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Biomedical subjects

J F Tulasne

Publications and source records attributed to J F Tulasne.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Maxillofacial abnormalities of syndromes of the 1st branchial arch].

Hemifacial microsomia and Treacher Collins syndrome are the most frequent among the first and second branchial arch syndromes to include anomalies of the facial skeleton. Hemifacial microsomia is almost always unilateral and is characterised by hypoplasia or agenesis of the mandibular ramus. Treacher Collins syndrome is always bilateral and involves specifically the zygomatic bones. The treatment of skeletal anomalies is seldom started before 10-12 years of age, except in severe form with major aesthetic impairment. Such cases are treated at the beginning of school age, on and after 6-8 years. Several operations, including osteotomies of the jaws and bone grafts, are usually necessary to achieve an acceptable result.

Bone Transplantation↗
PubMed1986

Long-term results of Le Fort III advancement in Crouzon's syndrome.

Six patients with Crouzon's syndrome who were operated on by Dr. Paul Tessier between 1966 and 1976 were reviewed for long-term follow-up. Cephalometric study with superimposition was not possible because the radiographs were taken in different places according to different standards. However, it is interesting to observe the 10- to 17-year soft tissue follow-up of these patients.

Adolescent↗
PubMed1986

Maxillary growth following total septal resection in correction of orbital hypertelorism.

A rapid survey of eight cases with orbital hypertelorism did not reveal any evident change in maxillary displacement during facial growth following resection of nasal septum and medial displacement of orbital cavities. Accurate analysis of four cases according to the Ricketts long-term growth forecast showed a reduction of growth in the region of anterior nasal spine and only in the posteroanterior direction. This is not necessarily due to the absence of nasal septum. These patients have such severe deformities and the surgical procedure is so extensive that many factors can be responsible for deficient premaxillary growth. Further studies are needed, particularly in patients who, since 1975, have had the same operative method, but without septal resection, to know whether this more conservative procedure has changed the posteroanterior growth of the premaxilla. However, a nasal bone graft has a good prognosis, even when performed in children.

Bone Diseases, Developmental↗
PubMed1986

Results of the Tessier integral procedure for correction of Treacher Collins syndrome.

A new procedure is proposed for correction of the malformations of severe cases of Treacher Collins syndrome in the areas of the maxilla, mandible, and orbit. The operation essentially consists of a rotation of the midfacial segment around a transverse axis at the frontonasal angle. The midface is rotated forward anteriorly and downward posteriorly. It is stabilized by cranial grafts impinged into the temporal bone and the maxilla. The mandible is lengthened either by V shape osteotomy or bone grafting of the ramus. The mandible is fixed in an overjet class III dental occlusion. A posterior bite wafer is maintained for 2 months. The construction of the orbital cavity is completed with cranial bone grafts. The Tessier integral procedure for Treacher Collins syndrome has been done in one stage in six patients and in two stages in five patients. Sufficient data were available for analysis of only four patients.

Adolescent↗
PubMed1984

Secondary repair of cleft lip deformity.

A considerable number of procedures have been described for secondary improvements of the lip. They involve the scars, the Cupid's bow, the philtrum, the alar base, the vestibulum and the columella. In fact, these procedures may give a good aesthetic result in a static position, but the truly successful results occur with normal movements. A normal motion of the lip is impossible without a proper dissection and reorientation of the muscles. Satisfactory lip motion cannot be realized with a defective alveolus or piriform aperture that retracts the alar base. Consequently, a good lip or nasal base cannot be achieved without bony restoration of the alveolus and piriform aperture. A transversely short lip never has normal mobility, and it must be widened by an Abbé flap. A tight, retruded lip on a retruded maxilla cannot be improved by a prosthetic vestibular plate because a greater tension will restrict movements. The lip must be advanced with the maxilla, then widened if necessary by an Abbé flap. A thick prolapsed lip never has normal movement; it must be raised by an infranasal excision. A cleft lip has nothing to gain from being displayed under a short nose, or, still worse, under a upturned nose. The nose must be kept long enough to cast a shadow on the lip. For the same reason, a bone graft is often necessary in bilateral clefts because the nose is short and retruded.

Adolescent↗
PubMed1983

[The place of condylectomy in the treatment of hypercondylosis].

Condylectomy is an indication of choice for unilateral hypercondylia, whatever the age of the patient, and should be conducted as early as possible and associated with intermaxillary elastic traction. Complementary one- or two-stage operations for mandibular correction are necessary in severe advanced cases. Complementary maxillary osteotomies are very rarely required.

Adult↗
PubMed1981

An architectural and structural craniofacial analysis: a new lateral cephalometric analysis.

