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Biomedical subjects

D Marchac

Publications and source records attributed to D Marchac.

At least 19 recordsLinked to original sources
PubMed1992

Intracranial pressure and intracranial volume in children with craniosynostosis.

Intracranial volume and intracranial pressure have been measured in 66 children with craniosynostosis, 48 boys and 18 girls. The premature fusion of skull sutures is assumed to restrict skull growth and predispose to elevated intracranial pressure. Thirteen children (20 percent) had raised intracranial pressure and demonstrated a significant restriction of skull growth. In this series, volume measurement alone, however, did not serve as a reliable predictor that the intracranial pressure was raised.

Adolescent↗
PubMed1990

Intracranial volume in children with craniosynostosis.

The intracranial volume of 104 children with craniosynostosis was measured. Premature fusion of skull sutures is thought to deny the growing brain room to expand, but contrary to traditional teaching the intracranial volume of such children is often within normal limits.

Cephalometry↗
PubMed1990

Fibrin glue in craniofacial surgery.

Fibrin glue has been utilized for the past 15 years in Europe in plastic surgery, especially at the beginning for nerve and skin grafts. For 4 years, we have utilized it in craniofacial surgery in over 72 cases. No adverse reaction has been observed, and the various applications are discussed.

Bone Transplantation↗
PubMed1990

The operative treatment of isolated craniofacial dysostosis (plagiocephaly): a comparison of the unilateral and bilateral techniques.

Both the safety and efficacy of the treatment of isolated craniofacial dysostosis (plagiocephaly) in infancy have been demonstrated. Opinions remain divided, however, as to the optimal type of procedure to be undertaken. In an attempt to answer this question, we have retrospectively evaluated a study population of 48 children operated on in infancy by either a unilateral or bilateral approach. Results of treatment at a minimal follow-up of 3 years were assessed based on preoperative and postoperative photographs and direct patient examination. Based on this retrospective comparison of the unilateral and bilateral approaches to the treatment of isolated craniofacial dysostosis, we conclude that (1) either approach as specifically outlined will give excellent results in the majority of patients, (2) there is no statistically significant difference in the results obtained by using either procedure, (3) in the majority of instances, less than ideal correction was manifested by contour irregularities evident in the temporal and/or lateral forehead region, and strict attention should be given to these areas in an attempt to further improve results, and (4) in those cases where significant protrusion is observed on the "normal side," a bilateral approach is preferable.

Bone Transplantation↗
PubMed1988

The calculation of intracranial volume using CT scans.

A method of calculating intracranial volume from horizontal computerized tomography scan slices is presented. The accuracy of this technique was confirmed by applying it to 10 dry skulls and comparing the values obtained with the true intracranial volumes, as determined by filling the skulls with water. Values ranging between 98.14% and 102.6% of the true values were obtained, the mean error being 1.13%. This technique is now being used to study intracranial volume changes in children with craniostenosis.

Adult↗
PubMed1988

Experience with the "floating forehead".

The effectiveness of the "floating forehead" operation for treating brachycephaly in infants has been assessed. All children who had undergone this procedure at the Hôpital des Enfants Malades between 1977 and 1984 were reviewed retrospectively by an independent observer. Particular attention was paid to the effects on cranial growth, facial growth and morphology.

Acrocephalosyndactylia↗
PubMed1988

Craniofacial surgery for craniosynostosis: functional and morphological results.

The functional and morphological aspects of craniosynostoses are reviewed, based on a series of 462 operations, 350 intra-cranial pressure recordings and 300 I.Q. assessments. Increased intracranial pressure and mental impairment are linked. The frequency of intracranial hypertension is higher when more than one suture is involved, but even monosutural craniosynostoses can be affected. Increased intracranial pressure had mental deficiency are more frequent after one year of age than before. Surgery lowers the intracranial pressure and halts the mental regression. The younger the patient is at the time of surgery, the better the results. Surgery does not improve the I.Q. once it is already impaired. Morphological results of frontocranial remodeling are good and remain so with growth. Facial anomalies associated with craniosynostoses improve after early frontocranial remodeling, except for the severe midface retrusion of Crouzon's disease and Apert's syndrome that need in most cases a supplementary midface advancement.

Cephalometry↗
PubMed1988

[Genetic counseling in craniostenosis. Results of a prospective study performed with a group of studies on craniofacial malformations].

Result of a family study based on 584 patients with craniostenosis brings some answers useful for genetic counselling. For 98 patients (15%) a syndrome is associated. Third part of them has Apert syndrome, an other third part has Crouzon syndrome, and for the last third more exceptional acrocephalosyndactyly syndrome (Saethre-Chotzen, Pfeiffer) or others atypical associations, sometimes not yet described, but with an autosomal dominant inheritance. Non syndromic craniostenosis involves differently according to the type of join, but the localization is the same if recurrence will be happen. Coronal craniostenosis seems to be a dominant autosomal character, when scaphocephaly is more often sporadic; for both, an autosomal dominant inheritance is not excluded for some pedigrees. If the recurrence risk exist in some cases, it is generally well accepted by parents on account of the good neurosurgeon prognosis.

Dysostoses↗
PubMed1988

Mammaplasty with a short horizontal scar. Evaluation and results after 9 years.

