Results of an evaluation of clinical practice in orthognathic surgery in France in 2002

BACKGROUND: Over the years, orthognathic surgery has become a mainstay of maxillofacial surgery and is the object of many publications and oral communications. However, in spite of well-established methodology, disparities still exist in France basically concerning the way orthognathic surgery is performed. MATERIALS AND METHODS: In relation with the XXXIXth congress of Stomatology and Maxillofacial surgery, a questionnaire was mailed to 100 French maxillofacial surgeons. Questions dealing with some practical points of orthognathic surgery (condylar positioning, osteosynthesis technique, rate of condylar resorption.) were asked. RESULTS: Overall reply rate was 37%. Condylar positioning was performed empirically in 73% of the cases. Mandibular osteosynthesis was achieved by titanium miniplates alone in 70%. Post-operative condylar resorption rate was about 2%. This survey produced numerous astute comments. DISCUSSION: This survey highlighted the interest of maxillofacial surgeons for practical aspects of orthognathic surgery including the questions of condylar positioning or osteosynthesis technique. These points are instrumental in achieving high-quality surgical result.     

Use of ultrasound in detection of sinus disease in children

A prospective study utilizing a small, portable A-Mode ultrasound apparatus (Sinus-V 2500 Radionics Medical) was undertaken to screen children with signs and symptoms of sinusitis. Fifty-three children (age 2-16 years) were tested both by ultrasound and compared to standard radiographs of the paranasal sinuses. The sensitivity of the ultrasound to evaluate small, developing paranasal sinuses in children was low (22%). Sinus pathology, particularly mucosal thickening, was difficult to confirm. However, even opacified sinuses were only detectable in 58% of the time. Therefore, portable ultrasound devices to detect sinus disease in children, have limited usefulness for this particular population.     

Efficacy of Curcumin in the healing of paracentesis in rats

Objectives

The present study was designed to investigate the possible beneficial effect of Curcumin (CMN) in healing of paracentesis in terms of wound thickness, sclerosis and closure by histological evaluation. To evaluate the efficacy of CMN, paracentesis was performed experimentally in the rats; and the results were presented histologically.

Methods

Sixteen, each 270–310 g weighted, healthy Sprague-Dawley female rats were included into the study. In both groups, paracentesis was performed into the eardrum bilaterally. In Group 1 (Paracentesis + Saline Group), saline drop was applied; and in Group 2 (Paracentesis + Curcumin group), Curcumin drop treatment was applied. Paracentesis area did not healed bilaterally in two rats (one in Group 1 and one in Group 2). Therefore, these two rats were excluded from the study. Histological examination performed in 14 rats and 28 temporal bones on the 15th day after the completion of drop treatment and closure of the paracentesis-area and wound healing were evaluated according to the histological examination criteria: Thickening of the tympanic membrane (ThicTM); and sclerosis.

Results

Both tympanic membrane thickening and sclerosis values of Paracentesis + Curcumin Group (Group 2) were significantly lower than those of the Paracentesis + Saline Group's (median: 2.0) (p = 0.001). Histological examination by light microscopy showed that in Paracentesis + Curcumin Group (Group 2), the structure of the tympanic membrane is near to the normal and decreased sclerosis was observed in connective tissue. Whereas in Paracentesis + Saline Group (Group 1), tympanic membrane thickening and connective tissue sclerosis were observed.

Conclusions

Curcumin improves wound healing process in paracentesis of TM. By using Curcumin drops, the closured paracentesis area was observed near to the normal eardrum; and thickness of the TM and sclerosis were less than the control, showing the improved healing at 15th day. The possible mechanisms may be anti-inflammatory effect, improving collagen deposition, and increasing fibroblast and vascular density in wounds thereby enhancing impaired wound healing.     

Role of angiogenesis in the pathogenesis of cholesteatoma in adults

The aim of the study was to compare the vessels among cholesteatoma perimatrix, cholesterol granuloma and skin sections and to investigate the localization and expression of CD34 antigen. 14 cholesteatoma specimens were used in this study. Comparative material consisted of skin specimens taken from the retroauricular area during the ear surgical procedure and 4 specimens of cholesterol granuloma collected from children. Monoclonal mouse antibodies against human CD34 were used for immunohistochemistry which was performed using a standard labelled avidin-biotin technique. Automatic imaging analyzing system was used for counting. The skin specimens showed presence of small blood vessels in the subepithelial area and around the glands. The mean number of the vessels in these specimens was 5.44/mm2 and the mean relative proportion of total vessel area/total area of connective tissue: 4.9+/-2.0%. In the specimens of cholesterol granuloma the mean number of vessels was 34.06+/-21.2/mm2 and the mean relative proportion of total vessel area/total area of connective tissue: 22.1+/-3.1%. In cholesteatoma perimatrix, the mean number of microvessels calculated within 1 mm2 of the subepithelial connective tissue was significantly higher (22.79+/-11.2/mm2) and the mean relative proportion of total vessel area/total area of the perimatrix was 12.1+/-2.8%. Angiogenesis appear in the subepithelial connective tissue of cholesteatoma (perimatrix). The process of angiogenesis makes possible and sustains the migration of keratinocytes into the cavity of the middle ear, their increased proliferation and the expansion of cholesteatoma. Therefore, angiogenesis is considered to be one of the destructive features of this disease.     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

