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Biomedical subjects

F Boutault

Publications and source records attributed to F Boutault.

At least 37 records · Page 2Linked to original sources
PubMed1996

[The Internet in oral medicine and maxillofacial surgery].

The authors give an Internet short historical record, then describe the different services offered and the possible applications for oral and maxillo-facial surgery. Electronic-mail (E-mail) provides the ability to compose, send and receive messages through the computer and allows exchanging informations with colleagues around the world. Programs, files and graphics can be transferred from one computer to another. The "news groups" are interesting in various subjects and allow a team work. We find several hundred sites about maxillo-facial surgery. These sites present a medical department, diagnosis problems or therapeutic solutions, medical press. Any information submitted is insecure and could be observed by a third party while in transit. Internet potential (educational benefits, digital access to medical literature, online consultation service) is mentioned in the end of the article.

Communication↗
PubMed1996

[A superiorly pedicled nasobuccal flap. Its value in the reconstruction of posterior-superior loss of substance of the oral mucosa].

Superiorly based nasolabial flap is an interesting solution for reconstruction of moderate size maxillary defects. The operative technique and its results are described. Advantages (reliability in flap vascularity, versatility, easiness of elevation) and limits of this procedure for closure maxillary defects are mentioned. Then they are compared to the other reconstructive maxillary techniques.

Aged↗
PubMed1996

[The coral orbital floor. Its value in traumatology. The results of a multicenter study of 83 cases].

A madreporic coral graft was used for orbital floor reconstruction following facial trauma. This report presents a multicentric study of 83 patients with a follow-up period of 15 to 24 months. The results of this study indicate no significant rejection or infection opposed to so many synthetic implants outcome. The radiological follow-up demonstrates a partially resorption of the implant within about 2 years and its replacements by new bone. Coral implant was used to correct enophthalmos or diplopia due to enlarged orbital dimensions. It was technically easy to insert and its anatomic shape does not require to be fashioned before use. Its inflexibility allows to bridge large bone defects and this implant should be considered as an attractive alternative to autogenous grafts, avoiding a second surgical site, in reconstructing orbital floor fractures.

Adolescent↗
PubMed1995

Rehabilitation of long-term facial paralysis.

A wide variety or techniques have been developed over the years in an effort to reduce the devastating impact of facial paralysis on the patient. The authors choose to perform hypoglossal-facial nerve anastomosis when facial facial nerve anastomosis, or cross-over, or microvascular muscle transplantation are impossible. Nevertheless, these results appear always insufficient for palpebral occlusion. The authors propose to associate two rehabilitation technique to obtain optimal results. They perform hypoglossal facial nerve anastomosis using the technique modified by U. Fisch, and they associate temporal muscular transfer to improve ocular protection. This association imposes an increased strain on the patient in an effort to undertake double re-education which modifies twice his classic corporeal scheme. The surgical technique are associated after evaluation of the possibility of the patient adherence to the long duration physical therapy.

Anastomosis, Surgical↗
PubMed1995

[The value of lidocaine-prilocaine cream in the surgery of detached ears].

The possibility to obtain a skin anaesthesia using only an ointment may be very usefull for outpatient surgery. Recently available in France, the lidocaine-prilocaine cream give an interesting local anaesthesia. We have used this new presentation as skin preparation before otoplasty for 10 patients. As the local anaesthesia injections are then performed without pain, the comfort of the patient is greatly improved. Furthermore, it is easy to sue and without side-effect. The main disadvantage consists in the action delay of one hour, with the necessity to ask the patient to come earlier.

Adolescent↗
PubMed1995

[Reconstruction of the orbit floor using a resorbable polydioxanone (PDS degree) cup. Analysis of a series of 71 cases].

A 71 patients series is presented, concerning primary orbital floor reconstruction by a polydioxanone cup (PDS degree) which has been used for five years. The technical data and surgical procedure are exposed. No infection either intolerance manifestation has been observed until the materiel was resorbed. Two early displacements of the implant are reported, due to a technical fault during the insertion of the cup. Only one late enophtalmy was observed for a patient with a large orbital floor defect. The loss a the rigidity of the polydioxanone seems to be relatively fast (probably 2-3 months) and leads to contraindicate its use in cases of large osseous traumatic defects. In all other cases, this surgical technique seems to be very useful.

Adolescent↗
PubMed1995

[Removal through the coronal approach of the upper wisdom teeth. Apropos of a case of bilateral migration into the temporal fossa].

