[Pediatric dentistry and maxillofacial surgery (author's transl)].
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Biomedical subjects
Publications and source records attributed to G Couly.
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Microscopic study of the human lacrimal ducts places the emphasis on the delicacy and complexity of the relations between the lacrimal muscle and the mobile lacrimal tubular system. The fixed part of the lacrimal ducts (nasolacrimal duct) contracts with the anterior pillar of the face, a fixed relation which inevitably exposes this part to lesions by shearing in the case of anterior maxillofacial trauma. The proximity of the nasolacrimal duct to the piriform cover is such that the duct may be approached surgically by trepanation of the anterior bony surface of the anterior pillar of the face.
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All of the principal salivary glands are in contact with the membranous mandible, in the form of contiguous relationships which develop and disappear respectively at the time of phylogenesis and ontogenesis of the first branchial arch. A contrast must also be drawn concerning the static relations between the submaxillary and sublingual glands and the inner aspect of the horizontal branch and the dynamic relations between the posterior edge of the ramus and the parotid gland ensured by the inter-mandibulo-parotid sliding space. In this perspective, the physiological slope of the posterior border of the ramus is certainly of parotid origin. This slope may be exaggerated in the presence of a parotid tumour, forming the indirect radiological sign of sagittal lordosis of the ramus, sometimes associated with a certain degree of frontal scoliosis in the case of a tumour with pharyngeal prolongation. Once again in this perspective, the inter-mandibulo-parotid sliding space makes for easy separation of the anterior parotid aponeurosis of the mandible and of its muscular sling.
This condition is a genodermatosis, seen chiefly around the shores of the Mediterranean, characterised by early pigment disturbances which progress virtually inexorably towards a diffuse epitheliomatosis which usually results in death before the age of 20 years. Progression of the lesions is precipitated by exposure to UV rays. These lesions are seen essentially in exposed areas, in particular oculopalpebral. Treatment is first preventive (decrease in exposure to sun and protection). Otherwise, surgery remains the most effective method: either excision as required, or extensive cervicofacial prophylactic excision followed by grafting.
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The authors report a case of post-traumatic jugal lymphatical effusions associated to a fistula of Stensen's Duct. The lesions have healed by placing a suction drainage without modelling catheterism.
A commonly fatal condition, by virtue of the malignant infectious syndrome which it causes initially, facial noma leaves sequellary mutilitations which may be treated surgically using a panoply of technical procedures from maxillofacial surgery (skin flap, skin and mucosal graft, oestotomy, bone graft, plasty, mechanotherapy by mobilisers, facial massage etc.).
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The authors suggest a method for the reduction and immobilisation comminutive fractures in varus of the zygomatic arch. This procedure consists of the introduction of a Franchebois balloon filled with physiological saline into the external space of the manducatory sysarcoses, thereby maintaining the calibe of the zygomato-temporo-malar canal. The procedure falls within the context of the functional treatment of fractures of the facial skeleton.
The human face is a sensory complex with the task of transmitting to the central nervous system most of the information and signals from the surroundings. This perceptive centripetal activity is linked with continual centrifugal transmissions to the surroundings of a relational type. The cerebral extremity of a human being is ethological in essence. The human cephalic phenotype is, during the whole of its development, a succession of responses of the genome to the stresses of the environment: it is an open system. The phylogenesis of the cerebral cognitive organs and the phylogenesis of the skeleton which protects them are linked. The growth of the membranous cephalic skeleton is under the control of these cognitive organs. Practical applications are deduced from this in connection with the pre-operative functional test for prognathisms.
As an applied study of the human costal vascularisation, the authors describe the technique of costal graft in the reconstruction of the mandible with intercosto-facial micro-anastomosis. The accent is placed upon the value of these grafts. They describe the methods for determination of the survival of the vascularised bone (X-ray, technetium pyrophosphate and labelled red cell bone scan, hyperselective arteriography and bone biopsy).
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