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Biomedical subjects

D Marchac

Publications and source records attributed to D Marchac.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Cranio-facial and dental manifestations of erythrocyte abnormalities].

Various types of erythrocyte lesions are observed: hemoglobin anomalies, enzyme disorders, membrane anomalies. This leads to a reduction in the duration of life of the erythrocytes or to abnormal erythropoiesis with, in both cases, reactive development of hematopoietic tissue. This extension of the medullary field in bones results in alterations that are initially visible on radiography, and then, in the severe forms, in the development of mainly craniofacial and dental dysmorphia with, in some cases, additional secondary enamel and dentine anomalies of the hemolytic origin. These anomalies were present to varying degrees in a series of patients in whom cranial radiographies were performed. In two cases there was a fortuitous association of dental anomalies of the melanodontia and opalescent dentine types. These patients may raise particular problems during dental care and treatment: risk of infection, respect of drug contraindications, latent cardiac insufficiency.

Adult↗
PubMed1983

[Enlarged transbasal approach by mobilization of the medial fronto-orbital ridge].

Tumors involving the base of the skull are best approached by the transbasal route as described by Derome. However this approach can be improved by mobilization of the medial part of the supra-orbital ridge according to the technical principles used in treatment of craniosynostosis. This allows a wide exposure of the ethmoido-sphenoidal area with minimal retraction of the frontal lobes. The axis of working becomes parallel and even inferior to the plane of the cribriform plate and gives a better access to the upper part of the clivus. Rhinologic complementary approach (rhinoseptal or transfacial) can be associated with this technique. However a more anterior part of the nasal mucosae is exposed by this procedure: one can control the mucosae in front of the tumor and avoid a complementary rhinoseptal route. This simple technical trick has been used in seven cases with satisfactory results.

Humans↗
PubMed1983

[Early treatment of orbital asymmetry in plagiocephaly].

Plagiocephaly results from premature unilateral closure of the coronal suture with subsequent frontal and orbital asymmetry and inequality of ocular levels requiring complex osteotomies if treatment is delayed. From 1976, early treatment from the age of approximately 6 months has been instituted by means of bilateral frontal remodelling. Results in 25 neonates in whom the operation was performed demonstrated that not only was the frontal correction maintained with growth, but that principally the facial asymmetry was reduced and later orbital surgery was never necessary. More complicated problems were raised in 15 infants with plagiocephaly operated upon at a later stage.

Child↗
PubMed1982

[Craniofacial surgery].

Deformities in the orbital area can also be corrected by craniofacial surgery. Early surgery within the first year of life is indicated in cases with intracranial pressure if permanent damage to the eye is to be avoided. Otherwise, corrective surgery should be performed in early childhood, although it can also be performed on adult patients. More severe strabismus cannot be treated, but disturbance of lid function can be positively influenced. From the esthetic point of view considerable improvement can be achieved. These very protracted operations require intensive interdisciplinary cooperation.

Adolescent↗
PubMed1982

Curative and aesthetic results of surgical treatment of 138 basal-cell carcinomas.

We herewith present a review of 138 basal-cell carcinomas, mostly on the face, that were treated by surgical excision and immediate repair. In a few cases, frozen sections were taken to ensure complete excision of the neoplasm. Local flaps were favored; distant flaps and full-thickness skin grafts were required in selected case. The recurrence rate with a minimum of 3 years of follow-up is 2.1%. Cosmetic results, evaluated by the patients themselves and by one of the authors (G.D.) who did not participate in the surgery, were judged "excellent," that is, without visible scars or deformities, in 61.4% of the cases, and "good" in 31.4%. The results are discussed.

Aged↗
PubMed1982

Intracranial pressure in craniostenosis.

In this study, intracranial pressure (ICP) was recorded with an epidural sensor for periods of 12 to 24 hours in 92 cases of craniosynostosis. Pre- and postoperative recordings were performed in 23 patients, and 55 children underwent preoperative psychometric testing. The ICP was found to be normal in one-third of the cases, was obviously elevated in one-third, and was borderline in one-third. Waves of increased ICP were recorded during rapid eye movement (REM) sleep. After surgery, ICP decreased progressively and returned to normal in several weeks. A significant statistical relationship was found between the patients' ICP and their mental level: the higher the ICP the lower the mental level. The regression curve of ICP as a function of age shows that ICP is maximal at the age of 6 years and decreases later. The significance of these results is discussed. The authors recommend that ICP be recorded in cases of craniosynostosis since it is of some help in deciding whether patients should undergo surgery.

