Kimura's disease of the parotid region: report of 2 cases and review of the literature.
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Adult↗
Biomedical subjects
Jacques-Charles Bertrand
Publications and source records attributed to Jacques-Charles Bertrand.
Posterior maxillary segmental osteotomy for mandibular implants placement: case report.
The loss of mandibular molars can result in a maxillary dentoalveolar extrusion, leading to an insufficient interarch space. In severe cases, this space must be regained before the prosthetic reconstruction of the opposite edentulous area. The posterior maxillary segmental osteotomy (PMSO) is a simple but precision technique to manage this problem; without which one can achieve a good surgical outcome but a poor final occlusion. The purpose of this paper was to present a case of PMSO for mandibular implant placement and to discuss the important steps.
Adult↗
Facial transplantation: a comprehensive review of the literature.
PURPOSE: Composite tissue allotransplantation has become a clinical reality and a major breakthrough in reconstructive surgery. The current boundary of dispute on composite tissue allotransplantation is regarding the full-face transplantation. The aim of this article is to provide a comprehensive overview of how facial allotransplantation has been approached in the scientific literature. MATERIAL AND METHODS: The selection of articles was conducted using PubMed at between January 2000 and September 2005. The search terms were "facial graft," "facial transplantation," and "facial allotransplant." The criteria of analysis were the category of articles and the presence of 6 items: 1) issues regarding the donor; 2) psychological impact on the recipient; 3) surgical risks; 4) immunologic risks; 5) socio-cultural aspects; and 6) expense. RESULTS: Thirty-eight articles were included. The first article was published in 2002. Most articles over the last 4 years dealt with issues of medical ethics. The annual rate of basic research articles was relatively stable. Conversely, the rate of 'view points,' notably regarding ethics aspects, increased dramatically in 2004. The issues regarding the donor were found in 26% of the articles, the psychological echo on the recipient in 53% of the articles but in 81% of the medical ethics papers, the immunologic risks in 81% of the articles, the surgical risks in 66% of the articles, socio-cultural aspects in 34% of the articles, and expense problems in 5% of the articles. CONCLUSION: Psychological, immunologic, and surgical risks are the problems addressed most in the literature. Cost, donor, social, and cultural aspects are least addressed. There is a lack of hard data in the literature regarding those problems.
Bibliometrics↗
Endoscope-assisted submandibular sialoadenectomy: a pilot study.
PURPOSE: To describe an endoscopic technique for submandibular sialoadenectomy in humans, as well as the equipment, instrumentation, and pertinent anatomy. MATERIALS AND METHODS: Six submandibular sialoadenectomies were carried out in 5 patients (3 women, 2 men; mean age, 26.6 years; range, 16 to 42 years) via a 15 to 20 mm neck incision for insertion of the endoscopic camera and surgical instruments. RESULTS: All operations were successful without conversion to an open surgery. Operative time was 20 to 120 minutes (mean, 65 minutes). All patients were discharged the day after surgery. There were no postoperative complications (hematoma, nerve injury, infection). All patients experienced a mild degree of edema, which had resolved totally at the 6-month follow-up visit. All patients were satisfied with the outcome and especially the cosmetic result. CONCLUSIONS: Absence of extensive scars, nontraumatic dissection, and magnification of anatomic structures are the most obvious advantages of this innovative technique.
Adenoma, Pleomorphic↗
Drooling of saliva: a review of the etiology and management options.
Drooling of saliva appears to be the consequence of a dysfunction in the coordination of the swallowing mechanism, resulting in excess pooling of saliva in the anterior portion of the oral cavity and the unintentional loss of saliva from the mouth. Drooling can produce significant negative effects on physical health and quality of life, especially in patients with chronic neurological disabilities. Various approaches to manage this condition have been described in the literature, including oral motor therapy, behavior modification via biofeedback, orofacial regulation therapy, drug therapy, radiotherapy, and surgical treatments. Minimally invasive modalities, such as injection of botulinum toxin, photocoagulation, and acupuncture, have also been reported. This article provides a comprehensive and thorough overview of drooling, with an emphasis on understanding its etiologies and modalities of treatment.
