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D Goga

Publications and source records attributed to D Goga.

At least 19 recordsLinked to original sources
PubMed2003

[Uterine liposarcoma invading abdominal wall and inguinal region. Immediate reconstruction using a pedicled anterolateral thigh flap].

The anterolateral thigh flap is a particular flap of the vastus lateralis musculocutaneous flap (perforator flap). This flap was used as a pedicled flap to reconstruct the abdominal wall and to cover the inguinal region following the resection of a voluminous tumor of the womb invading the abdominal wall, the femoral vessels and the skin. The flap included a large facial paddle nourishing a skin island and a little muscle paddle including the perforator vessel. This medially positioned facial paddle allowed to increase the area of useful flap. So it was possible to reconstruct a 10x15 cm abdominal wall defect, and to cover the vascular decking in inguinal region with this only flap. In spite of the harvesting of a small muscular paddle of vastus lateralis (with conservation of the motor nerve) the function of thigh extension has been preserved. Besides the subtlety described to increase the "solid" surface of the fragment, it seems that the anterolateral thigh flap is perfectly useful to cover defects of soft tissues in inguinal region after vascular surgery, indication which was not reported to our knowledge in spite of the high frequency of these losses defects.

Abdominal Wall↗
PubMed2002

[Early surgery of immature hemangiomas with the aid of an ultrasonic scalpel. Apropos of 81 cases].

BACKGROUND: The natural course of immature hemangiomas in infants is well-known. A rapid phase of growth from 6 to 8 months is followed by a period of stability then regression. Since approximately 70% of these immature hemangiomas resolve spontaneously, abstention is generally the rule. The volume or localization of certain lesions may nevertheless have a serious functional or morphological impact. MATERIAL AND METHODS: This retrospective study included 81 children who underwent surgery between October 1994 and March 2000. The children were aged 2 to 38 months at the time of surgery. Orbital localizations predominated (33 children). The indication for surgery was based on two criteria: risk of a functional impairment or risk of morphological sequela. All children with orbital hemangiomas with a functional risk of amblyopia were initially treated with corticosteroids. Surgery was performed in case of failure. The CAVITRON was used for 77 children and DISSECTRON for 4. These two ultrasound devices allowed easy dissection with little hemorrhage. RESULTS: There were no peroperative hemorrhagic complications. Few postoperative complications were observed. After resection of the orbital hemangiomas there was little functional impact and the postoperative ophthalmologic examinations were normal within several weeks. Mean follow-up was 12 months after surgery. Use of an ultrasound dissector allowed early and safe treatment of immature hemangiomas. DISCUSSION: Certain voluminous or poorly localized hemangiomas, particularly on the face, can have a serious function, morphological or psychological impact. Medical treatment is not always active and surgical resection may be required before the development of definitive sequelae. Ultrasound dissection, not previously used in this indication, can contribute significantly to the surgical outcome as demonstrated in these children operated on early. This technique is safe and shortens operative time. In light of these results, we believe early resection of immature hemangiomas should be reevaluated. It should not be considered as a last resort but rather as a complementary treatment.

Age Factors↗
PubMed2002

[Anterolateral thigh free flap. Surgical technique].

The anterolateral thigh free flap is a cutaneous or fasciocutaneous flap vascularised by one or several perforating arteries arising from the descending branch of the lateral circonflex femoral artery. Venous drainage occurs via the perforators or a similar route to the deep femoral system or the femoral vein. This flap is commonly used in Asia (China, Japan) where for certain teams, it replaces the classical radial forearm flap or the rectus abdominis myocutaneous flap for the reconstruction of head and neck defects after tumor ablation. We briefly describe the anatomy and vascularization of this flap and present the harvesting technique as well as the properties of the flap.

China↗
PubMed2001

[Early implant treatment of a child with anhidrotic ectodermal dysplasia. Apropos of a case].

The purpose of this article is to report the clinical course and follow-up of a child with ectodermal dysplasia who was treated with implants surgery very early. Different possibilities for prosthetic restoration in the anodontic child are reviewed. Tolerance was excellent. Good cover of the implant was achieved at four years. We propose early implantation reconstruction surgery for these exceptional cases. A prospective multicentric study of this condition would be useful.

Anodontia↗
PubMed2000

[Chronic desquamative gingivitis syndrome: retrospective analysis of 33 cases].

OBJECTIVE: Desquamative gingivitis is a chronic diffuse inflammation of the gingiva. The aim of this study was to determine the causes and the clinical characteristics of desquamative gingivitis. PATIENTS AND METHODS: This was a retrospective descriptive study including 33 consecutive patients (25 women and 8 men) seen at a dermatology clinic for erosive gingivitis. RESULTS: Thirteen patients (39 p. 100) had cicatricial pemphigoid, 12 (36 p. 100) had lichen planus, and 5 (15 p. 100) had pemphigus. Delay to diagnosis was a mean 19 months. The pinch sign was positive in 12 of the 13 cases of cicatricial pemphigoid. Dapsone improved the buccal lesions of cicatricial pemphigoid in all cases. Systemic corticosteroid therapy and acitretine were the most effective treatments for lichen planus and corticosteroid therapy improved pemphigus in all cases. At the time of assessment, only 3 cases of cicatricial pemphigoid, 2 cases of lichen planus and 1 case of pemphigus had reached complete remission without treatment. DISCUSSION: Cicatricial pemphigoid and lichen planus are the most frequent causes of desquamative gingivitis, accounting for three-quarters of the cases. Positive diagnosis may be difficult and may require sophisticated techniques to avoid delay. Despite the effectiveness of symptomatic treatment, desquamative gingivitis may have a long course.

