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Biomedical subjects

B Ricbourg

Publications and source records attributed to B Ricbourg.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Triangular skull. Apropos of trigonocephaly].

The authors present 87 patients with trigonocephaly who were operated on. They take an interest in the consequence of the early synostosis of the metopic suture. The metopic suture combine with the sagittal sutural system, but his spot of manifestation is unambiguous. Its manage the dimension of the frontal bone which himself has repercussions on the set of the orbits. Thereby the fronto-orbito-facial dysmorphy has two component parts. One direct with little frontal bone and a thick sutural spot which extend more or less to the bregma and a second indirect with early deformation of the orbits and late deformation of the parietal bones. Three clinical patterns are described: micro-frontal shape, medio-frontal shape and orbito-frontal shape. In the pure shapes there is no direct impact on the encephalon but the venous stasis is high and probably liable for the encephalic damage when they exist. A single surgical proceeding does not meet the many varieties of deformations. Resection of fused metopic suture from a bifrontal flap; confection of orbito-fronto-nasal band which is opened by greenstick fracture on the metopic site; transposition of an hemicoronal suture between the two hemifrontal valves lateraly translated; foreward mobilisation and interventing temporal flaps. To finish the modeling it is necessary to open the periosteum sheet in order to translate temporal muscles then to overlay with interparietal pedicularly periosteum the anterior step. Metopic synostosis is ordinarily only an aesthetic deformity infrequently associated with intracranial pathology. The treatment must be required for pronounced deformities to prevent significant psychosocial consequences.

Abnormalities, Multiple↗
PubMed1994

[Remodeling the cranial vault in anterior craniosynostoses. Our therapeutic experience of trigonocephaly and plagiocephaly].

The authors propose two simple techniques to improve the adaptation of the frontal vault after remodeling the orbito-naso-frontal flap in anterior craniostenosis. In trigonocephaly: the metopic suturectomy is enlarged by lateral translation of the two half frontal bones, then to fall the place the coronal suture is used. The temporal plates are moved forward and turned to fill the failure of fronto-temporal junction due to valgisation of orbito-naso-frontal band. In plagiocephaly: the frontal flattened flap is cut with oblique radial osteotomies starting at bregma so called "Daisy petal". The first internal petal is sacrificed. The others are rotated axially in a medial direction. Internal table corticotomies must be performed at two levels to recurve the flattening and to obtain a curve in the coronal plane. In this two techniques the pericranium and dura-mater must be carefully teated to obtain a better adaptation of the new bone shape and to permit the spontaneous reossification.

Craniosynostoses↗
PubMed1994

[Cranial asymmetries. Reflexions on plagiocephalies. Premature sutural synostosis or extracranial origin?].

The authors relate a clinical and radiological (X Ray and TDM tridimensional) study with an anthropological (dry skulls) study of plagiocephaly. The aim is to find with the aid of a physical examination, some anatomic parameters which permit to differentiate cranial asymmetry with coronal premature synostotic suture from functional deformation with extracranial outset. The term plagiocephaly is used to define forehead asymmetry. It is necessary to study orbital rim, nasal root, malar eminence, ear and chin mid point position. The morphology of the skull is important to look: frontal flattering and also occipital flattering or bulging, contra-lateral frontal and pterional aera bulging. The authors conclude that a single parameter is necessary to differentiate the two kinds of plagiocephaly: the petrous bone position on the flattened frontal side: sagittalisation: fonctionnal plagiocephaly; frontalisation: synostotic plagiocephaly.

Cephalometry↗
PubMed1993

[Forum on tissue expansion. Fast continuous expansion. A 3-years evaluation of its use from a retrospective study of 78 cases].

The authors report their experience of cutaneous expansion in a retrospective study of 78 cases. They compare the two methods usually applied: discontinuous slow expansion in two thirds of cases versus rapid continuous expansion in one third of cases. Both methods, as they are defined in the department, are described. Statistical analysis revealed two important facts: the complication rate was considerably lower in continuous expansion. Length of hospital stay was similar for both techniques. The results, not yet studied in a strictly scientific way, do not appear to argue against continuous expansion. Rapid cutaneous expansion may be considered to be a valuable technique in the future, but it must be chosen for certain people only and must be adapted to each patient.

Adolescent↗
PubMed1992

[No, Mozart was not trigonocephalic].