Acupuncture Therapy↗
Osteosynthesis for open rhinoplasty of the hump nose.
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Humans↗
Odontogenic cysts: a clinical study of 695 cases.
The aim of this study was to analyze the files of 695 consecutive patients operated on under general anesthesia for odontogenic cysts in an adult French teaching hospital for comparison with findings in world surveys. A retrospective survey of cysts of the jaws was undertaken at the Maxillofacial department, Pitié-Salpêtrière University Hospital, Paris, France. Data were retrieved from case notes, imaging, histopathology records and follow-up reports from January 1995 to January 2005. The mean age of patients was 41.8 +/- 15.8 years. There was an overall male to female ratio of 1.86:1. Mandible to maxilla ratio was 3:1. Regarding the mandible, the angle was involved in 36% of the cases, horizontal branch in 32%, parasymphysis in 18%, ramus in 11.6%, coronoid process in 1.5% and condyle in 0.9% (total = 100%). Regarding the maxilla, the canine to canine region was involved in 40% of the cases, premolar and molar region in 45%, and wisdom tooth region in 15% (total = 100%). The three most frequently diagnosed odontogenic cysts were radicular cysts (53.5%), dentigerous cysts (22.3%) and odontogenic keratocysts (19.1%). Together, these three entities represented 94.9% of all odontogenic cysts. The mean number of operation per patient was 1.16 (SD: 0.6, range: 1-10). The mean cumulated duration of hospitalization for one patient was 2.46 days (SD: 1.9, range: 1-28). The mean length of follow-up was 8.4 months (SD: 15.2, range: 0-120). Sixty five percent had a follow-up inferior to 6 months and 18% had no follow-up at all. The two most important findings of this case series are 1) the important number of radicular cysts that could be avoided because most of these cysts develop as a consequence of advanced carious lesions and 2) regarding other types of cysts, the dramatic rate of patients lost to follow-up.
Adult↗
Parotidectomy: assessment of a surgical technique including facelift incision and SMAS advancement.
BACKGROUND: Despite its proven safety and its relevance regarding the cosmetic outcome, the SMAS-lifting technique is not a routine procedure for many surgeons. AIM: To compare the classical (subcutaneous flap and neck incision) with the SMAS-lifting techniques for parotidectomies from the patient's perspective. PATIENTS AND METHODS: Both procedures are described, tricks are pointed out. In both procedures the posterior branch of the great auricular nerve was not preserved, hence the two procedures were not evaluated regarding sensitivity of the auricle and preauricular area. Forty consecutive patients were asked to classify their concerns before (1-4 months) and 1 year after surgery (10 classical technique and 30 SMAS-lifting technique). RESULT: Before parotidectomy, patients were concerned in a decreasing order with the facial nerve function, the scar, the soft-tissue defect in the dorsal part of the cheek and Frey's syndrome. Following use of the classical technique, patients were concerned in decreasing order with the soft-tissue defect, the scar and Frey's syndrome. Following the SMAS technique, no one was concerned with the scar, Frey's syndrome, or the soft tissue defect although a slight asymmetry could still be noticed. CONCLUSION: The SMAS-lifting technique might possibly appear to offer a new standard procedure for parotidectomy, except for malignant tumours or in obese patients.
Adult↗
MUC1, MUC2, MUC4, and MUC5AC expression in salivary gland mucoepidermoid carcinoma: diagnostic and prognostic implications.
