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Biomedical subjects

B Devauchelle

Publications and source records attributed to B Devauchelle.

At least 19 recordsLinked to original sources
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↗
PubMed2001

[Writing].

Explore the source record for details and available documents.

Humans↗
PubMed2000

The KBG syndrome: an additional sporadic case.

We report the sporadic case of a boy with clinical features of KBG syndrome, including slight mental retardation, characteristic facies, macrodontia, and skeletal anomalies.

Abnormalities, Multiple↗
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↗
PubMed1996

[The coral orbital floor. Its value in traumatology. The results of a multicenter study of 83 cases].

A madreporic coral graft was used for orbital floor reconstruction following facial trauma. This report presents a multicentric study of 83 patients with a follow-up period of 15 to 24 months. The results of this study indicate no significant rejection or infection opposed to so many synthetic implants outcome. The radiological follow-up demonstrates a partially resorption of the implant within about 2 years and its replacements by new bone. Coral implant was used to correct enophthalmos or diplopia due to enlarged orbital dimensions. It was technically easy to insert and its anatomic shape does not require to be fashioned before use. Its inflexibility allows to bridge large bone defects and this implant should be considered as an attractive alternative to autogenous grafts, avoiding a second surgical site, in reconstructing orbital floor fractures.

Adolescent↗
PubMed1995

[Computer-assisted design and manufacture of an orbital cavity prototype].

Based on the results obtained in two dimensions or extrapolated into three dimensions by current medical imaging techniques (CT scan, magnetic resonance imaging), it is possible, under certain conditions, to create hard complex anatomical specimens, of obvious value in cold surgery. Two successive approaches of design and manufacture of an orbital cavity prototype are presented, as a preliminary to industrial productions soon to be released onto the market.

Biomechanical Phenomena↗
PubMed1995

[Third dimension and craniofacial plastic surgery].

Via an inverse approach to that of the Renaissance painter's treatment of perspective, the third dimension must be obtained from flat radiological information in order to reconstitute (virtually and materially) the volumes which it analyses. These images are analysed mathematically by computer. The applications are and will be numerous, especially in cranio-maxillo-facial surgery. Surgical simulation, without claiming to assess their soft tissue repercussions, section and virtually reposition bone segments: symmetrization and correction of hypotrophy are easy to visualize; computer-assisted surgical teaching applications (endoscopic surgery) are discussed. Multimodal images superimpose information from various sources: operative views and pre-recorded images are available to the surgeon and guide him in his "surgical navigation". Prototyping of skeletal anatomical specimens (prior to tumour or soft tissue specimens) provides the therapist with a precise preoperative spatial configuration of the abnormalities to be corrected, and the reconstructions to be performed. These developments, and others to come, are the sole objective of 3D imaging, beautiful in itself, but ineffective alone.

Computer Simulation↗
PubMed1994

[Microsurgery and reconstruction in facial oncology].

The desire to improve the post-operative lives of throat cancer patients and the additional problem posed by trying to conceal visible facial scars are the main motivations of reconstructive surgery in facial cancer treatment. In this field, microsurgical techniques have found their place and are used to the upmost efficiency when the final result is taken into account. Even better, these techniques are used to attempt an accurate reconstruction of different structures destroyed by the tumor or drastic surgical intervention, by using other parts of the patient's body. Microsurgery is bringing us closer to the miracles of Cosmas and Damian, the legend that surrounds. Tagliacozzi, the figures of surrealistic pantings, and the universival myth of the mask... The relative youth of these techniques in the facial cancer field and the lack of effective medical treatments lead us to believe that its potential growth is quite large and promising. Four distinct chapters are used to illustrate the different microsurgical techniques in cutaneous tissue loss, mucous tissue loss, bony tissue loss and the repair of sequellas. But reality reminds us that tissue composition is much more complex and that even today, microsurgery offers only a crude replacement in relation to the structures that it seeks to reconstruct.

Bone Transplantation↗
PubMed1992

[Should microsurgical mandibular reconstruction be dissociated?].

Microsurgical transplant has the additional advantage over bone graft of being a composite tissue, resembling the defect it is intended to replace. This applies particularly to the mandible, as the mucocutaneous tissues are intimately applied over the bone. Regardless of the ingenuity of the transplant design and the different variations, none of the flaps used in this series of 37 microsurgical reconstructions was able to validly reconstruct bone and/or mucosa and/or skin in a single operative stage. It very rapidly became apparent that microsurgical reconstruction of the mandible needs to be divided into several stages in order to taken into account the mucosal defect. This choice of a more difficult alternative based on the lack of bone donor sites is compensated by the good tolerance of intestinal transfers to the buccal cavity.

Adult↗
PubMed1991

[Metoclopramide intolerance and oral manifestations].

Metoclopramide is a widely used product, which can accidentally cause acute dyskinesia, of which several forms may be observed, including dysarthria, tetany, spasmophilia, false cerebral vascular insult, trismus, hysteriform spell.... In all those cases, one should think of giving an antiemetic and of properly orienting history-taking, thus avoiding a longer stay in hospital that would not be justified. This is demonstrated by two patients recently admitted into the department of maxillofacial surgery and stomatology with maxillofacial signs related with the adverse effects of this kind of drug.

Adolescent↗