This report presents a case of double migration of third maxillary molar in temporal fossa and their removal by a coronal approach. A 15 years of old boy, was seen for major trismus. 2 months before, he underwent under general anaesthesy impacted third maxillary molar removal. The radiologic examination showed that superior third molar has been pushed and left into the temporal fossa in both sides. After computed tomography examination, teeth were removed by a coronal approach. This was the only approach in order to preserve facial nerve and to allow with good chances to remove the teeth. Intervention was successful. Postoperative course was uneventful. The buccal apperture was normalized three months after surgery.

Adolescent↗
PubMed1994

[Are there still indications for Wassmund's osteotomy?].

The surgical treatment of anterior alveolar protrusion is usually based on the so-called Wassmund osteotomy. Although the anterior occlusal results are always good, the esthetic impact is very often bad, due to the upper lip recession. However, a good statistical evaluation can be achieved concerning cutaneous movements after surgery, as established by many authors and confirmed by a study particularly focused on lip length and nasolabial angle modifications. It seems mandatory to make a profile prediction tracing for each surgical indication to avoid an irreversible esthetic degradation. In fact, the best surgical indication is very often to perform mandibular advancement with or without associated maxillary surgery.

Adolescent↗
PubMed1994

[Difficult diagnosis of a hypervascularized tumor: "angiomatous epulis"].

Based on a case presented by the patient himself, the authors describe the difficult management of a very large, recurrent epulis arising in a context of flat angioma of one half of the face according to a vascular mode. After a brief review of the clinical and aetiopathogenic aspects, the authors discuss the value of complete surgical treatment and raise the question of the possible relation, in this particular case, between angioma and this recurrent so-called angiomatous epulis.

Adult↗
PubMed1992

[Mandibular reconstruction by free transfer of the fibula after cancer excision].

The authors present five cases of mandibular reconstruction using a vascularised fibula free transfer in cases of mandibulectomy for cancer. After giving a short account on the anatomy, they describe the technical details of fibula preparation and its transfer at the recipient site. The clinical observations are described. This recent technique seems to be developing, taking in account the qualities of the fibula: available bone length, possibility of performing osteotomies with preservation of the vascular supply, low morbidity at the level of the donor site, and satisfactory cosmetic and functional results. Despite of one recent failure, this short series seems to confirm the great interest in this type of bone reconstruction.

Adult↗
PubMed1992

[Reconstruction of the mouth floor with nasolabial flap after cancer resection. Report of 81 cases].

The authors report functional results in a series of 81 patients with carcinoma of the floor of the mouth treated by surgical resection and reconstruction by nasolabial flap. The study confirms the literature concerning advantages and limits of such a flap. With regards to others techniques of reconstruction, nasolabial flap is still perfectly usefull in reconstruction of T2 T3 carcinomas of the floor of the mouth.

Adult↗
PubMed1992

[Decision strategy in orthognathic surgery. Part 2: The esthetic choice in orthognathic surgery--practical applications].

Even if the functional factors are the most important in the decision, we have always to remember the need of our patient concerning aesthetic improvement. At this moment, the traditional approach based upon morphologic cephalometric analysis (which are frequently discordant) must be substituted by an aesthetic approach. The goal is to obtain a realistic 3D-imaging of the face as it will be after surgery. But it cannot really be achieved yet and we are obliged to work on lateral X-ray cephalograms. The most important at this stage of the decision is not to make a static aesthetic evaluation. It is on the contrary to perform a prospective simulation of the new profile line, as accurate as possible, based upon statistical correlations between soft- and hard-tissues changes. Even if there are some technical problems, even if the results are not currently good enough, the aesthetic prospective analysis allows validation or modulation of the initial functional surgical indication. We can compare for instance the aesthetic results of different amounts of displacements in bimaxillary surgery. Meanwhile, it is sure that the result depends also on the precision of the surgical procedure and on the good functional re-equilibration which is essential for the stability.

Esthetics↗
PubMed1992

[Primary malignant lymphoma of the mandible. A study of 3 cases and a review of the literature].

Three cases of non-Hodgkin malignant lymphoma (LMNH in text) of the mandible are described, and findings compared with those reported in the literature. The mean age of patients was 46 years, without any significant male preponderance (sex ratio: 1.19), the preferential localization being the horizontal branch. Detection of the lesion was, by decreasing order of frequency, based on: mandibular tumefaction, pain, local neurologic disorders and dental mobility. Diagnosis was confirmed by histology of a deep biopsy specimen, facilitated by immunohistochemical techniques: the most frequently encountered histologic type was the diffuse large cell type (group G of the international clinical classification). Diagnosis was difficult because of the similarity of the presentation with other dental diseases and the difficulty of histologic interpretation. The principal differential diagnoses are osteomyelitis, sarcoma and carcinoma, the first one raising the risk of a long delay in diagnosis, the others of unnecessary mutilating surgery. The lesion was localized in more than half the cases, without accompanying enlarged cervical glands or metastatic visceral invasion. Treatment was by radiotherapy, usually in association with multiple chemotherapy because of the high incidence of intermediate or elevated histologic malignancy. Global prognosis was good (5 year total clinical remission rate of more than 60%), the poorest prognostic factor being metastatic spread.

