[Hemodilution and anti-edema effect: experimental study in the rabbit].
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Biomedical subjects
Publications and source records attributed to P Maxant.
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Important advances in the use of CT scan imaging for exploration of the temporomandibular joint include the obtaining of direct sagittal section images and the possibility of surveillance. This avoids the need for more invasive and painful techniques such as arthrography. The position of the meniscus can be determined from either direct or indirect signs and bone structures and muscles are particularly clearly demonstrated. This technique can be used while awaiting more widespread availability of NMR apparatuses for meniscal exploration.
Possible influence of masticatory muscles on facial growth was investigated in the rat by the formation of several experimental groups: excision of right masseter muscle of right temporal muscle, of both masseter muscles, of both temporal muscles and of both masseter and temporal muscles, section of inferior maxillary nerve and masseter transplantation. Results demonstrated that overall masticatory muscles provided equilibrium of masticatory function, any rupture of this equilibrium producing effects on mandibular growth and that of the facial mass.
The buccal vestibule is described and its physiologic interest with respect to the position of alveolar processes emphasized, the latter being compromised by the cleft and its repair. The need for its restitution to ensure function of good quality implies the use of a total skin graft before school age for cases of total bilateral clefts.
An experimental study evaluated the effect of various surgical procedures on maxillary growth. Raising and excision of palatine muco-periosteum did not modify facial or palatine growth. Resection of the bony palate showed the non-essential nature of the medial palaxine suture during normal growth, even in the transverse direction. Coagulation of the two posterior palaxine arteries disturbed palaxine growth, but ligature of the external carotid artery failed to alter facial growth. Several tests were carried out to determine the importance of functional matrices: excision of facial nerve trunk did not affect bone growth, destruction of the trigeminal provoked obvious disturbance of craniofacial growth while obturation of a nasal fossa produced no observable anomaly. Enucleation demonstrated the need for an intact globe for normal orbital growth, and resection of the mandibular condyle showed the primordial role of cartilaginous centers in mandibular growth.
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The Urbach-Wiethe disease is a rare condition, where a hyaline substance of an unknown biochemical nature is accumulated in both teguments and mucous membranes. It has an autosomic and recessive genetic transmission. Cutaneous and mucous lesions (especially on the upper digestive tract) are described, insisting about the laryngeal location and the neurological troubles (with their main symptom: intracranial calcifications). The association of the disease with congenital indifference to pain is to be noted. Two particular cases are reported.
A method for reconstruction of temporomandibular joint is proposed using an intermediary prosthesis and non-sealed cupula. This prosthesis respects the cranial articular slope and provides twofold mobility at the cupular level, which approaches physiological conditions and allows reproduction of buccal opening and closing movements as well as lateralization. A strict surgical procedure is essential when inserting the prosthesis, particular care being necessary in the approach to the facial nerve and control of its temporofacial contingent until above the zygomatic arch. Indications for this procedure are discussed in relation to injuries and tumoral, degenerative and malformatory lesions.
Conventional methods for reconstruction of the mandible require an adequately vascularized receiving bed and total absence of cutaneous and mucosal fluid loss. These conditions are rarely attained during immediate reconstructive surgery and secondary operations are very often of doubtful outcome because of previous infection. A part from the treatment of small post-traumatic loss of substance by means of iliac or costal bone grafts, it is suggested that free osteo (musculo) cutaneous grafts be used for other cases. The flap preferred is one from the anterior iliac crest pediculated on the deep iliac circumflex vessels.
Pierre Robin syndrome continuously raises problems of intensive care that are difficult to surmount. A peak has to be overcome, the date of which varies as a function of the severity of the affection, following which the infant remains a neonate at high risk. Intensive care of these infants during the neonatal period involves avoidance of the sequence of disturbances provoked by the disorders of ventilation and deglutition. Surveillance of biological variables, feeding and the fight against glossoptosis are mainly the concern of medical procedures: from orthostatic nipples to continuous gastric feeding, from procubitus to intubation with assisted ventilation, and including pharyngeal catheters and physiotherapy. Surgery is required only exceptionally at this stage, mainly in the form of hyomandibulopexy.