Change in Serotonin Level in the Organism in Cases of Hypoxia

This study was performed on both volunteers and test animals subjected to different extreme effects, causing different types of hypoxia. It is found that at high initial values of blood serotonin, the organism is more resistant to hypoxia. In individuals in whom the serotonin level is increased after extreme impacts, the hypoxic state is less readily sustained. The results of this study are used for determining the individual reactivity of an organism to hypoxia and for selecting for hire persons who may be required to work in extreme conditions.     

Complications of otitis media in children in the era of antibioticotherapy

Otogenic complications in children occur most commonly secondarily to acute otitis media. Intratemporal complications are predominant and mastoiditis is most frequently seen. Meningitis in the course of acute otitis media is the most common intracranial complication. Complications of chronic otitis media are rare today, but can be more difficult to diagnose, because antibiotics may mask symptoms and change clinical presentation. Antibiotic use, however, has not completely eradicated the otogenic complications and ENT doctors should remember about this possibility.     

The use of Preyer's reflex in evaluation of hearing in mice

Preyer's reflex, the elicitation of startle response to auditory stimuli, has been widely used for the evaluation of hearing in rodents and other animals. Surprisingly, however, the sensitivity and specificity of Preyer's reflex in the assessment of hearing has not been adequately studied. The aim of this study was to investigate the utility of Preyer's reflex in the evaluation of auditory function in mice. Forty-six adult albino mice on an FVB background with variable hearing loss were used for this study. Two different methods for eliciting a Preyer's reflex were tested: a handclap and a sharp metallic sound. The reflex was considered positive when a rapid movement of the whole body of the animal was clearly noticed. Thereafter, the mice underwent auditory brain stem response (ABR) testing with broadband clicks. The presence or absence of Preyer's reflex was compared with the corresponding ABR thresholds. Five of the 46 animals studied (11%) showed a negative Preyer's reflex, while the remaining 41 animals demonstrated a positive Preyer's reflex. There was no difference between the abilities of the two different stimuli to elicit a Preyer's reflex. The click-evoked ABR thresholds in the test animals varied between 8 and 136 (mean 50) dB sound pressure level (SPL). Preyer's reflex was positive in all animals with an ABR threshold of < or = 76 dB SPL, but was absent in animals with an ABR threshold of > or = 81 dB SPL. Preyer's reflex is effective for identifying profound sensorineural hearing loss in experimental mice, but is insensitive for detecting less severe auditory dysfunction. For definitive hearing assessment, and for defining the hearing thresholds. objective electroacoustical methods such as ABR should be used.     

电子鼻咽喉镜在小儿腺样体肥大诊治中的应用

目的 探讨电子鼻咽喉镜在小儿腺样体肥大诊治中的应用。方法 对578例具有上气道阻塞症状的患儿（病例组）采用电子鼻咽喉镜检查，分析腺样体增大程度与上气道阻塞的关系及其可行性。结果 ①本组病例中，411例能主动配合，119例稍有哭闹，仅48例是在协助固定体位下进行。②14例因鼻中隔偏曲导致一侧后鼻孔和鼻咽部无法检查，5例因双侧鼻腔狭窄无法检查，其余559例均可检查。③559例均有不同程度的腺样体增大。④29例在检查中出现鼻黏膜少量出血，未引发其他并发症。结论 电子鼻咽喉镜检查适合于小儿，该法直观、准确、安全，是判断小儿腺样体肥大最有效、最直观的检查方法。Ⅳ°腺样体是小儿上气道阻塞的主要病因，是手术治疗的适应证。     

Study of aberrant methylation of TSG in saliva in case of upper-aerodigestive-tract cancer

CURRENT SITUATION: Early detection of the relapse in case of tumor located in the upper aerodigestive tract (UADT) is an important point for improving prognosis. Clinical control has not been efficient and, until today, no biological biomarker has been validated for surveillance of patients. In a preliminary study, we have shown the benefit of the methylation status of six tumor suppressor genes (TSG): TIMP3, ECAD, p16, MGMT, DAPK, and RASSF1A in saliva for early diagnosis of tumor relapse. The main objective of this second study is to confirm the initial results. MATERIAL AND METHODS: This is a bicenter, prospective, diagnostic, single-blind study. The study started in December 2007, running for one year. The main inclusion criterion is a patient with squamous-cell carcinoma of the oral cavity or the oropharynx, stages I to II, without previous treatment for this location. Eighty patients will be included. The data analysis will use a multivariate Cox model. EXPECTED RESULTS: If our preliminary results are confirmed, identification of methylations in saliva would be able to constitute the first usable biomarker, for the follow-up of patients with UADT cancer.