Adolescent↗
PubMed1982

Reduction mammaplasty and correction of ptosis with a short inframammary scar.

The main sequelae of mammaplasties are scars, particularly visible when they trespass the breast limits. If the new inframammary fold is located higher than the original, the horizontal limb of the T-suture can be kept short and can be hidden beneath the breast. The glandular tissue is split vertically and overlapped for ptosis. For reduction, an inferior resection with medial or lateral remodeling is performed. The results are very satisfactory for ptosis and mild to moderate hypertrophy. High conical breasts with minimal scars are produced.

Adult↗
PubMed1981

Cranio-facial surgery for cranio-synostosis.

Cranio-facial principles have been applied to the treatment of craniosynostosis by the senior author since 1973, and original techniques have been developed for the treatment of oxycephaly, trigonocephaly, plagiocephaly brachycephaly and scaphocephaly; 156 patients have been operated upon. There is now enough follow-up material to establish that the good morphological results obtained initially are maintained through growth, and that there is a definite improvement in affected facial structures when early correction has been performed. The functional results have also been very satisfactory and reoperation for insufficient release has been rare. A multidisciplinary approach is highly recommended, and this type of surgery should be performed in a pediatric neuro-surgical environment.

Adolescent↗
PubMed1981

[Surgery in craniofacial syndromes (author's transl)].

Craniofacial surgery deals with the correction of congenital acquired deformities of the skull and face. This kind of surgery together with microsurgery can be regarded as the most outstanding development within the past decade. Plastic surgery, as the center of organisation is responsible for coordination with many other medical disciplines. Since 1978 an interdisciplinary group for craniofacial surgery started with operations at the University Hospital for Plastic Surgery in Innsbruck and the Department for Plastic Surgery at the Klinikum rechts der Isar in Munich. In this article first experiences are reported and three cases, a Morbus Apert, a Morbus Crouzon and a Hypertelorismus presented. The indication for such treatment is directed for functional disturbance but also for aesthetical reasons to improve the psycho-social structure of the patient. An early operation is indicated in stenosis of cranium and face to avoid damage of the brain and eyes. If not urgent, these interventions should be started beyond the age of about 8, after dentition.

Child↗
PubMed1980

[Early treatment of facial-craniostenosis (Crouzon-Apert) (author's transl)].

The possibilities of treatment of the facial deformities related to Apert and Crouzon syndromes were transformed by the total facial advancement osteotomies described by Paul Tessier. These facial osteotomies are possible in children, and there is enough follow-up nom to assure that facial advancement osteotomies in children do not impair significantly the remaining growth possibilities. There are however severe psychological sequalaes in patients operated as children or youngsters, resulting from a deformed appearance during early childhood. We therefore try to give these children an acceptable appearance before entering school, around 3 or 4 years of age. Now in fact, we are trying not only to correct, but to prevent these deformities by early age release of the synostoses. The synostoses are usually involving the coronal suture and the cranial base. The cranial base being out of safe reach, we have started in 1976 to perform a 2 cm advancement of the forehead, including the supra-orbital rim. At first, we were using a lateral tenon-mortise fixation. We have tried the extended coronal craniectomy advocated by McCarthy and Coll., but since July 1977, we are using the original floating forehead principle: the advanced forehead is wired back only to the face, malar bones and root of the nose, leaving behind and extended craniectomy. Thus, the rapidly expanding brain of the infants is able to project anteriorly the forehead and upper part of the face. We have operated on 26 infants with faciocraniostenosis and severe brachycephaly according to these early release principle, the last 11 with the floating forehead approach. The results are very encouraging, the appearance being normal or subnormal after a few months. Even if an upper maxillary osteotomy is necessary later, we feel that an early improvement of these children is of high benefit to them. The improvement can also be functional, the psychological tests and the intracranial pressure measures showing that an early release is benefitial even in the absence of obvious intracranial hypertension.

Child, Preschool↗