Search PubMed⌕ Search

Biomedical subjects

P Tessier

Publications and source records attributed to P Tessier.

At least 55 records · Page 3Linked to original sources
PubMed1981

Fronto-facial advancement for Crouzon's and Apert's syndromes.

This paper reviews the evolution of the surgical approach to the facial deformities in Crouzon's and Apert's syndromes. Since the first high maxillary osteotomy performed via an extracranial approach, various procedures have been used. These procedures were, successively, the intracranial route permitting simultaneous advancement of the mid-face and frontal bone in adult; then the use of trephine holes to protect the dura and brain during osteotomies obviating the need for a craniotomy. Likewise, more precise craniofacial fixation by interosseous wiring and bone grafting frequently obviate the need for intermaxillary fixation. More recently the fronto-facial advancement in one piece has been used in children between 4 and 10 years of age. The advantages and disadvantages of this procedure are considered.

Child↗
PubMed1981

Mandibulo-facial dysostosis. Analysis; principles of surgery.

Before regarding the treatment of facial deformities in mandibulo-facial dysostosis, the clinical, radiological and anatomical findings are reviewed. The plastic surgical correction of the main deformities are then considered. The aims of the treatment are: close the palpebral coloboma, build the zygomatic bones and zygomatic arches, correct the malformation of the auricles and the macrostomia, re-establish normal dental occlusion if necessary and harmonize the profile by reducing the nose and excessive vertical dimension of the mental symphysis.

Adolescent↗
PubMed1981

[Compatibility between primary cranial surgery and secondary cranio-facial surgery (author's transl)].

Craniofacial surgery can radically correct the most severe dysmorphias of fronto nasal encephaloceles, trigonocephaly, plagiocephaly, telorbitism, Crouzon, Apert, Chotzen... Its procedures can make to normal their general morphology, the projection of the mid face and maxilla, centering and inter relationship of the orbital cavities. It can also correct or improve many dysfunctions such as : naso-pharyngeal atresia, dental malocclusion, exorbitism, exotropia and, consequently, strabismus. According to syndromes and degree of severity, craniofacial surgery is undertaken between 2 to 10 years of age. This surgery is both cranial and facial, it uses or passes through the "orbito frontal bandeau" : glabella (frontal sinus), orbital roof, supra-orbital ridges down to the fronto-zygomatic sutures. Consequently, primary cranial surgery must not make impracticable the procedures of secondary craniofacial surgery. Consequently, the neuro-surgeon - acting as a cranial surgeon - must keep intact the "orbito-frontal bandeau" 25 mm high, orbital roof and the fronto-zygomatic sutures, included and also temporal crests and temporal muscles. When these elements have been dissected or removed, they must be replaced or reconstructed. Moreover, bone grafts assigned to the fixation or construction of the mid face are more and more often harvested from the parietal bones. Consequently, the parietal bones may be isolated by craniotomies; they must not be destroyed by craniectomies.

Face↗
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

[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

[Treatment of Binder's maxillonasal dysostosis (author's transl)].

The treatment of Binder's maxillonasal dysostosis raises many problems and difficulties of both orthodontic and surgical natures. Orthodontic therapy should be conducted as early as possible and include, principally, an advancement of the maxilla by heavy extra-oral postero-anterior traction on an orthodontic mask. If good occlusion is obtained the patient can then be treated to improve the anatomical conditions of the muscles of the nose and upper lip. Maxillary, and more rarely mandibular osteotomies are indicated in cases with poor occlusion. When occlusion is reasonably good the hypoplasia has to be compensated for by using large portions of ilac bone to reconstruct the ridge and point of the nose. A preseptal graft on the ridge and secondarily, revisions of the point of the nose are often essential to ensure the best results.

Adolescent↗