Adult↗
PubMed1992

[The premaxilla and facial growth 68 years later].

The thesis of Dr Etienne Cadenat on the embryology of cleft-lip dates from 1924. From this epoch onwards it was demonstrated that the human premaxilla had a specific development not corresponding to that of other mammals, in whom the suture between the pre- and post- maxilla is active and participates in the sagittal, transversal and vertical growth of the maxilla. Numerous studies have been undertaken to verify that the human premaxilla does in fact exist, and several have gone as far as to conclude in its non-existence. The author restudied the question from the histologic angle, and showed that the zone of union between premaxilla and maxilla did not contain any histologic elements that could identify a growth suture. Indeed, the spatial orientation of this suture would not allow anteroposterior growth. It can be concluded that the human premaxilla does exist but its specificity has again been demonstrated.

Cranial Sutures↗
PubMed1992

[Decision strategies in orthognathic surgery. Part 1: The predominance of functional factors in the choice of osteotomy sites. A theoretical study].

Most of the scientific papers concerning facial osteotomies are focused on the surgical procedures. However, the most important thing to consider is how to go to the right indication and not how to do it. By an only morphological approach, as we can do with dental casts and cephalometric studies, it is obvious that we forget the functional factors. They nevertheless are essential to consider. Their knowledge permits understanding the physiopathology of the deformity and avoiding the postsurgical relapses. The main five factors concern: the dentoalveolar corridor, between tongue and orbicularis oris muscle, the facial bone growth modeling by functional matrix, the relations between upper incisors, lower incisors and lips, the posterior airway and the rest position of the tongue, the vertical muscular balance. Surgery has to normalize the abnormal function which is at the origin of the abnormal morphology. For this reason, maxillary surgery is better than mandibular surgery for the correction of a Class III deformity. Moreover, the transversal and vertical dimensions are always to be considered at the light of the functional parameters. Most of cases of dentofacial deformities are to be treated by bimaxillary osteotomies, including often transversal and/or vertical modifications. When the anatomical sites of these surgical procedures are determined, then we have to make an aesthetic facial profile simulation to validate the total amount of the bone displacements (cf. Part 2).

Alveolar Process↗
PubMed1990

[Diffuse sclerosing osteomyelitis of the mandible. Apropos of a case followed for more than 10 years].

Diffuse sclerosing osteomyelitis (DSO) is a well-known chronic osseous disease. However, the diagnosis can be difficult as it has been observed for a case which is presented with more than 10 years survey. The clinical, radiographic, scintigraphic, histologic and bacteriologic aspects are discussed. The treatment can be made by various medical or surgical methods. None of these is completely efficient, even if good results could be observed in some cases. The prognosis seem to be at least uncertain. The real etiology is probably infection, but has never been proved.

Adrenal Cortex Hormones↗
PubMed1990

[Condylar retrusion in the algo-dysfunctional syndrome of the mastication apparatus].

Although T.M.J. dysfunction-pain syndrome is a multicausal affection, it is obvious that occlusal disturbance is one of the greater etiologic factors. In order to evaluate the role of condylar position in the glenoid fossa, a statistical study has been made on a 16 patients series. These patients presented an uni- or bilateral T.M.J. dysfunction-pain syndrome without arthrosis, ankylosis or traumatologic deformation. The vertical and horizontal relationships of the mandibular condyle to the temporal were quantitatively evaluated from lateral tomographs. Pain and clicking were noted (Y or N) for each of the 32 T.M.J. Condylar position doesn't seem to have any relation with clicking, which is present in cases of meniscus anterior displacement. On the contrary, condylar horizontal retrusion is statistically connected with pain (p less than 0.05) even if one can see condylar retroposition without pain. On the other hand, vertical changes in condylar position cannot be connected with pain. The importance of condylar retrusion in the pain-group can surely be related to inflammatory histologic injuries at the level of the posterior disc attachment. Then, in these cases, the etiologic treatment must be focused on anterior mandibular release by orthodontics, prosthetics or orthognathic surgery.

Adolescent↗