The precise circumstances of Mozart's death and burial remain unclear at now. In this, the ownership of the skull supposedly belonging to the great musician and deposed at the Salzburg Museum is still a matter of controversy. A comparison between the cephalometric dental and cranial characteristics of this skull and portraits of Mozart, either genuine or reconstituted, has been established. The hypothesis of a trigonocephaly reported initially by Puech and Tichy seems to need modification to the benefit of a regional brachycephaly. On the other hand our study does confirm the great probability for this skull to be Mozart's one.

Austria↗
PubMed1992

[Applied anatomy of the breast: blood supply and innervation].

Convinced of the importance of a precise understanding of anatomy in modern surgery, the author studied the arterial blood supply and venous and lymphatic drainage and re-evaluated the innervation of the mammary gland; 60 fresh cadavers, 350 thermographies and 5 in vivo arteriographies were analysed. Twenty years of surgical practice either supported or contradicted these anatomical findings. Schematically, the arterial blood supply is ensured by three plexuses: cutaneoglandular plexus, retroglandular plexus, intraglandular anastomotic plexus; the cutaneoglandular plexus corresponds to a combination of the dermal and the glandular blood supplies. The ectodermal embryological origin of the mammary gland clearly accounts for this common blood supply. This concept allowed the development of deepithelialised periareolar pedicle reduction mammaplasty and acts as a guide for subcutaneous mastectomies. The retroglandular plexus is supplied, in particular, by the musculocutaneous and, in this case, musculoglandulocutaneous arteries. This plexus ensures the blood supply of the remaining gland following posterior or inferior pedicle reduction mammaplasty techniques. The venous drainage was studied in particular detail. Two venous plexuses are present: one runs parallel to the arterial blood supply and the other is superficial, subcutaneous and anastomotic not only with the deep plexus, but also with the all of the surrounding regions. This plexus, quiescent under normal conditions, becomes functionally important in certain pathological conditions or after correction of mammary hypertrophy. The external and internal pathways of lymphatic drainage have been described for a long time. The authors describe the lesser known accessory pathways which nevertheless play an essential role in certain forms of metastatic spread or recurrence of breast cancer. Lastly, the authors describe the sensory innervation of the mammary gland which is an essential element for preservation of nipple sensitivity, in particular, following reduction or augmentation mammaplasty or even breast reconstructions.

Breast↗
PubMed1991

[Morbidity of iliac bone grafts. A study apropos of 100 consecutive cases].

A study of the real morbidity after iliac bone graft harvesting was conducted on a homogenous series of 100 consecutive cases. Functional and aesthetic consequences were evaluated in relation to the immediate post-operative course and the long-term follow-up and in relation to the indication, the technique used and the amount of bone removed. Considering the small number of sequelae observed, autogenous iliac bone graft remains the best material for craniomaxillofacial reconstruction. The main disadvantage consists of the resorptions noted; which raises the possibility of using other types of bone grafts or bio-materials in some indications.

Adolescent↗
PubMed1991

[Rapid tissue expansion: value of the measurement of the transcutaneous oxygen pressure and intraprosthetic pressure].

Tissue expansion is often unpleasant for the patient because of its long duration. The authors present a series of 16 rapid expansion prostheses implanted in 10 patients. The expansion was monitored by measuring the percutaneous oxygen partial pressure and intraprosthetic pressure. The expansions were performed without any complications. Monitoring of the expansion by measuring the pcPO2 appears to ensure good results.

Adolescent↗
PubMed1991

[The inframammary fold: myth or reality?].

Is the inframammary fold an anatomical entity? In order to answer this question, the authors conducted an anatomical, histological and radiological study. The results of these studies were concordant and were able to anatomically define the inframammary fold. The inframammary fold corresponds to a division of the fascia superficialis. It contains numerous fibres stretched between the fascia superficialis and the fascia prepectoralis. In contrast, there are no fibres connecting the fascia superficialis to the deep dermis.

Adult↗
PubMed1991

[One-stage columellar reconstruction. Use of a vascularized double labial flap].

The author describes a technique for one-stage repair of the columella which he has used since 1984. The procedure is based on the anatomical concept of the venous drainage of the columellar region and philtrum. Two vascularised para-alar flaps are raised from the philtrum then raised 90 degrees with an equivalent horizontal rotation. The donor site is closed by primary suture with no cicatricial sequelae. A columellar support can be inserted between the two flaps. The long-term results were considered to be good in every case.

Follow-Up Studies↗
PubMed1991

[Sphenoid fissure syndrome in orbital fractures. Case presentation and literature review].

