[Examination of the patient with maxillofacial trauma].
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Biomedical subjects
Publications and source records attributed to G Princ.
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46 cases of acquired immunodeficiency syndrome permit the authors to detail the particular aspects of the oral and facial lesions in AIDS. In patients at risk, a lymphadenopathic syndrome is thought to represent a prodromic phase of the illness. The authors insist upon the differences between the classic Kaposi's sarcoma and that associated with the AIDS (mean age and initial sites of tumor). One third of these sarcomas is completed by a digestive candidiasis. The review of the literature reveals squamous cell carcinoma and Burkitt's lymphoma with the AIDS. We must be aware of early diagnosis and transmission factors in the individuals at risk with tumors and opportunistic infection.
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The authors present a cases of localised exostosis of the angle and the ascending ramus of the mandible. They stress the technical problems posed by this giant exostosis and they propose an original operative approach together with a complete review of the literature.
Difficulties encountered during surgery on maxillary angiodysplasias were studied in relation to case-reports of patients treated in the stomatology and maxillofacial surgery unit directed by professor Vaillant, Hôpital Salpêtrière, Paris. Findings allowed certain conclusions to be drawn with respect to diagnostic and therapeutic features and to compare these with those reported in the international literature.
The two essential problems posed by craniofacial trauma are assessed in the light of 70 collected cases. Firstly, the "time" of treatment. Immediate surgery by two teams, neurosurgical and maxillofacial, may be justified in the presence of craniocerebral lesions. This occurs rarely. The cranial problem is often explored during the first 3 or 4 days and with the exception of certain cases of immediate or delayed coma, maxillofacial treatment may be undertaken early. The treatment of cerebrospinal fluid fistulae remains controversial. Secondly, the surgical technique. Accent is placed upon two points which are still discussed : cutaneous phase and bone phase in open trauma ; reconstruction of the cranial level and the facial mass by fixation using plates or steel wire, bone grafts or inert materials, with in particular surgery for fractures of the floor of the orbit in all cases. A number of clinical cases suggest that suitability of eclectism in this surgical approach to craniofacial trauma.
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