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Biomedical subjects

S Testelin

Publications and source records attributed to S Testelin.

14 recordsLinked to original sources
PubMed2006

[Tuberculosis of the submandibular gland: a case report].

INTRODUCTION: Tuberculosis remains an important public health problem in France. After a certain decline, its incidence has remained unchanged since 1990. 30% of tuberculosis cases are extra-pulmonary form, most of them concern nodes especially in cervical areas. CASE REPORT: This case of submandibular tuberculosis illustrates diagnostic and therapeutic difficulties. DISCUSSION: There are few clinical signs or laboratory clues suggestive of tuberculosis, however a surgery cannot be avoided and must be performed in combination with antituberculosis chemotherapy.

Antitubercular Agents↗
PubMed2005

Comparison of two computer-assisted surgery techniques to guide a mandibular distraction osteogenesis procedure. Technical note.

The accuracy of distracted facial bone displacement depends on the preoperative clinical assessment, surgical planning and technique. The aim of this study was to evaluate two different techniques to guide the mandibular distraction surgical procedure using an intraoral device. This study was performed on a fresh cadavre. 3D reconstructions from a computed tomographic (CT) acquisition were used for the two techniques. The first technique comprised a customised stereolithographic template and the second technique used a computer-assisted surgery (CAS) unit to guide the osteotomy and the positioning and screwing of the distractor device. Both methods were planned and compared with the same 3D software. The authors discuss the feasibility and reliability of the two techniques. The accuracy of the two techniques appears to be comparable for clinical applications, although the rapid prototyping template technique appears to be more satisfactory.

Cadaver↗
PubMed2004

Total lower lip functional reconstruction with a prefabricated gracilis muscle free flap.

Total lower lip reconstruction was performed in an 18-month-old boy following a dog bite. In order to obtain an optimal functional result and to avoid any additional facial scarring, a prefabricated gracilis muscle free flap was used in a two-stage procedure. Firstly, the muscle was delayed on its main pedicle, a 'tendinous' strip was inserted along its free border and a silicone sheet was slid under its predicted intraoral side. At the time of reconstruction, the neomucosal lining obtained in this way reconstituted the labial vestibule. Furthermore, the muscle, reinnervated by the mandibular branch of the facial nerve, was also put under minimal tension and suspended between the two modioli using the 'tendon' graft. This allowed both lip occlusion and normal speech development to be restored without any impairment of mandibular growth during a 4-year follow-up.

Animals↗
PubMed2003

[Cavernous hemangioma of the nasal bones].

Cavernous hemangioma of the nasal bones is a rare benign tumor. 31 cases have been published in the world literature. The tumor appears as a firm swelling involving the nasal bone, adjacent tissues are uninvolved. The CT scan is helpful in defining tumor characteristics and extent. In most cases surgery appears curative without major cosmetic deformation. We present a case of nasal bones hemangioma where a coronal flap approach was used for tumor resection and cranial bone grafts for reconstruction.

Aged↗
PubMed2003

[Cherubism: the value of imaging and preoperative embolization].

Cherubism is a benign, hereditary, autosomal dominant disease, with variable penetrance and expressivity. It presents as a characteristic indolent deformity of the lower half of the face, associated with multicystic bone tumors. The definitive diagnosis is established by pathology. Radiology contributes greatly to its diagnosis (CT or MRI scan), and preoperative arterial embolization can provide valuable help to the surgeon when excision of this hemorrhagic lesion is necessary. The present article presents a case showing the advantage of this type of devascularization prior to surgery, not previously described in the literature.

Cherubism↗
PubMed2001

Cerebro-costo-mandibular syndrome in a father and a female fetus: early prenatal ultrasonographic diagnosis and autosomal dominant transmission.

Ultrasonography in a female fetus revealed cystic cervical hygroma, severe micrognathia, and vertebral and upper limb anomalies suggestive of cerebro-costo-mandibular syndrome (CCMS) which was diagnosed ultrasonographically at 16 weeks' gestation. The father is affected and presents with a Pierre Robin sequence, short stature and typical costovertebral anomalies. CCMS is a rare and severe disorder. The high frequency of sporadic cases, vertical transmission, and the excess of sibs affected via horizontal transmission suggest dominant autosomal mutation with possible germinal mosaicism. The vertical familial case detailed in the present report is a reminder of the high risk when one parent or one sibling is affected and the extreme variability of phenotype and costal ossification. Early prenatal ultrasound diagnosis is possible in a severely affected fetus.

Abortion, Therapeutic↗
PubMed2000

[Orthognathic surgery and stereolithographic models. A new technic of dental occlusion transfer].

Use of stereolithographic models in orthognathic surgery is limited by the difficult in considering the facial osteotomies and the dental occlusion at the same time. Different techniques allow the surgeon to perform the simulation using composite prototypes after including the dental casts on the models. These techniques require complex "stereotaxic" systems or a surgical approach before CT scanning in order to insert the reference screws. They cannot overcome the problem of mandibular movement during the CT session. Our technique is a simple way to include the dental casts in the stereolithographic model with high precision. This can easily be done in a maxillo-facial environment and does not require any further special knowledge other than that which can be aquired in a classical dental laboratory. The occlusion transfer is achieved with a silicon cast of the teeth and the bony structures of the sterolithographic model on which we include the plaster dental casts. The silicone cast of the dental occlusion can also be used to decrease the mandibular movement during CT scanning.