The superior orbital syndrome has been reported as a very rare complication of orbital fracture. In emergency clinical examination and computed tomography of the cranio-orbital region have provided diagnosis of the compression of the superior orbital fissure content by oedema and/or hematoma. These examinations have determined the type of cranio-orbital fractures and the absence of extra-dural haemorrhage, optical nerve damage or compression, which required emergency treatment. After surgical treatment of the cranio-orbital fracture by temporal and transconjunctival approach, the orbital fissure syndrome has required supervision. The recovery of ophthalmoplegia has taken several months. Minor after effects have been observed for the patient reported.

Humans↗
PubMed1991

[Orbital neurofibrosarcoma. Clinical and etiological study; apropos of a case].

This case report is about a relapsing conjunctive sarcoma affecting a 67 year old woman, involved with Von Recklinghausen's neurofibromatosis. Surgical orbital exenteration was necessary for curative treatment and reconstruction used a temporal muscle flap. Through this report, emphasis is placed on diagnosis difficulties and possibility of serious development concerning these malignant tumors in the scope of neurofibromatosis.

Aged↗
PubMed1990

[Breast cancer following breast prosthesis and irradiation in childhood].

The authors report a case of breast cancer developing 7 years after insertion of a breast prosthesis. This patient was 45 years old at the time of this discovery and had received low dose radiation during childhood for a haemolymphangioma of the homolateral axillary region. The possible factors predisposing development of cancer are discussed: haemolymphangioma, low dose axillary irradiation during childhood, peri-prosthetic fibrous capsule. These various points are examined in the light of data from the literature. The conclusions recall the necessity for clinical and radiological follow-up of breast prostheses, preferably performed by a plastic surgeon.

Axilla↗
PubMed1990

[Malherbe's calcified epithelioma. Review of 80 cases].

The authors review a series of 80 Benign Calcifying Epitheliomas (BCE), and describe their main clinical, histologic and prognostic features, in comparison with those reported in the literature. BCE or pilomatrixoma arises from the hair matrix, and represents approximately 1/1,000 of all skin tumors. Statistically, it is found more frequently among children under the age of 10 years and anatomic locations are mostly located on the face and upper limb. These benign tumors tend to develop slowly in subcutaneous tissue, and their treatment consists of simple surgical excision, except in some instances, where signs of more aggressive behavior can be found.

Adolescent↗
PubMed1990

[Use of fibrin glue after insertion of an expansion prosthesis].

The concept of tissue expansion is based on the elasticity of the skin which implies its retractability after removal of the prosthesis and insertion of the expanded flap, resulting in tension of the suture margins. Fibrin adhesive applied to the expansion cavity and under the expanded flap has two objectives: to prevent tension of the skin edges/and to prevent sero-haematoma in the expansion cavity. 15 successive cases of expansion prosthesis were successfully treated in this way. The technical protocol and results are presented.

Adolescent↗
PubMed1990

[Prospective study of the specific liability of the plastic surgeon].

The authors of the article first pose this question: might plastic surgery not fit into the general principles that guide any medical procedure? The general principles, especially as regards the distinction between liabilities in terms of means and liabilities in terms of results, are discussed in the first part of the survey. The authors then demonstrate that the plastic surgeon does differ from other surgeons: he has to comply with the same restraints as any surgeon. However, the survey then presents certain aspects specific to this branch of surgery, and their implications in terms of responsibilities. The article successively discusses: the patient's freedom of choice, the need for particularly thorough information and its form, the limits to the practitioner's freedom in choosing the technique, and most importantly the so-called obligation to avoid (which the authors study in particular detail in the field of analysis and responsibilities) of obviously useless operations. The authors, after recalling important recent legal precedents, come to the conclusion that it is necessary to establish an institution: "the medical ombundsman" defined by a bill in the 1988 sitting of the French Parliament.

France↗
PubMed1990

[Nasal reconstruction: a comparative study between the Converse scalping flap and expanded median forehead flap].

The authors, reviewing a series of 16 at least subtotal nasal reconstructions over the past 4 years, discuss the respective advantages of the two methods, which both give good results for this purpose. Nowadays, the balance favors expansion despite its duration and complexity for the very significant aesthetic benefits in terms of forehead scarring. The guidelines concerning this technique employed in 6 cases are described and reviewed in detail. Nevertheless, the Converse scalping flap remains a simple and quick solution especially after cancer resection in the elderly; some details seem important to diminish its sequelae.

Basal Cell Carcinoma↗