Aged↗
PubMed2000

[Osseous leiomyosarcoma of the mandible. Case report and review of the literature].

Primary leiomyosarcoma localized in the mandibular bone is exceptional. We report a case with active intraosseous development and review eight other cases in the literature. The clinical signs at discovery were nonspecific. Radiological imaging showed osteolysis with no periosteal reaction. MRI was required to study extension to soft tissues and was useful for guiding wide excision. The risk is dominated by distant metastasis rather than locoregional extension. The histological diagnosis is difficult and requires an immunohistochemistry study. No therapeutic consensus has been established.

Adult↗
PubMed2000

[Dental agenesis. Results of a prospective study of 30 cases].

OBJECTIVE: We conducted a prospective study to determine the types of bone anomalies observed in different types of dental agenesia. PATIENTS AND METHOD: This prospective series included 30 patients who attended our pluridisciplinary clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of syndromal agenesia. Patients consulted for a variety of reasons, no specific sign was found. The diagnosis was based on the panoramic x-ray and confirmed at the genetic consultation. RESULTS: Results were systemized by localization of the agenesia. In all cases, the height of the bone crest was preserved compared with the adjacent teeth. In the anterior part of the maxillary, the bone crest was thin showing a water drop aspect. In the posterior maxillary, there was a decrease in the subsinusal height due to invagination of the floor of the sinus. In the anterior part of the mandible, the crest had a knife blade aspect but no loss of height and in the posterior part, a preserved distance between the residual crest rim and the dental canal. DISCUSSION: In 60% of the solitary agenesias in the anterior part of the maxillary, augmentation was not required. A sinus graft was required in all cases involving the posterior maxillary. Multiple anterior or lateral agenesias were treated with a parietal graft.

Adolescent↗
PubMed2000

[Pre-implantation iliac graft in the sinus. Retrospective study of the complications encountered in 100 cases].

MATERIAL AND METHODS: This series included 60 patients operated on between 1996 and 1998. Preoperative work-up included a x-ray study bone quality, preparation of the buccal cavity and assessment of the rhinosinus. We used the surgical technique described by Boynes and Tatum with modifications. The bone graft, mean 16 cm2 was fixed with a stud and clamp assemble or a long screw through the gingival crest, or with a microscrew on the lateral wall of the maxillary sinus. Minimal follow-up was two years. RESULTS: Mean age was 54 years (range 20-80). There were only two minor (hematoma) donor site problems. At the receiver site, there were 30 perforations of the mucosa that had no effect on the graft vitality. During the postoperative period, there were 2 hematomas that resolved spontaneously and 20 cases of dysesthesia in the V2 territory. Mid-term outcome (15 days to 6 months postoperatively) showed: 4 graft infections requiring removal in 3 cases and 6 partial resorptions requiring a new parietal bone graft in 3 cases. DISCUSSION: The iliac bone graft provided abundant cancellous tissue. The mid-term outcome was satisfactory although the postoperative problems resolved more slowly and were more painful than when harvesting a parietal graft. Mucosal perforations were frequent but reparable and did not increase postoperative morbidity. Infection was the most severe complication. Our incidence (3%) was slightly higher than reported in the literature. A possible explanation would be the mean height of the graft (18-20 mm) and the severity of the atrophies treated.

Adult↗
PubMed1999

Serratus anterior free fascial flap for dorsal hand coverage.

Reconstruction of the dorsal surface of hand defects requires thin, pliable, well-vascularized tissue with a gliding surface for the extensor tendon course. Fasciocutaneous or fascial flaps are the two surgical options. Fascial flaps present the advantages of thinness and low donor site morbidity. The authors present 4 cases of serratus anterior free fascial flap (SAFFF) used to cover the dorsum of the hand. The SAFFF with skin graft has many advantages for a fascial flap: long, constant vascular pedicle; very thin, well-vascularized tissue; low donor site morbidity; and the possibility of simultaneous donor and recipient site dissection. Furthermore, it can be associated with other flaps of the subscapular system for complex reconstructions. Of the 4 observations described, 2 used associated flaps, 1 used the SAFFF with a latissimus dorsi flap, and 1 used a scapular bone flap with the SAFFF. One flap was lost due to an electrical lesion to the forearm vessels.

Adult↗
PubMed1999

[Serratus anterior muscle flap: indications and sequelae. 26 cases and review of the literature].

The authors report their experience of the use of the serratus anterior flap. Between 1992 and 1997, this flap was used for 14 head and neck and 11 limb and 1 intra-thoracic reconstructions. Twelve patients were examined for functional evaluation of the donor site. When only 2 or 3 slips are raised donor site morbidity is limited to moderate winging of the scapula with no functional disorders. Because of its thinness, and the length and diameter of the vascular pedicle, the serratus anterior flap is our favourite option for small wounds of the distal limb or composite and large defects in association with flaps of the subscapular system.

Adolescent↗
PubMed1999

[Teamwork].

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France↗