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H Bénateau

Publications and source records attributed to H Bénateau.

At least 19 recordsLinked to original sources
PubMed2006

[Sequelae of haemangiomas: surgical treatment].

The cure without after-effect of an hemangioma is classic but sometimes the spontaneous involution, a premature surgical treatment or an evolutionary complication can be at the origin of a definitive after-effect. In these cases, the treatment of the hemangioma, often multidisciplinary, will be begun in a late way during the late childhood or the adolescence. Surgical excision of an excess tissue or of a wide scar, lipoaspiration of a fat remainder, lasertherapy and fat tissue reinjection are simple and mostly sufficient procedures. In the most complex cases, notably at the facial site, a surgery heavier as a rhinoplasty, a resection of lip, a local flap or orthognatic surgery can be necessary.

Adipose Tissue↗
PubMed2005

[Detection of the sentinal node in squamous-cell carcinoma of the oral cavity and oropharynx. Preliminary study].

INTRODUCTION: The sentinel lymph node is defined as the first relay of the lymphatic drainage of the tumor. Isotopic detection of the sentinel lymph node and absence of its metastatic invasion should theoretically be predictive of total drainage of the tumor. The goal of this study was to evaluate sentinel lymph node detectability by lymphoscintigraphy in N0 and/or N1 squamous-cell carcinoma of oral cavity and oropharynx and to determine its negative predictive value. MATERIAL AND METHOD: Lymphoscintigraphy was used for sentinel lymph node detection. The procedure required peritumoral injection of technicium-labeled colloids to enable anatomical and cutaneous location of the sentinel lymph node. A one-way Tyco-Mallinckrodt probe was used for intraoperative detection of the sentinel lymph node. This prospective study included 21 patients with N0 or N1 squamous-cell carcinoma of the oral cavity and the oropharynx. The surgical attitude based on T and N was not modified in this prospective study without direct individual benefit for the patient. Neck dissection was achieved without difficulty. RESULTS: The sentinel lymph node was identified in 20 out of 21 subjects. The sentinel lymph node was not identified in one patient with recurrence T2N0M0 squamous-cell carcinoma of the oropharynx radiated 3 years earlier. The percentage of false-negatives was 12.5% (1 false-negative out of 8 positive patients), giving a sensibility of the detection method of 87.5% (IC (95%)=[47.35-99.68]). This false-negative patient had a T3N0M0 squamous-cell carcinoma of the oropharynx with a sentinel lymph node removed in territory III. Neck dissection revealed 1 N + R- in the sub-mandibular territory associated with 27 N-R-. The probability of not finding a metastatic node at neck dissection when the sentinel lymph node is not metastatic (negative predictive value) was 92.3% (12/13) (IC (95)=[63.97-99.81]). The specificity of the method was 100%, as was the positive predictive value, because no sentinel node was diagnosed positive wrongly on frozen sections among patients without true histological node metastasis. DISCUSSION: For routine care of patients with squamous-cell carcinoma of the oral cavity and the oropharynx detection of the sentinel lymph node is proposed primarily for patients with T1T2N0 staging. Larger tumors can modify the architecture and flow within the lymphatic ducts, and consequently even the concept of a sentinel lymph node. Systematic neck dissection is required or T3T4, even when N0. Our series of T1T2N0 tumors is too small to enable statistically significant conclusions. A low level of false-negative in a larger series would be necessary to propose this technique instead of convention neck dissection for T1T2 tumors of the oral cavity and oropharynx.

Carcinoma, Squamous Cell↗
PubMed2005

[Anhidrotic ectomermal dysplasia (AED): four cases].

INTRODUCTION: Anhidrotic ectodermal dysplasia (AED) or Christ-Siemens-Touraine syndrome is a rare, hereditary genodermatosis, classically X-linked recessive disorder. MATERIAL AND METHODS: [corrected] We report the cases of 3 children and a male adult. RESULTS: The mode of diagnosis, the clinical signs and the therapeutic option are detailed. DISCUSSION: AED is characterized by a malformative state derived from the ectodermal layer of the embryo which results in the triad: anhidrosis (or hypohidrosis), hypotrichosis, anodontia (or hypodontia). Hypohidrosis causes thermoregulation disorders, which in the infant, can be life threatening. It is important to recognize the affection early to avoid accidents of hyperthermia. Once the diagnosis is established, family investigations are necessary to determine whether it is a family form or a new sporadic case. Carrier mothers must be informed of the high risk recurrence for future male infants. Symptomatic maxillo-facial treatment strives to improve masticatory function and facial growth and thus limit the psychological impact and improve patient comfort.

Adult↗
PubMed2005

Gunshot wounds: reconstruction of the lower face by osteogenic distraction.

