurgie Maxillo-faciale, Stomatologie et Odontologie Hospitalière, Centre Hospitalier Universitaire de Besançon, Besançon, France.,Nanomédecinelab, EA 4662, UFR SMP, Université de Franche-Comté, Besançon, France
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Morelon JB, Meyer C, Parmentier J, Prost G, Weber E, Louvrier A. [Treatment of a unilateral Brodie's syndrome by surgical contraction of the maxillae]. J Stomatol Oral Maxillofac Surg 2017; 118:57-62. [PMID: 29595476 DOI: 10.1016/j.jormas.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 08/25/2016] [Accepted: 11/17/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Brodie's syndrome consists in a transverse occlusal discrepancy in relation with an excessive width of the maxilla, a narrow mandible or a combination of both, leading to lateral scissors bite. This kind of infrequent malocclusion is usually treated by orthodontics alone in children. In adults, additional orthognathic surgery id often required. We present a case of unilateral Brodie's syndrome treated by surgical contraction of the maxillae. OBSERVATION A 22-year-old patient presented with a left scissors bite and severe unilateral molar overbite. After failure of an attempt to ingress the left molars by help of a sub-apical corticotomy and anchorage mini-screws, the patient was referred for surgery. The mandible being considered as normal, a segmented Le Fort I osteotomy was planned, combining a contraction (4mm) and an impaction (4mm) of the left maxilla. This allowed for an immediate correction of the skeletal discrepancy and for the achievement of orthodontics in less than 6 months. DISCUSSION Le Fort I osteotomy provides a good access to the sagittal suture. Maxillary contraction is an uncommon procedure that enables a quick management of scissors bite and doesn't need any patient cooperation. Treatment time is reduced and the need for intraoral devices is limited.
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Affiliation(s)
- J B Morelon
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - C Meyer
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; EA 4662, UFR sciences et techniques, Nanomedicine Lab, Imagery and Therapeutics, université de Franche-Comté, 16, route de Gray, 25030 Besançon cedex, France
| | - J Parmentier
- Cabinet de chirurgie maxillo-faciale et stomatologie, 2, rue de Mirande, 21000 Dijon, France
| | - G Prost
- Cabinet d'orthopédie dento-faciale, 14, bis rue de Mulhouse, 21000 Dijon, France
| | - E Weber
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - A Louvrier
- Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France
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Marty P, Louvrier A, Weber E, Dubreuil PA, Chatelain B, Meyer C. [Arthrocentesis of the temporomandibular joint and intra-articular injections : An update]. ACTA ACUST UNITED AC 2016; 117:266-72. [PMID: 27554488 DOI: 10.1016/j.revsto.2016.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Arthocentesis of the temporomandibular joint combined with intra-articular washout and, more recently, intra-articular injection of pharmacological agents has been developed from the 1990s and is nowadays extensively in use for the treatment of temporomandibular dysfunctions (TMDs). The goal of our work was to answer 3 questions: 1. Is intra-articular washout effective for the treatment of TMDs ? 2. What kind of pharmacological agents may nowadays be injected in addition to washout and are these injections useful ? 3. What is the place of these treatments in the treatment strategies of TMDs ? MATERIAL AND METHODS A bibliographic research has been carried out in the PubMed database using following keywords arthrocentesis, temporomandibular joint. The 27 articles published between 1991 and 2016, indicating patient's inclusion criterions and objectively evaluating the clinical results (mouth opening, intra-articular noises, pain) were selected. Pharmacological agents were noticed when used. RESULTS 1. All authors concluded to the efficacy of intra-articular washout. No prognostic factor for arthrocentesis efficacy could be identified. 2. Main pharmacological agents used were steroids, hyaluronic acid, morphine-based drugs and platelet rich plasma. Superiority of ith-injection protocols failed to win unanimous support. All authors who compared with- and without-injection protocols concluded to the superiority of with-injection protocols, whatever the agent. DISCUSSION Numerous studies have proven the efficacy of intra-articular washout for the treatment of TMDs resistant to noninvasive treatments. The advantage of any kind of pharmacological agent is not clear. Mechanisms of action are not all elucidated. No pharmacological agent showed any superiority over another. Study methodologies are often defective: imprecise inclusion criterions, short follow-up, confounding variables not taken into account, few comparison between pharmacological agents.
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Affiliation(s)
- P Marty
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - A Louvrier
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - P-A Dubreuil
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab, Imagery and Therapeutics-UFR SMP, 19, rue Ambroise-Paré, 25030 Besançon cedex, France
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Louvrier A, Foletti JM, Guyot L, Chossegros C. [Combined approach of parotid lithiasis. A technical note]. ACTA ACUST UNITED AC 2015; 116:139-42. [PMID: 25841269 DOI: 10.1016/j.revsto.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/18/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sialendoscopy, extracorporeal lithotripsy and transoral removal are the usual treatments for parotid lithiasis. These techniques cannot treat all the patients. In fact, removal of lithiasis bigger than the ductal diameter and situated in the middle or posterior third of the duct may fail with such techniques. For this reason the combined approach has been developed. Our technical note describes this procedure. TECHNICAL NOTE Preoperative check-up needs an ultrasound or a CT scan of the parotid region. The procedure is conducted under general anesthesia. It begins with the localization of the lithiasis with help of the sialendoscope light visible through the skin. A face lift approach is performed giving access to the SMAS that is opened over the lithiasis and the transilluminated area. A window is opened on the duct and the lithiasis is removed. Proximal duct permeability is assessed with the sialendoscope. The different layers are sutured and a suction drainage is left in place. DISCUSSION Combined approach is indicated in case of failure of conservative techniques. It provides good results in removal of lithiasis located in the posterior or middle thirds of the duct. Its morbidity is low. It can avoid performing a parotidectomy and lowers the risk of facial palsy. In case of failure, botulinum toxin injection may be indicated.
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Affiliation(s)
- A Louvrier
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - L Guyot
- Service de chirurgie maxillo-faciale et plastique de la face, CHU Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, 13284 Marseille, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Aix-Marseille université, 13284 Marseille, France
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