We determined whether immunostaining for mucins could provide a better characterization of salivary gland mucoepidermoid carcinoma (MEC). We investigated 63 MECs by immunohistochemistry for MUC1, MUC2, MUC4, and MUC5AC. Mucin expressing cell types and labeling patterns were recorded. The results were compared with microscopic grade, tumor-associated lymphoid infiltrate, mucin expression in surrounding salivary glands, clinical features, and outcome. MUC1 and MUC4 labeled the apical membrane of glandular tumor cells and the entire membrane of intermediate, clear, and epidermoid tumor cells. MUC2 and MUC5AC were expressed in the cytoplasm of glandular, mucous, and intermediate tumor cells. In contrast to MUC1, MUC4 expression decreased with tumor grade (P < 0.01). Unlike MUC2, MUC5AC was expressed in more than 50% of high-grade tumors, including 2 cases that were not stained with Alcian blue. MUC1 and MUC5AC were associated with tumor-associated lymphoid infiltrates (P < 0.05), but not with tumor-associated lymphoid follicles. The proportions of tumors expressing mucins were 71% for MUC1, 21% for MUC2, 79% for MUC4, and 68% for MUC5AC. MUC1 and MUC5AC were more frequently expressed in tumors than in surrounding glands (P < 0.0001). MUC1 expression correlated with shorter progression-free survival (P < 0.05). In conclusion, mucin expression in MEC differs from that in salivary glands. Intermediate cells express MUC1 and MUC4 all along their cell surface and MUC2 and MUC5AC in their cytoplasm. Staining for MUC5AC in high-grade tumors can be helpful for distinguishing high-grade MEC from squamous cell carcinoma. While MUC4 is related to tumor differentiation, MUC1 expression indicates a worse prognosis.
Biomarkers, Tumor↗
Extra-cellular signal-regulated ERK-1/ERK-2 pathway activation in human salivary gland mucoepidermoid carcinoma: association to aggressive tumor behavior and tumor cell proliferation.
Information on oncogenetic events accompanying salivary gland mucoepidermoid carcinoma is so far limited. Activation of extracellular signal-regulated kinases ERK-1 and ERK-2 is strongly correlated to cancer. Using an antibody specific for phosphorylated (active) ERK-1/ERK-2, we examined human salivary gland mucoepidermoid carcinoma samples by immunohistochemistry. The comparison in paired tumor and normal tissue samples showed that phosphorylated ERK-1/ERK-2 immunoreactivity was higher in tumor cells as compared to surrounding normal salivary parenchyma. ERK-1/ERK-2 phosphorylation was observed in approximately 39% of mucoepidermoid carcinomas. Those tumors where the ERK-1/ERK-2 pathway was activated had a more aggressive tumor behavior as compared to the group where this pathway was inactive. The association of ERK-1/ERK-2 phosphorylation to a worse prognosis was independent of histological grade. ERK-1/ERK-2 phosphorylation was associated with increased Ki67 and cyclin A indexes, which indicated that ERK-1/ERK-2 pathway activation increased tumor cell proliferation. There was no relationship between ERK-1/ERK-2 phosphorylation and HER-2/neu or p16/INK4a protein expression. In conclusion, ERK-1/ERK-2 pathway is active in salivary gland mucoepidermoid carcinoma and this activation is associated to a more aggressive tumor behavior and a higher proliferative activity. These data suggest that deregulation of ERK-1/ERK-2 pathway contributes to mucoepidermoid carcinoma phenotype and, possibly, represents a target for new anticancer drugs.
Carcinoma, Mucoepidermoid↗
Depression, anxiety and quality of life: outcome 9 months after facial cosmetic surgery.
