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Biomedical subjects

J L Blanc

Publications and source records attributed to J L Blanc.

At least 19 recordsLinked to original sources
PubMed2006

[Patient perception of functional and cosmetic outcome of orthognathic surgery. Retrospective analysis of 45 patients].

INTRODUCTION: Orthognathic surgery is generally indicated for the treatment of maxillo-mandibular deformities. Surgery is performed to repair functional abnormalities, but also has a cosmetic impact. MATERIAL AND METHODS: We conducted a retrospective study of 60 patients who underwent orthognathic surgery in 1996 and 1997 in order to assess patient perception of functional and cosmetic outcome. A questionnaire was sent to all patients one year after their surgery; 45 responded. RESULTS: We noted cosmetic, functional, and psychological changes. Patients considered that the changes were for the better. For functional abnormalities, 88.9% considered their occlusion had improved and 80% their chewing; 73.4% reported psychological improvement stating they had more self-confidence; 97.8% considered their cosmetic aspect had improved. DISCUSSION: This study enabled us to assess patients' perception of surgical outcome. It must be recalled that the patient basically decides to undertake surgery for cosmetic reasons while the surgeon proposes surgery to improve function. The psychological consequences of orthognathic surgery must be taken into account because the impact is considerable.

Attitude to Health↗
PubMed2004

Correlation of clinical features and methylation status of MGMT gene promoter in glioblastomas.

In an effort to extend the potential relationship between the methylation status of MGMT promoter and response to CENU therapy, we examined the methylation status of MGMT promoter in 44 patients with glioblastomas. Tumor specimens were obtained during surgery before adjuvant treatment, frozen and stored at -80 degrees C until for DNA extraction process. DNA methylation patterns in the CpG island of the MGMT gene were determined in every tumor by methylation specific PCR (MSP). These results were then related to overall survival and response to alkylating agents using statistical analysis. Methylation of the MGMT promoter was detected in 68% of tumors, and 96.7% of methylated tumors exhibited also an unmethylated status. There was no relationship between the methylation status of the MGMT promoter and overall survival and response to alkylating agents. Our observations do not lead us to consider promoter methylation of MGMT gene as a prognostic factor of responsiveness to alkylating agents in glioblastomas.

Aged↗
PubMed2002

Is lingual nerve protection necessary for lower third molar germectomy? A prospective study of 300 procedures.

Lingual nerve damage is one of the most common complications of lower third molar removal. However evaluation of the factor involved in these lesions is difficult since most previous series are heterogeneous. The purpose of this prospective randomized study was to ascertain the impact of lingual nerve protection in a homogeneous series including only patients undergoing third molar germectomy (i.e. removal of the developmental bud prior to anchoring of the roots in the jaw). Data from a total of 300 germectomy procedures were included in this study. All procedures were performed by the same experienced surgeon randomly with or without lingual nerve protection. No lingual nerve injury was observed after third molar germectomy regardless of whether or not lingual nerve protection was used. Lingual nerve protection is unnecessary for lower third molar germectomy.

Adolescent↗
PubMed2001

Posterior disk displacement of the TMJ: MRI evidence in two cases.

Posterior disk displacement is a rare temporomandibular joint (TMJ) disorder. The main clinical sign is sudden molar open-bite (jaw locked in the open position). This may be accompanied by a sensation of intra-articular foreign body and more rarely joint pain. Joint sounds are unremarkable. Mouth opening may be slightly impaired. Hypothetically, like anterior disk displacements, posterior disk displacements can be classified as either reducible or nonreducible. A definitive diagnosis requires magnetic resonance imaging (MRI). There is no consensus concerning treatment. A conservative course of treatment can be successful in patients with functional impairment and should always be attempted before irreversible, invasive therapy.

Adult↗
PubMed2001

"Axial split osteotomy" of free fibular flaps for mandible reconstruction: preliminary results.

Vascularized free flaps are now considered the most appropriate choice for mandible reconstruction because they offer excellent cosmetic and functional results. Various techniques have been proposed. Free fibular flaps have numerous advantages in terms of versatility and contouring. Shaping can be achieved by wedge osteotomy with excellent results. However, this technique leads to bone loss and may be difficult in the later stages of the procedure. The purpose of this report is to describe a simple and safe flap-shaping method involving axial split osteotomy.

Bone Transplantation↗
PubMed2001

[Infectious complications of mandibular osteotomy].

BACKGROUND: Infection is a rare complication after orthognathic surgery. A rate of 1% to 15% has been reported in the literature. We reviewed our experience. MATERIAL AND METHODS: We reviewed retrospectively 60 mandibular osteotomies performed between 1998 and 1999. There were 41 women and 19 men, mean age 24 years. All were given antibiotic therapy using cefamandol 1500 mg preoperatively then 750 mg every 6 hours peroperatively and cefixime 400 mg/d postoperatively for 7 days. Patients were followed for at least 6 months after surgery. RESULTS: There were 10 infections (16% of the cases) involving a hematoma in 2 cases, adenitis in 1, osteitis on a cortical fragment in 2 and osteitis on implanted material in 5. DISCUSSION: We defined infection following orthognathic surgery as a collection or purulent fistula with either a high polynuclear count in the discharge fluid or a positive culture. Both soft tissue (for example infection of a perimandibular hematoma) or bone infections were equally considered. We found two types of risk factors: patient-related or procedure-related. Patient-related factors included smoking, paradontal status, and dental hygiene. The main procedure-related factor was duration of surgery. Measures of prevention include extraction of the wisdom teeth, interruption of smoking, preoperative scaling and careful dental care, rigorous operative technique, antibiotic therapy.

