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Biomedical subjects

P Menard

Publications and source records attributed to P Menard.

At least 19 recordsLinked to original sources
PubMed2006

[Double-barrel fibular free flap for mandibular reconstruction: beneficial alternative for dental implanted rehabilitation (5 cases)].

INTRODUCTION: As major loss of mandibular bone stock requires a vascularized transfer, fibula free flap reconstruction is considered to be the best free flap for its length and reliability. Its main advantage is to accept dental implants. Single or double-barrel reconstruction can be performed. Double-barrel reconstruction is generally preferred because the bone superposition offers enough height to allow dental implants. MATERIAL AND METHODS: We reviewed five selected cases of double-barrel fibula free flap adaptive mandibular reconstruction performed among a series of 11 oral rehabilitations with planned dental implants, focusing on the technical aspects. RESULTS: Today, dental rehabilitation has been achieved in three double-barrel fibula flaps. Details are reported concerning the implant step. DISCUSSION: In this perspective, we discuss the choice of the reconstructive technique in order to obtain adequate bone height. Early in our experience and for different reasons discussed in the text, we used a single barrel fibula flap. This technique provided sufficient height in some cases, but had to be completed by bone grafts in few patients. Our experience illustrates the usefulness of the double barrel technique which provide definitive bone height sufficient for dental implants. The double-barreled technique should be considered as the best solution.

Adult↗
PubMed1999

Functional characterization of the S. cerevisiae genome by gene deletion and parallel analysis.

The functions of many open reading frames (ORFs) identified in genome-sequencing projects are unknown. New, whole-genome approaches are required to systematically determine their function. A total of 6925 Saccharomyces cerevisiae strains were constructed, by a high-throughput strategy, each with a precise deletion of one of 2026 ORFs (more than one-third of the ORFs in the genome). Of the deleted ORFs, 17 percent were essential for viability in rich medium. The phenotypes of more than 500 deletion strains were assayed in parallel. Of the deletion strains, 40 percent showed quantitative growth defects in either rich or minimal medium.

Culture Media↗
PubMed1998

Mesenchymal chondrosarcoma of the jaws. Report of four cases.

Mesenchymal chondrosarcoma (MCS), described in 1959 by Lichtenstein & Bernstein, is a very rare malignant tumour. Only 46 cases have been previously reported in the jaws. Over a period of 30 years, four chondrosarcomas of mesenchymal type (of which one has already been published in 1987 with a three-month follow up) were treated in our department. Two patients have been followed for more than 17 years, of whom one has died of an intracranial extension and the other is still alive after surgical treatment of numerous recurrences and metastases. The two others are tumour-free with a follow up of 18 months and 11 years respectively. Histological, epidemiological and clinical features and treatment of MCS are discussed relevant to the data published in the literature.

Adolescent↗
PubMed1998

Infrahyoid myocutaneous flap in reconstructive maxillofacial cancer and trauma surgery.

We report the use of an island infrahyoid myocutaneous flap, pedicled on the superior thyroid vessels, in a group of 21 patients. This flap allows reconstruction of intraoral defects or defects of the lower portion of the face, as large as 10 x 4 cm. We used it in 15 cases to repair parts of the oral cavity, after tumour resection, in 2 patients with mandibular osteoradionecrosis and in 4 patients with gunshot injuries. Among the 21 flaps, no muscular necrosis was observed; however, 4 total necrosis and 4 partial necrosis (< or = 25% of the skin area) of the skin paddle were recorded. Loss of the skin paddle was primarily attributable to the anatomical variations of the veins draining this flap.

Adult↗
PubMed1994

Leaning on myself.

Explore the source record for details and available documents.

Career Choice↗
PubMed1993

A survey of different high resolution visualization modes of a volumetric object with applications.

