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Biomedical subjects

M Lejour

Publications and source records attributed to M Lejour.

At least 37 records · Page 2Linked to original sources
PubMed1989

Anatomy of the orbicularis oris muscle in cleft lip.

The anatomy of the orbicularis oris muscle was studied using histological sections of 18 operative specimens of unilateral cleft lip (14 incomplete and 4 complete). In incomplete clefts the intrinsic part of the orbicularis, located in the vermilion, is simply interrupted without distortion. The extrinsic part, lying higher in the lip, crosses the cleft but is distorted vertically according to the degree of the nasal deformity. In complete clefts the intrinsic bundle ends in the submucosa of the vermilion as in incomplete clefts. The extrinsic bundle is deviated towards the ala nasi on the lateral side. On the medial side, the fibres are rarer and more horizontal. Conclusions are drawn regarding reorientation of the muscle fibres during cheiloplasty.

Cleft Lip↗
PubMed1989

Pterygium colli: surgical treatment.

The authors report three cases of pterygium colli. Two of them presented as part of Turner's syndrome and were treated following a personal technique. The third, which was probably due to jugular lymphatic obstruction, was treated according to the butterfly excision technique of Shearin.

Adolescent↗
PubMed1989

Reconstructive options after cancer surgery of the breast.

Breast cancer is now treated either by conservative therapy or by mastectomy. In the first case, no reconstruction is usually necessary, although some patients require additional surgery for asymmetry, distortion or even severe damage, by surgery or radiotherapy, of the treated breast. In these cases, reconstructive surgery should be performed very carefully, taking full account of the risk of operating in irradiated tissues. Minor procedures are usually adequate, but major surgery, reconstruction with abdominal flap, is sometimes the only solution to solve difficult postradiotherapy disasters. When a mastectomy is the choice of the patient and the surgeon, immediate reconstruction is now performed more often than before, as expansive prostheses are now available, allowing immediate implantation without endangering the skin flaps. In most cases of mastectomy, however, reconstruction is performed as a secondary procedure, in two stages if possible (volume and symmetry after the first, areola after the second). Most of the reconstructions are done by simple implantation of a prosthesis. When local conditions require a flap, the latissimus dorsi musculocutaneous has been the best choice for years, but the lower rectus flap is now taking over, as it gives the advantage of reconstructing a breast with autologous tissue.

Breast Neoplasms↗
PubMed1988

Innervation of the rectus abdominis muscle: implications for rectus flaps.

The usefulness of leaving lateral strips of the rectus abdominis muscle in place during a transverse rectus abdominis musculocutaneous (TRAM) flap procedure is questioned. Since textbooks do not agree on the course of the intercostal nerves in the rectus fascia and no precise description is given of the exact site of penetration of the nerves in the rectus muscle, six fresh cadavers were dissected. It has been observed that the nerves enter the deep face of the muscle in its middle portion. Lateral parts of the muscle are consequently denervated during a transverse rectus abdominis musculocutaneous flap, which preserves them. This has been confirmed by CT scan of the abdominal wall in 10 patients 2 to 37 months after a transverse rectus abdominis musculocutaneous flap. In these patients, a progressive fibrosis and disappearance of the remaining muscle could be demonstrated. It is concluded that a partial taking of the rectus abdominis muscle does not preserve its muscular function.

Abdominal Muscles↗
PubMed1988

Analysis of long-term results of 326 breast reconstructions.

It has been the experience of many surgeons that results following breast reconstruction change with time. To evaluate long-term results, the 350 breast reconstructions performed in the authors' department from January 1977 to April 1986 were reviewed. The results of the 326 cases in which there were sufficient data are presented here, and some late results are shown.

Breast↗
PubMed1986

Routine reinsertion of the hump in rhinoplasty.

Reinsertion of the hump as a free graft, a technique based on the rhinoplasty described by Skoog, has been performed for more than 10 years in severely deviated noses to hide residual deformities of the septum after rhinoplasty. The results have been so encouraging that this technique is now routinely used in all rhinoplasties requiring a reduction of the profile. Grafting the hump after remodelling gives a natural aspect to the dorsum, especially in patients with thin skin where irregularities of sharp edges of the cut nasal bones are otherwise often seen. The hump is tailored into a thin composite graft (bone + cartilage) 3-4 cm long and 3-5 mm broad. No major complications have been observed. 32 cases have been reviewed after a mean delay of 24 months. 29 show radiographic evidence of bone graft survival although no fusion with the nasal bones is observed. It is suggested that facial bone grafts survive better in the nose than grafts taken from the iliac crest or the ribs.

Humans↗
PubMed1985

[Selected reconstructive technics in the surgery of cancers of the face].

The technique of facial reconstruction used by the plastic team at the Cancer Center of the University of Brussels are presented. Free grafts are seldom performed because they often lead to disfigurement. An appropriate evaluation of the margins of resection is obtained during the operation by multiple frozen sections, and reconstruction is achieved by local flaps when possible. It is considered that a normal appearance is of extreme importance for old patients suffering from facial cancer, and that the aim of surgery is not only complete eradication of the lesion but also careful reconstruction of the removed structures by simple and safe procedures. The selected techniques are presented for each region of the face.

Aged↗
PubMed1983

Experience with 33 epigastric rectus flaps in breast reconstruction.

The contralateral epigastric rectus flap (ERF) is a myocutaneous island flap, including epigastric skin, and the upper part of the rectus abdominis muscle with the superior epigastric artery. It measures at least 20 X 8 cm. In breast reconstruction, the ERF is transferred from the normal side to the mastectomized side on its vascular pedicle. The donor site is hidden in the submammary fold. The ERF has many advantages over the latissimus flap (larger amount of skin, skin comparable to breast skin, that can be taken without position change during surgery, no muscle dysfunction, no donor site in the back, upper abdominal lift with major addition of homolateral epigastric skin to the reconstruction), but is not so suitable in patients with thin or irradiated skin. Compared to the lower rectus flap, it is a less extensive procedure with no abdominal scar, but it brings less adipose tissue to the reconstructed breast.

Abdominal Muscles↗
PubMed1982

Primary lengthening of the columella in bilateral clefts of the lip.

Children with bilateral complete cleft lip and palate were treated by a two stage repair of the lip and nasal floor, including a small prolabial flap to lengthen the columella according to the technique of Skoog. Seventeen of these children, now at least 2 years of age were reviewed. In no case was normal length of the columella obtained, six children had obvious scars, in five the flap bulged at the base of the columella, and in four there was a displacement of the flap toward the lip. Three cases have already required a secondary forked flap. We concluded that the results of this procedure are inconsistent and od not justify the additional scarring.

Child↗