BACKGROUND: Although osteogenic distraction is a well-established technique, the distraction device still needs to be improved, miniaturized, and made lighter, more flexible, and more adaptable for mandibular reconstruction in adults with gunshot wounds. The authors successively used unidirectional and bidirectional devices, followed by a bone transporter with a horseshoe-shaped trammel. The trammel system was then replaced by an endless screw, and finally by a customized endless screw. METHODS: Eleven adult patients with gunshot injuries underwent mandibular reconstruction using osteogenic distraction with an external device. RESULTS: An average bone gain of 79 mm was achieved. No infectious complications were observed. The authors encountered equipment problems during the study, requiring a change of material. The mean duration of mandibular distraction was 3.5 months. CONCLUSIONS: Distraction of bone fragments facilitates the simultaneous expansion of soft tissues, avoiding free or pedicled myocutaneous flaps, for soft-tissue reconstruction. The alveolar ridge with the attached gum is also recreated by distraction, allowing dental reconstruction by osseointegrated implants.

Adult↗
PubMed2004

Anatomic study of the tendinous insertion lamina of the temporalis muscle.

Lengthening temporalis myoplasty is indicated in long-standing and congenital facial paralysis. Its principle is the transfer of the coronoid tendinous insertions onto the lip and the nasolabial fold. Knowledge of the anatomy of this strong and wide tendon is necessary for successful use of its anatomic advantages. A study on 10 cadavers (20 temporalis muscles) confirmed the surgical anatomy found during lengthening temporalis myoplasty procedures: the strong tendon, when freed from the coronoid process, is 4-6 cm wide.

Aged↗
PubMed2004

[Interest of PET/CT scan fusion to assess mandible involvement in oral cavity and oro pharyngeal carcinomas].

UNLABELLED: The aim of the study is to assess mandible involvement in oral cavity and oropharyngeal carcinomas. OBJECTIVE: To evaluate interest of fusion of Positron Emission Tomography (PET) with Computed Tomography scan (CT scan). METHOD: Eight patients were included in this prospective study. Each patient underwent PET and CT scan of the head and neck before surgery including tumorectomy and mandibulectomy. We compared results of PET- CT fusion with histologic examinations. RESULTS: Oral cavity (6), oropharyngeal (2) carcinoma: Mandibular invasion was suspected by PET-CT in 3 cases, but was confirmed in histological examination in only 2 cases. In 5 cases, PET-CT did not find mandibular invasion; this was confirmed in histological examination in all cases. Sensibility of PET-CT fusion was 100%, specificity was 83%. Positive predictive value was 66% and negative predictive value was 100%. DISCUSSION: PET-CT fusion provided maximal sensitivity. Specificity was better than for MRI but less than CT-scan. There were no false negatives and the false positive rate was 33%. CONCLUSION: PET-CT fusion is interesting to predict mandible involvement. Further studies are necessary to confirm these preliminary results.

Aged↗
PubMed2003

[Lengthening temporalis myoplasty and transfacial nerve graft (VII-V). Technical note].

Authors report the first five cases of lengthening temporalis myoplasty associated with transfacial nerve grafting. After a follow-up period of 10 months and 8 months for the 2 first cases, temporalis reinnervation by the facial nerve could be observed. Nerve growth was documented by electromyography. Three other cases have been performed using this technique and are in the nerve growth phase. Operative technique is described in detail. Transfacial nerve grafting seems to help the transposed temporalis muscle obtain more facial function and therefore, improve the quality of the spontaneous smile. The temporalis muscle become double innervated (trigeminal and facial nerve). It should be indicated in children, young adults or in patients in whom physical therapy will be difficult.

Anastomosis, Surgical↗
PubMed2003

Tumour of the juxtaoral organ.

The juxtaoral organ is a normal and constant structure of the oral cavity. It consists of benign epithelial nests. We describe an intraoral tumour of the juxtaoral organ in a child. The tumour was not diagnosed after clinical and radiological examinations because it is extremely rare. A histological examination revealed a tumour of the juxtaoral organ, presumed to be neuroid hamartoma. This is only the second time that a tumour of the juxtaoral organ has been described in a child. We also describe the location, the embryology, the histology and the function of this organ. This is important because this structure can be confused with carcinomas of the oral cavity when examining frozen sections.

Cheek↗
PubMed2002

[Therapeutic approach of cleft lip and palate at Caen University Hospital].

