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Biomedical subjects

J Lachard

Publications and source records attributed to J Lachard.

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

[The place of composite flaps in maxillofacial surgery].

The preferred composite flap is the musculocutaneous flap from pectoralis major for repair of loss of mucocutaneous substance due to cancer or injury. In rare indications the musculocutaneous flap from sternocleidomastoid muscle is used. When loss of bone substance combined with a cutaneous or mucosal defect has to be corrected use is made of the bone-muscle-skin flap from pectoralis major to include the 5th rib, or the bone-muscle-skin flap from sternocleidomastoid to include internal portion of clavicle. Reliability on use of these two flaps has led to their application in surgery for mandibular osteoradionecrosis. In addition to allowing repair of bone continuity, the vascular and cellular capacities of the flap provide colonization and rehabilitation of the borders of lost substance with live tissue, as shown by subsequent bone remodelling. Results of statistical analysis of 50 cases are presented.

Bone Transplantation↗
PubMed1987

[Köle's operation].

Kole's operation combines segmental alveolar osteotomy of lower incisor-canine region with a reduction mentoplasty. The procedure usually provides a reduction in height of mentum, sometimes with an advancement, and involves ablation of an intermediate bone fragment. Ablation of lower border as described by Kole too frequently results in an esthetically poor chin. Insertions of platysma and digastric muscles are untouched. The inferior segmental osteotomy separates the lower incisor-canine region, which is displaced upwards or upwards and backwards after extraction of premolars, displacement being maintained by interposition of bone detached during mentoplasty. A reduction glossectomy is almost constantly associated. The best indication for Kole's operation is anterior gaps with or without proalveoli. It is often combined with segmental or total surgery to maxilla. Results are generally stable, especially after mentoplasty, but from the dental aspect pulp mortifications are not rare.

Chin↗
PubMed1987

[Temporomandibular arthrography].

Results of 104 arthrotomography scans with contrast of temporomandibular joints of 71 patients are used to define normal arthrography criteria (15.4% of cases). Reducible anterior displacements represented 28.8% of cases, non-reducible displacements 40.4%, perforations 12.5% (5.8% associated with a reducible luxation, 6.7% with a non-reducible luxation). The failure rate was 2.9%. Arthrography provides important information on articular morphology and dynamics, the state and position of the meniscus and of the posterior brake, and the state of the joint capsule. Performed by an experienced operator it possesses few complications.

Adult↗
PubMed1986

[Current treatment of osteoradionecrosis].

Conventional treatment of osteoradionecrosis of mandible is by antibiotics combined if necessary with a hemimandibulectomy. A method is proposed which reduces bone excision to infected and necrotic tissue while respecting mandibular continuity. The bone remaining is covered by a flap taken from a distant region. Five cases treated in this way are reported. When mandibular continuity has to be interrupted to suppress infected foci, immediate repair is performed using an osteo-musculo-cutaneous flap, and six cases treated by this method are reported. A part from their mechanical covering and reconstructing roles these well vascularized flaps improve vitality of tissues they enclose, including the mandibular bone.

Combined Modality Therapy↗
PubMed1985

[Localized myositis with eosinophilia].

A 49-year old man developed myositis of the left masticatory muscles followed by myositis of the right supinator longus; these two lesions were histologically confirmed. Blood and bone marrow eosinophilia was present. Cure was obtained with systemic corticosteroids. Only one similar case was found in the literature. These cases differ from the various localized or focal forms of myositis as well as from eosinophilic polymyositis. Despite some similarities with masseteric myopathies in animals, no hypothesis can be formulated concerning the cause of the disease.

Eosinophilia↗
PubMed1985

[Surgical treatment of temporomandibular joint syndromes].

This analysis of replies to a questionnaire raises three questions: Is surgery indicated in the treatment of this syndrome? What are the factors on which the indication for surgery should be based? If surgery is indicated what type of operation should be performed? Complications of surgery are discussed.