To obtain a shorter horizontal branch of the inverted T used in mammaplasties, the senior author has developed a technique based on a vertical skin resection stopping above the inframammary line. An evaluation of the results after 9 years of experience has been carried out in 176 patients. Results were satisfactory overall because the shape obtained was pleasing and stable in most cases; the horizontal scar remained hidden beneath the breast in the standing position. Modifications and refinements of the technique since its first publication in 1980 are discussed.

Adult↗
PubMed1987

Treatment of craniosynostosis in infancy.

Craniosynotosis affects approximately one infant out of 1000. The increase of intracranial pressure and the risks of functional problems are more frequent than usually estimated, especially in monosutural synostosis. Frontocranial remodeling will correct both functional and aesthetic consequences of craniosynostosis. The best operative period is the first year of life, 2 to 3 months of age for the brachycephalies, and 6 to 9 months of age for the other craniosynostoses. Not only does growth not adversely affect the results of the forehead remodeling, but the adjacent orbitonasal areas improve with time. In Crouzon's disease and Apert's syndrome, early frontal advancement does not prevent the midface retrusion, and a radical frontofacial advancement may be indicated in very severe cases.

Child↗
PubMed1986

A frontal pattern for frontocranial remodeling.

In early 1983 we developed a frontal pattern to aid in remodeling the forehead in craniosynostosis. We also designed a rigid wire to assist in checking the proper curvature of the supraorbital bar. In approximately 150 frontocranial remodelings the pattern has proved very useful and has simplified the procedure.

Adult↗
PubMed1986

[Ophthalmologic complications of craniofacial stenoses. Apropos of 244 cases].

The authors present a review of the most commonly observed ophthalmological troubles in 244 cases of children affected by cranio-facio stenoses and hospitalized for a first examination. The fundus examination shows that nearly all types of cranio-facio stenoses can be complicated by intracranial hypertension with potential damage on the optic nerve. The hyper and hypotelorisms, particularly frequent, carry along aesthetic prejudice and effect on the ocular motility. In the most severe forms of the diseases (Alport), pseudo-exophthalmy by retrusion of the face can justify preventive surgical procedures in emergency. Squint is frequent (36.5%). All types can be found. Finally, the authors certify the frequency and the seriousness of ocular repercussion, even in so called benign types of cranio-stenoses, such as plagiocephaly, trigonocephaly, and scaphocephaly.

Acrocephalosyndactylia↗
PubMed1986

[Cutaneous expansion by inflatable implant].

The capacity of the skin to stretch and expand, as shown in pregnancy, has been used by Radovan who, in 1976, introduced skin expanders made of silicone. These are empty balloons of different sizes and shapes which are surgically placed under the skin and gradually filled with saline. The saline solution is introduced through a valve with a syringe and a 21 G needle. Skin expansion usually requires 6 to 8 weeks to be completed. Transient redness of the skin is frequently observed. A thin capsule can be found around the expander but does not need to be removed. The excess skin can be utilized as advancement flap, rotation flap or even two-stage distant flap. Our experience is based on 33 expansions performed in 26 patients (table I). Giant naevi were the most frequent lesions treated (20 cases), and face, scalp and neck were the most frequent localizations (27/33 cases) (table II). Complications occurred in 21 p. 100 of the cases, and 5 expanders had to be removed. Nevertheless, expansion could be completed in most cases, sometimes after replacement of the prosthesis. The results of repair surgery using expanded skin have always been satisfactory: in colour and texture the expanded skin was similar to that of adjacent areas, and sensation was preserved. Skin expansion in fact made it possible to perform local flaps--which usually represent the best solution for skin replacement--by creating hyperlaxity in areas adjacent to the pathological areas. There has been no retraction of the expanded skin, and the scars have shown no tendency to hypertrophic reaction or distension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Craniofacial surgery for craniosynostosis improves facial growth: a personal case review.

An evaluation of 220 cases of frontocranial remodeling for craniosynostosis is reported. The follow-up period was 10 years for children, 7 years for infants. The principles of the craniofacial techniques described in 1974 [4] and 1978 [3] were not modified; only variations were added. The floating forehead [5] concept has also remained basically unchanged. Intracranial pressure recordings have been used continually to help evaluate borderline indications and to assess results [9]. Our results show that 14% of cases of craniosynostosis affecting only one suture, usually considered as merely aesthetic problems, in fact were accompanied by increased intracranial pressure. The postoperative recordings have shown a return to normal pressures. Growth has not deteriorated the initially satisfactory results at the level of the forehead. At the midface level, improvement has been observed after surgery, especially for plagiocephalics. Their orbitonasal asymmetry has nearly completely disappeared. Patients with bilateral faciocraniosynostosis show an improvement of midface development compared with non-operated patients, but in severe cases an inverted bite still develops and further facial osteotomies remain necessary. The Apert's patients remain the most difficult to improve.

Child↗
PubMed1985

Abdominoplasty in infants for removal of giant congenital nevi: a report of three cases.

The abdominal wall of the infant presents a significant skin excess. Applying techniques of aesthetic abdominoplasty, it is possible to excise extensive abdominal wall lesions, as often seen in children with congenital hairy nevi. Three cases of congenital nevi were handled in this manner and are presented. One case involved the upper abdomen, while the other two involved the lower abdomen.

Abdominal Muscles↗