In view of the variety of 3D representation techniques, a clinical study was carried out in order to evaluate their respective usefulness. It appears that a single technique cannot be claimed to be valid for all clinical situations and that a combination of representations brings more relevant information. Among the different techniques a clear delineation must be established between those which allow the accurate definition of landmarks (multiplanar reformation, surface representation), and those which do not (integral shading, reconstructed radiology). The main point is the possibility to recognize anatomical landmarks on these latter modes and to choose oblique cut planes in relation to them. Visualization quality is strongly dependent upon the acquisition protocol which must provide a spatial resolution as isotropic as possible.

Arachnoid Cysts↗
PubMed1993

[A brown tumor of the mandible and hyperparathyroidism secondary to chronic renal insufficiency. Review of the literature apropos of a case].

We report on a brown tumor of the mandible in a hemodialysed female patient with severe uncontrolled secondary hyperparathyroidism. Multiple other brown tumors were associated. The hyperparathyroidism was treated with a subtotal parathyroidectomy because only three parathyroids were found. Parathyroid removal led to normal C-terminal parathyroid hormone concentration (0 ng/ml). A review of the literature has shown that parathyroidectomy is usually curative. Our patient demonstrated, eleven days after the parathyroid surgery, rapid growth of the mandibular tumor. This unusual evolution has justified a local excision of the tumor. Histological preparations have confirmed the diagnostic of brown tumor with an important capillary proliferation.

Adult↗
PubMed1993

[An auricular prosthesis attached by intra-mastoid implants. Apropos of 11 cases].

The use of osseointegrated implants to provide support for auricle prosthesis as been carried out by Tjellstrom. This method has provided the maxillofacial surgeon with another approach to the treatment of defect of the auricle. The principles and concepts of extra-oral osseointegrated implants are the same as those of the intra-oral application developed by Branemark 26 years ago. This simple and reliable method allow the attachment to splint bar fixated to three or two mastoid osseointegrated implants. This method represent an interesting possibility for the management of auricle defects. We report on our experience of 11 cases.

Adult↗
PubMed1992

[Cervical Castleman's disease in a 12 year-old child].

A case of unifocal cervical Castleman's disease without systemic manifestations occurring in a 12 year-old child is reported. Histological examination showed the characteristic features of angiofollicular lymph node hyperplasia. The results of immunological and in situ hybridization studies are also reported. A local IL6 secretion in the interfollicular areas was demonstrated.

Castleman Disease↗
PubMed1992

[Mandibular reconstruction by a free peroneal transfer].

After an anatomical study of the osteo-septo-cutaneous fibular flap, we reported 4 reconstructions of segmental mandible defects by this procedure, published in 1989 by D. Hidalgo. 2 patients presented mandibular defects associated with intraoral soft- tissue loss, following resection for epidermoid carcinoma with pre or post-operative radiation. The third patient had a multirecurrent ameloblastoma associated with extraoral soft-tissue extension. The fourth patient presented a complex loss of soft tissue and mandible following a war injury. The flaps survived in all patients. The osteo-septo-cutaneous fibular flap for mandible reconstruction has presented several advantages. The flap has been elevated under a tourniquet, the distant donor site has allowed a two-team approach. The osteo-septo-cutaneous blood supply has been adequate to support a skin island for intra or extraoral soft-tissue replacement. Biomechanical properties of the fibula have allowed fixation with miniplates and no postoperative intermaxillary fixation. Osteointegrated implants (Branemark) for dental rehabilitation were done for one patient. There was no long-term donor-site morbidity.

Adult↗
PubMed1991

[Mandibular reconstruction using free vascularized fibula transplant].