The therapeutic approach of facial cleft in Caen University Hospital depend on two teams: primary treatment by the Pediatric Plastic Unit (60 cases/year), and secondary treatment by the department of Plastic and Maxillofacial Surgery (more than 30 cases/year). The lip closure is realised before the age of one month with the Tennisson's technic. The palate closure is performed between 6 and 12 months old. Each patient is presented at a multidisciplinary consultation which include a surgeon, an orthodontist, an orthophonist, a psychologist and otologist. At about 5 years old, the orthodontic approach begins with palatal expansion with a modified quadhelix to prepare function its treatment is underwent at this age too. After the age of 9-10 years the orthodontic treatment continued on the permanent teeth. If necessary, the sequelae on maxilla, lips and nose are treated at the end of the adolescence.

Academic Medical Centers↗
PubMed2002

[The temporal periosteum: anatomical study and surgical implications].

The periosteum of the temporal area is mentioned at different places in the literature: either against the osseous plane like everywhere in the human body, or between the deep and the superficial temporal fascia. The subperiosteal subtemporal approach in craniofacial surgery in children is in favour of a juxta-osseous localization of the periosteum. Ten premature still-born neonates and two adults cadavers have been dissected for this study and, permit anatomical and histological (with HES coloration) studies. With every specimen, the authors concluded that the temporal periosteum is against the outer table of the calvarium. It became thinner in adults because of direct insertions of the temporalis muscle in the calvaria. An anatomical description of the layers of the temporal area is realised and discussed with an extensive review of the literature. The authors have proposed a subperiosteal subtemporal approach in craniostenosis surgery.

Fascia↗
PubMed2002

[Surgical procedures for labial reanimation in facial paralysis].

With an extensive review of the literature, the authors described the surgical approach of the labial reanimation in facial palsy. First they remind some important points about neural suture, with or without graft. After, the palliatives procedures are detailed (upper and lower lip, unilateral or bilateral). The main surgical treatments are exposed in technical notes, particularly lengthening temporalis myoplasty and free muscle transplantation.

Facial Paralysis↗
PubMed2002

[Lip kinetic disorders].

There are many lips kinetic disorders whose clinical appearances greatly differ. An acute examination directs toward the diagnosis on a neurologic, neurogenous, muscular, myogenous, medicamentous, dermatological or psychiatric etiology. The authors review the different etiologies that have to be discussed, in order to choose the appropriate further investigations and specialized examinations, before a possible surgical treatment.

Facial Paralysis↗
PubMed2002

[Indications for labial reanimation in facial paralysis].

The therapeutic approach of labial reanimation depends on several points, like the association with others abnormalities, the palsy which can be complete or partial, the age of the patient and the practice of the surgical team. Nevertheless, the authors try to propose a surgical approach of labial reanimation in facial palsy, depending on the facial nerve which can be reparable or not, and on the facial muscles which can be used or not. At least, the indications in partial labial palsy are recalled.

Adult↗
PubMed2002

[Radial forearm or Chinese flap].

The Chinese or radial forearm flap, first described by Yang et al. (1981), is useful both as a free or a pedicle flap. This flap has proved to be one of the safest and most versatile flap in widely differing clinical situations. It is generally classified as a fasciocutaneous flap, but can also be used together with a segment of radius as a composite flap. However, the most common objection to this flap is the donor-site morbidity. The donor defect is significant, with a poor graft take over the exposed tendons. Inclusion of bone in the flap leads to a greater contour defect and to a risk of fracture. Many suggestions are given to minimize the complications on the donor-site defect. The surgical technique, the advantages, the disadvantages, and at least the indications of this flap are detailed.

Anastomosis, Surgical↗
PubMed2002

[Contribution of the semi-free radial forearm flap for head and neck reconstruction].

Flap failure is mostly caused by venous thrombosis of the anastomosis. The failure rate is higher in post-irradiated neck. To reduce the risk of venous thrombosis, the authors propose to harvest the radial forearm flap using the cephalic vein as the drainage vein and as a pedicle. Only a single arterial anastomosis is carried out. This technique has been described already in patients who underwent head and neck ablative surgery with radical neck dissection. The authors report 2 cases in patients with post-irradiated neck. The flap transfers were successful in the 2 cases. The operative time of harvesting this hybrid version is the same with the conventional free flap technique. This version of the radial forearm flap can be a method of choice for some complex microvascular reconstruction in the head and neck region.

Aged↗
PubMed2002

[The three-dimensional spiral scanner and volume rendering technique: importance in craniofacial traumatology and reconstructive surgery].

There are two reconstruction methods for 3D imaging with a helical scanner: a surface rendering process providing a 3D-SSD (Surface Shaded Display) image that looks like a plaster cast skull and 3D-VRD (Volume Rendering Technique) which is more precise and gives 3D images similar to radiographs. We review briefly the techniques used to acquire these images and present 3D volume-rendering scanners, pointing out its usefulness in craniomaxillofacial traumatology and reconstructive surgery.

Adolescent↗