Adult↗
PubMed2000

[Bilateral carotid paraganglioma].

We report an unusual case of bilateral paraganglioma of the carotid. The tumor had been neglected for a long time and increased in volume during pregnancy, inducing compression and requiring surgical treatment. We focus on the therapeutic strategy: devascularization followed by percutaneous sclerosis before total surgical removal in a two-step procedure.

Adult↗
PubMed1998

[Secondary repair of oro-pharyngectomy with mandibular resection and radionecrosis].

There are two pitfalls to be avoided in transmandibular buccopharyngectomy: mandibular amputation and inversely a contemplative wait-and-see attitude. Preservative measures require a precise evaluation of bone invasion, surgical approaches respecting the lip and cutaneo-muscular flaps, and an early assessment of the secondary effects of radiotherapy. Reasonable use of bone periosteal free flaps and striving for immediate reconstruction of each defect certainly leads to an interventionist behavior, but which can be conducted under better conditions and more attainable objectives than after mandibular deformation, a pharyngostomia or recent radionecrosis. Microsurgical procedures are nothing more than technical mastery and can lead to arrogant behavior. Fifty cases illustrate this position.

Amputation, Surgical↗
PubMed1998

[Microsurgery and ballistic traumatology of the face].

The use of free flaps to fill and repair facial defects due to suicidal gunshot wounds has considerably extended and refined the possibilities available to reconstructive surgeon. The objective is no longer to close the defect at any cost, or "fill a hole", but to replace missing tissue by an identical tissue, able to restore an identical cosmetic appearance, support equivalent constraints, and restore analogous function. Retrospective analysis of 56 cases of large facial defects due to gunshot wounds revealed a total of 66 free flaps for 32 cases. The vascular quality of the flaps allowed better integration in a sometimes hostile recipient site and markedly reduced the treatment time. Although the objective results obtained in the treatment of these severe defects remain poor, the first-line use of these multiple flaps, exclusively reserved for deep repair, as the basis for reconstruction, has modified our behaviour. A real medium-term treatment strategy, based on a decision flow-chart, can be proposed which, despite several inevitable failures, leaves less room for improvisation and piecemeal surgery. Free flaps are only the hidden part of the reconstruction, as surface cover uses local flaps and other conventional reconstructive surgery techniques. However, this humble, hidden role is nevertheless fundamental, in the strict sense of the term, and guides the general approach to this surgery.

Adolescent↗
PubMed1997

[Digestive flaps and facial microsurgery].

Abdominal wall and contents can be used out of the coeliac cavity, as tissues donors site, for filling up or covering defects. Microsurgical technology mastery can extend their use in all the human body parts, especially in the craniofacial area. More than 110 digestive free transplants have been used during a 8 year period in head and neck surgical repairs. The report shows how to exploit at their best the anatomical and physiological properties of diverse abdominal tissues. Beyond this, the possible association of these transplants with other repair techniques opens new therapeutical perspectives, such as chimerical flaps whose pedicle distributes to heterogenous (or heteroclite) components, double flaps with a single or a double pedicle, replacing, at one single operative time, each missing tissue by the most adequate transplant. In consideration of this, abdominal tissues are an inexhaustible source of transplants, even through some imperfections must be managed.

Abdomen↗
PubMed1997

[Role of coral blocks in cheek augmentation surgery. Prospective study of 23 patients].

A two-year multicentre prospective study was performed from 1992 to 1995 in order to evaluate the real value of various kinds of coral blocks as bone substitute in maxillofacial surgery. This study was supported by the French National Agency for Research Valorization (GBM/TEP procedure). Ten Maxillofacial Surgery Units were included. During this time, 28 coral blocks (23 patients) of two different shapes were used as malar implants for correction of congenital or acquired zygomatic hypoplasia. The mean follow-up was 1.8 year (min: 1.5; max: 2). The tolerance was perfect for 89% of cases. The radiologic opacity never decreased more than 30% and the volume augmentation was always stable at the end of the follow-up period. Three implants were removed because of septic complications. Rigid fixation between the implant and the zygomatic bone appears to be the most important factor of success. On the other hand, the surgical approach (endo- or exo-buccal) does not seem to influence the success rate. The aesthetic improvement was always evaluated as satisfactory and stable by the patients and the surgeons. The authors discuss the real value of the various kinds of biomaterials and especially coral, comparing their personal data with those of the literature. Coral blocks clearly constitute a safe and reliable bone substitute, but further investigations are required to determine its long-term behavior.

Adolescent↗
PubMed1992

[History of microsurgical reconstruction of the mandible].

The history of mandibular reconstruction, initially prosthetic, dates back to Ancient Egypt and China, but developed rapidly and diversified from the 19th century onwards when C. Martin, in 1889 developed his "immediate prosthesis applied to resection of the jaws", while A. Barth, in 1895, performed the first bone grafts. The more recent history of microsurgical reconstruction commenced with free rib transfers in 1977-1978 (Ariyan, Couly). Other microsurgical transfers, either pure bone or composite osteocutaneous, osteoseptal or osteomyocutaneous were then rapidly developed and used with varying degrees of success for mandibular reconstruction: inguinoiliac flap (Talyor and Watson, 1978), dorsopedal flap using the second metatarsal (O'Brien, 1979), forearm flap with the radius (Soutar and Mac Gregor, 1986), lateral brachial flap with humerus (Martin, 1988), free fibular flap (Hidalgo, 1989)... and the story continues.

Bone Transplantation↗