Free revascularized fibular transplants have been used in surgery for the reconstruction of long bones since 1973. The reconstruction of the mandible using a free fibular transplant has been published in 1989 only by Hidalgo. The mandible and the fibula have little in common, except for their length and a similar structure in section. The anatomical study of the free osteofasciocutaneous fibular graft included 20 fresh subjects. The vascularization of the fasciocutaneous plate is either grouped or, more frequently, tiered (2/3 of cases). The technique to remove this graft is specified. Four clinical cases are reported, including three cases of neoplasm of the floor of the mouth invading the mandible, and one case of traumatic amputation of the lower part of the face. A free composed transplant taken from the fibula has been used in all four cases. The postoperative period was normal, and the grafts were completely successful. The main indications of free transplants made of fibular bone are: extensive (more than 8 cm) or compound losses of bony substance from the mandible. The richly vascularized transplant take from the fibula is very sophisticated and performant. The length of bone that can be removed is 25 cm; the bone may be osteotomized in 2 to 4 fragments retaining their vitality. Other tissular structures such as the skin, fascia, muscle, are removed with the bone. The independence in space is threefold and regards the bone, the teguments and the vascular pedicle. The microsurgical qualities of the vascular pedicle are considerable. These free transplants improve the quality of survival (endosseous implants in one case). The morphological, functional and esthetic result is good as a rule.

Adult↗
PubMed1991

[Sphenoid fissure syndrome in orbital fractures. Case presentation and literature review].

The superior orbital syndrome has been reported as a very rare complication of orbital fracture. In emergency clinical examination and computed tomography of the cranio-orbital region have provided diagnosis of the compression of the superior orbital fissure content by oedema and/or hematoma. These examinations have determined the type of cranio-orbital fractures and the absence of extra-dural haemorrhage, optical nerve damage or compression, which required emergency treatment. After surgical treatment of the cranio-orbital fracture by temporal and transconjunctival approach, the orbital fissure syndrome has required supervision. The recovery of ophthalmoplegia has taken several months. Minor after effects have been observed for the patient reported.

Humans↗
PubMed1991

[Reconstruction of the lip vermillion using a myo-mucosal advancement flap].

A classical method of reconstruction of full- thickness vermilion defects by myo-mucous advancement flap of the restant vermilion (15) has been used in five cases. The restant vermilion has been raised from the underlying white lip and stretched over the defect in one stage. For trauma or benign disease with a defect of one half or less of the vermilion, this one stage reconstruction has given fiable results. This technique has respected the lips function, the sub-unit aesthetic principles, and areas of tissue availability.

Adult↗
PubMed1991

[Pre-auricular sclerodermiform basocellular carcinoma extending to the temporomandibular joint. Presentation of a case].

Morphea form basal-cell epitheliomas of the external ear are rare often poorly delineated clinically, present a high rate of recurrence caused by inadequate treatment, deeply invasive and destructive lesions, development over embryonic fusion plane and other anatomical particularity of the external ear. For tumor superior to 2 cm or recurrent lesion conventional excisions are very multilating on this part of face with a 10 to 15% of recurrent rates. The micrographic surgery with total microscopic control of excision described by Mohs which was not disponible for this case seems to be the treatment of choice for morphea form basal-cell carcinoma.

Adult↗
PubMed1990

[Late solitary and benign neurilemmoma of the pterygo-maxillary region].

The neurilemmoma of the pterygoid fossa are very rare. The authors reports one case of a 32 years old man, with such a neoplasm, exteriorized on the lateral facial region (area of the glandula parotis) clinical and radiological data could not differentiate benign neurilemmoma or slow evolutive sarcoma and have justified a conservative latero facial approach of the neoplasm. The final diagnosis of ancient neurilemmoma was based on both light and electron microscopy morphology.

Adult↗
PubMed1989

[Expansion prostheses in restorative and esthetic surgery of the head].

The authors discuss the results of 29 cases of tissue expansion, using 40 expanders, at the head and neck level, in an attempt to achieve a constructive self-criticism. The results have been classified into excellent (18 over 28 cases), good (4/29), fair (3/29) and poor (4/29). Complications were those usually reported: pain, infection, wound dehiscence, reservoir failure. In summary, 23 of 29 patients have definitely gained from tissue expansion. The remaining 6 cases considered as failures are carefully discussed leading to some practical conclusions.

Adolescent↗