Facial Paralysis↗
PubMed1985

[Anatomical lesions of the condylar head in a case of temporomandibular joint syndrome].

Radiography in a patient with this syndrome showed marked lesions in the condylar head. Histology after condylectomy showed alterations throughout the condyle with associated arthrosic and osteonecrotic lesions. Possible relations between the two processes are discussed, the extensive nature of the necrosis suggesting that this is the initial lesion.

Adult↗
PubMed1985

[A technic for osteotomy of the malar bone].

On the basis of the results of osteotomy of the malar in malunion of facial fractures, the authors suggest the use of this operation in the correction of maxillary malformations including faulty development of the cheeks. Two cases are described.

Adolescent↗
PubMed1985

[Current trends in the treatment of mandibular osteoradionecrosis. Use of a sternocleidomastoid osteomyocutaneous flap].

An osteomusculocutaneous flap using the clavicle, and pedunculated on the sternocleidomastoid muscle, was used in two patients to repair loss of post-radicular mucosa and bone substance. Healing of mucosa and bone consolidation was obtained with evidence of production of bone callus on radiography. The hypothesis advanced to explain this reconstruction of necrosed mandible is the presence of the new vascular supply.

Bone Transplantation↗
PubMed1984

[One-stage surgical treatment of temporo-mandibular ankylosis and its facial deformity].

A patient with temporomandibular ankylosis was treated by resection of the ankylosed block followed by lengthening of the ascending ramus by an endoprosthesis. The place of the latter in the treatment of such lesions and the deformities that result from them is analyzed. Emphasis is laid on the value of displacement of the superior arch by a Le Fort I osteotomy in the correction of facial asymmetry in cases of laterognathia due to a mandibular development defect.

Adult↗
PubMed1984

[External temporomandibular ankylosis].

The predominant aetiology in 24 cases of temporomandibular ankylosis treated surgically since 1976 was trauma. Among the patients operated upon for post-traumatic ankylosis one anatomoclinical form could be identified characterized by an external block attaching the condylar neck to the zygomatic bone, and an internal joint by movement of the head or part of the condylar head. A favorable prognosis can be given in this type of lesion as resection of the block does not modify the height of the ascending ramus.

Adult↗
PubMed1984

[The dangers of Trauner's operation].

The technique described by Trauner for using retro-condylar cartilaginous implants is outlined, and the complications observed indicated. External or inferior luxation of the implant leads to recurrence of the deformity, whereas no inconvenience is caused by the opening of the joint. These pitfalls led to the use of a modified technique in which the cartilaginous implant is introduced into the supra-meniscal cavity of the temporo-mandibular joint.

Cartilage↗
PubMed1984

[Mandibular laterognathism and its treatment].

It is proposed to alter the classification of laterognathy due to excessive unilateral development of the mandible into hypercondyly and mandibular hemihypertrophy. Two forms are distinguished: those with occlusal modifications and those with conserved occlusal ratios and compensatory skeletal deformities usually involving the two stages. Treatment of laterognathy with occlusal deformity is usually by condylectomy--a simple operation with rapid results and excellent articular tolerance. Treatment of those forms with marked skeletal deformity is usually by condylectomy combined with a Lefort I of occlusal adaptation, surgery for the basilar border being difficult and aleatory except in the region of the chin.

Adolescent↗
PubMed1983

[Post-operative developments after resection of the mandibular body or angle for mandibular protrusion].

Teleradiographic examinations were conducted pre- and postoperatively and one year after resection of the body (5 cases) or angle (10 cases) of the mandible for mandibular protrusion in 15 patients. Clinical results of these operations appeared to be very stable, but teleradiographic modifications were observed constantly after one year. Resection of the body has little effect on the position of the ascending rami, whereas angle resection usually results in parasitic movements in this region, their pre-operative condition being re-established in practically all cases. Following shortening of the body there is an almost constant drop in the symphysial region. These movements appear to arise from activity of masticatory and suprahyoid muscles, with an accessory role being played by the tongue.

Adolescent↗