Adolescent↗
PubMed2001

[Complications of genioplasty].

Genioplasty is one of the safest interventions in orthognathic surgery. We reviewed a series of 200 cases of genioplasty with or without other osteotomies and found 6 complications. We compared our findings with the rare data reported in the literature. We were able to distinguish: peroperative complications: atypical osteotomy, hemorrhage, soft tissue damage, injury to the mental nerve; postoperative complications: neurosensory deficits, hematoma, infection, secondary displacement, bone necrosis, mental ptosis, defective ossification, dental lesions, paradontal lesions, irregular mandibular contours. We present a discussion on means of prevention and treatment of these complications following genioplasty.

Blood Loss, Surgical↗
PubMed2001

[Should the lingual nerve be protected during germectomy? A prospective study apropos of 300 procedures].

PURPOSE: Lingual nerve damage is one of the main complications of mandibular third molar removal. In literature, the series published are heterogeneous so we have decided to study the importance of the lingual protection only during germectomies (wisdom teeth without root formation). METHODS: We conducted a randomized prospective study in 300 germectomies, operated by the same skilled surgeon. These 300 third molar removals have been divided in two groups, one with lingual nerve protection and one without. RESULTS: Lingual nerve injuries following germectomies, with or without lingual protection was 0%. CONCLUSION: In germectomies, one can avoid lingual protection.

Adolescent↗
PubMed2000

Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature.

Large series of cauda equina tumors in adults are seldom reported. This French series retrospectively reviews 231 cases collected for the congress of the Societe Francaise de Neurochirurgie in 1996. The authors first analyze this series and then discuss the pertinent literature. Schwannoma was the most frequent benign tumor in this series, followed by ependymoma. Very few malignant tumors were recorded; these were usually malignant neurinomas nearly always in neurofibromatosis patients. Some other rare tumors were also recorded, including paragangliomas. This series confirms the importance of the pretherapeutic neurological status in functional prognosis. All schwannomas can be cured, while ependymomas and paragangliomas may recur after a very long delay. Surgery must be as complete as possible, since adjuvant therapies are proven to have little efficacy. This type of tumor requires very long follow-up. Prognosis is good for hemangioblastomas. Sphincter dysfunctions carries a poor prognosis and may appear after primary surgery, more often after treatment of recurrences.

Adult↗
PubMed2000

[Posterior disk displacement of the temporomandibular joint. Apropos 2 cases].

Posterior displacement of the temporo-mandibular joint disk is exceptional. The most typical clinical sign is sudden onset unilateral molar open bite. This lateral open bite is accompanied by a sensation of an intra-articular foreign body and more rarely by painful episodes. The joint sounds are not characteristic. Mouth opening is slightly limited. There is no consensus concerning treatment. Conservative treatment can be prescribed in cases with functional impairment. First line invasive techniques should be avoided.

Adult↗
PubMed1999

Full-thickness skin graft interposition after temporomandibular joint ankylosis surgery. A study of 31 cases.

Recurrence is a major problem after release of temporomandibular joint ankylosis. Early physiotherapy and choice of interpositional material are important in preventing recurrence. Currently, the most used technique is gap arthroplasty associated with coronoidectomy, temporalis muscle flap interposition and reconstruction of the condylar unit with a costochondral graft. Full-thickness skin graft interposition, using the technique described by Popescu & Vasiliu, can also be used. This retrospective review of 31 patients confirms the reliability of full-thickness skin graft interposition. Results were successful in 90% of the 20 patients with follow-up longer than one year.

Adolescent↗
PubMed1999

[Maxillary pre-implant rehabilitation: a study of 55 cases using autologous bone graft augmentation].

Preprosthetic rehabilitation of the maxillary bone is sometimes difficult due to severe bone resorption in the posterolateral regions. The sinus lift with autogenous bony graft has given us satisfactory results since 1990 but requires a rigorous protocol before and during surgery to assure a lasting anchorage to the prosthesis. We describe morbidity and technical choices of this intervention in a series of 55 patients.

Adult↗
PubMed1998

[Orthodontic preparation for orthognathic surgery. Various specific points].

Orthodontic preparation before orthognatic surgery must straighten teeth alignment to enable correct adaptation of the upper and lower arches. It must also rectify dento-alveolar abnormalities partially responsible for the dysmorphosis and which can hinder smooth articulation of the bones. Thus before and after the operation, the orthodontist will have to prepare and monitor the surgical splints used in posterior deficiencies.

Adult↗