OBJECTIVE: The request for cosmetic surgery is of a psychological nature. Very few studies have quantitatively assessed whether or not this psychological need was actually satisfied, and more precisely, which psychic components were satisfied. MATERIAL AND METHODS: This is a multicentric, prospective cohort study. One hundred and three patients scheduled for facial cosmetic surgery from three different hospitals were examined before and after surgery using four assessment scales validated using European populations. The Montgomery and Asberg depression rating scale (MADRS) measured the existence and intensity of depression, the self-assessment test of thoughts in social interaction (SISST) measured the positive or inhibitory thoughts in the context of social relationships, and the European quality of life 5 dimensions (EQ-5D) (generic test) measured the quality of life. In addition, a semi-directive interview was specially created by our team. For statistical analysis, ANOVA and Student's t test were applied. RESULTS: Twenty-four patients were lost to follow-up. Although the initial MADRS index was high (p<0.05), it did not change after surgery (p>0.1). SISST+ (positive thoughts): the social anxiety of the individual examined was significantly greater than that of the control group (p<0.005) and improved after surgery (p<0.01). The SISST- (inhibitory thoughts) did not change (p>0.1). The EQ-5D visual analogue scale (VAS) did not reveal any difference (p>0.1) while the descriptive EQ-5D demonstrated over-representation of anxiety/depression (p<0.01), and an improvement of this (p<0.05) postoperatively. The mean subjective satisfaction index was 8.1 (scale of 1-10) without sharing any influence of the complications suffered (65% of the patients made self-assessments). CONCLUSION: The best indications for facial cosmetic surgery seem to be a lack of self-confidence associated with a desire for social interaction, and a request focused on a specific physical feature. The results presented add documentary confirmation to the impression shared by the majority of cosmetic surgeons. However, it was also confirmed that cosmetic surgery is not limited to its technical components, but remains a medical act which must consider the overall effect on the whole patient.
Adolescent↗
P63 is expressed in basal and myoepithelial cells of human normal and tumor salivary gland tissues.
p63 is essential for epithelial cell survival and may function as an oncogene. We examined by immunohistochemistry p63 expression in human normal and tumor salivary gland tissues. In normal salivary glands, p63 was expressed in the nuclei of myoepithelial and basal duct cells. Among 68 representative salivary gland tumors, 63 displayed p63 reactivity. In all tumor types differentiated towards luminal and myoepithelial lineages (pleomorphic adenomas, basal cell adenomas, adenoid cystic carcinomas, and epithelial-myoepithelial carcinomas), p63 was expressed in myoepithelial cells, whereas luminal cells were always negative. Similarly, in mucoepidermoid carcinomas, basal, intermediate, and squamous cells expressed p63, in contrast to luminal mucous cells. p63 reactivity was also restricted to basal cells in Warthin tumors and oncocytomas. Myoepitheliomas and myoepithelial carcinomas all expressed p63. The only five negative tumors were three of four acinar cell carcinomas and two of three adenocarcinomas. In conclusion, p63 is expressed in the nuclei of normal human salivary gland myoepithelial and basal duct cells. p63 expression is retained in the modified myoepithelial and basal cells of human salivary gland tumors, which suggests a role for p63 in oncogenesis of these complex tumors.
DNA-Binding Proteins↗
[Dental and gingival lesions].
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Comorbidity↗
Depression, anxiety and quality of life among scheduled cosmetic surgery patients: multicentre prospective study.
Objective: To measure cosmetic surgery patients' state of psychological vulnerability. Method: A multicentre prospective study was carried out in three hospital departments. One hundred and three patients scheduled for cosmetic surgery were examined using a structured interview and using three assessment scales: the MADRS (Montgomery and Asberg Depression Rating Scale), the SISST (Social Interaction Self Statement Test) and the EQ-5D (EuroQol) which measures quality of life. Results: The MADRS index was higher than that of the control group (p<0.01) with 20% depressive patients. SISST: the social anxiety was greater than that of the control group (p<0.001). The EQ-5D visual analogue scale average was 77.39% indicating that there was no significant difference when compared with the control group, but the descriptive EQ-5D revealed an over-representation of the anxiety/depression category (p<0.01); 50% had already taken psychotropic treatment of which 27% were an antidepressant. Conclusion: The cosmetic surgery population presents a significant state of psychological vulnerability. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.
Journal Article↗