The architectural and structural craniofacial analysis is based upon mutual balance of the cranial and facial bony structures. With this technique, the bases and calvaria of the cranium and then the face can be studied successively in relation to the cranium and craniospinal articulation. Statistical averages are avoided, and individual proportions influenced by the unique features of each skeleton are relied upon. The dentition is placed within the cephalic context, and therapy etiologic factors of dentofacial dysmorphoses which would not otherwise be demonstrated by conventional analysis are made obvious. This technique is particularly useful to the maxillofacial surgeon, as it clearly demonstrates all of the maxillofacial deformities and the pathologic balances that need to be corrected. In severe craniofacial malformations, it offers better possibilities than other cephalometric analysis methods of detecting the various cranial and facial anomalies which characterize these conditions.

Cephalometry↗
PubMed1979

[Malformations of the spino-cervical joint and of the cervical spine associated with Binder's syndrome (author's transl)].

The authors found in 53.5% of the cases of Binder's Syndrome, where a radiological work up had been carried out on the cervical spine and the spino-cervical joint, malformations of varying importance in these related structures. This lesional association had not as yet been pointed out. After pathological groupings and an analytical study of the anomalies encountered, the question of a common inducer factor is raised, or at least a factor contemporary to the two dysplasias, maxillo-nasal and vertebral. In practical terms, it would seem vital that all individuals with Binder's syndrome have a radiological examination of the cervical spine and the spino-cervical joint. In those subjects presenting with malformations and in particular, complex corporeal dysplasias, the authors strongly insist on the necessity of regular follow up in order to make an early diagnosis of eventual neurological repercussion.

Abnormalities, Multiple↗
PubMed1979

[Uranostaphytopharyngoplasty using an inferior pedicle (author's transl)].

Treatment of deficiencies of the soft palate is dependent upon its condition, and the plastic surgeon is guided in his therapy by its length and suppleness. This was also the case when, in the past, a prosthesis had to be applied. If it is sufficiently long and supple a simple velopharyngoplasty, followed by phonetic reeducation, has every chance of producing a good result, at least in cooperative children and adolescents. When the soft palate is very shortened, however, a simple velopharyngoplasty does not ensure effective rhinopharyngeal occlusion and lengthening of the soft palate and the palatine mucofibrous tissue must be performed at the same time by means of a uranostaphylopharyngoplasty. In practice, this latter procedure is preferable in the majority of cases. We have used either superior or inferior flaps but over the last 25 years we have preferred the latter type of flap (Rosenthal) which produces better results because: 1) it is retracted laterally to a lesser degree, 2) it is more supple, 3) it is attached below and posteriorly to the soft palate (which permits the pharyngeal constrictor muscles, during contraction, to apply pressure against the lateral borders of the flap, and thus avoid any nasal regurgitation).

Child↗
PubMed1979

[Clinical and radiological aspects of maxillo-nasal dysostosis: "naso-maxillo-vertebral syndrome". A study of 34 new cases (author's transl)].

Maxillo-nasal dysostosis is not uncommon as we have noted 34 new cases in eight years. The most characteristic anomalies, well described by Binder, are nasal hypoplasia both of bone and cartilage with agenesis of the nasal spine, as well as a characteristic rearrangement of the naso-labial muscles. On first seeing the patient the disease is generally recognized by the very typical aspect of the nose. There very often exists however other dental, mandibular and cervical spine anomolies. It is indispensable to look for these anomalies in the work up of patients with this malformation syndrome "the naso-maxillo-vertebral syndrome", in order to better understand the disease and better treat the patients.

Abnormalities, Multiple↗
PubMed1979

[Bone reconstruction after resection of the mandible for osteoradionecrosis (author's transl)].

Resection of the sections of the mandibular affected by osteoradionecrosis has completely modified the progression and prognosis of this affection by ensuring that the patient does not have to suffer long periods of pain and suppuration, constantly observed when medical treatment is used alone. Unfortunately, these resections are usually extensive and are themselves responsible for functional and esthetic sequelae supported with difficulty by some patients, especially in the case of bilateral or mandibular arch resections. All efforts must be made, therefore, to limit the consequences, and with this in mind it is possible: -- to perform an uninterrupted resection limited to the alveolar area involved, in early cases of mandibular osteoradionecrosis; -- to reconstitute mandibular continuity with a bone graft in more advanced stages; -- to improve the esthetic appearance with skin and subcutaneous grafts whenever this is necessary. Good results can only be obtained if certain anatomical conditions exist and if surgical precautions are adapted to each case.

Adult↗