Reconstruction du ramus mandibulaire par greffe chondro-costale (étude rétrospective à propos de 54 cas)

La reconstruction du ramus mandibulaire est réalisée chez l'enfant et l'adulte, dans des indications d'hypoplasie mandibulaire ou de destruction articulaire pour des étiologies congénitales (dysplasie otomandibulaire) ou acquises (ankylose, arthropathie dégénérative). Nous avons réalisé 74 greffes chondro-costales sur 54 patients depuis 1990. Sur le plan fonctionnel, nos résultats ont montré une amélioration significative de l'ouverture buccale chez les patients porteurs d'une dysfonction sévère (OB pré-opératoire = 8,7 mm, OB post-opératoire = 24,7 mm, p=0,002). Sur le plan architectural, nos résultats ont montré un allongement de la branche montante important, significatif et stable (9mm, p<0,0001). Les complications sévères étaient l'infectionà court terme, et l'hypercroissance ou la récidive à long terme. Notre série est comparable à celles de la littérature. Des alternatives thérapeutiques telles que la prothèse temporo-mandibulaire et la distraction ostéogénique sont à discuter en fonction de l'âge du patient, de l'existence d'une dysfonction articulaire, et de la sévérité de l'insuffisance verticale postérieure.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

The Matrix Matters: Beverage Carbonation Impacts the Timing of Caffeine Effects on Sustained Attention

Both caffeine and the perception of refreshment delivered by cooling, tingling, and mouth-watering flavors have individually been shown to positively impact cognitive performance and mood, though presently there is limited evidence on their possible combined effects. This study explored the contribution of refreshing compounds in beverages, namely, carbon dioxide and citric acid, on the acute effects of caffeine on sustained attention and self-rated physical and mental energy. A randomized, controlled crossover trial was conducted by testing three products: a carbonated caffeinated beverage; a comparator caffeinated beverage; and a flavor-matched control beverage. Findings from 24 healthy adults revealed product-dependent variations in cognitive performance during a 60-min visual sustained-attention task, suggesting that the carbonated-caffeinated beverage led to faster, greater and more consistent levels of accuracy, compared to the control beverage. Specifically, significant differences were found between: (1) the carbonated-caffeinated beverage and the caffeinated beverage, and (2) between the caffeinated beverage and the control beverage for number of hits, reaction time and false alarm scores. Both caffeinated beverages led to higher physical and mental energy, and lower physical and mental fatigue 60-min post-consumption. These findings suggest beneficial effects on sustained attention through the combination of caffeine with refreshing compounds

Reconstruction techniques of the orbit after Brown class III maxillectomy : A systematic review

International audienceThis systematic review aimed to evaluate the surgical techniques used for orbital floor reconstruction after Brown class III maxillectomy for cancer. Three databases were searched from January 1990 to January 2022. Of the 614 studies identified, 20 were retained after eligibility assessment. The surgical techniques were classified into four groups: free bone flaps (A), alloplastic implants (B), bone grafts (C), and soft-tissue reconstructions (D). Ectropion and diplopia concerned 42.6% and 6.6% of the patients, respectively. Soft tissue reconstruction was more likely to cause ectropion (17/27), followed by the reconstruction techniques of group B (34/79), group C (26/70), and group A (1/7). Postoperative enophthalmos was identified in 18 patients (9.6%), mostly in group D (5/35), followed by groups B (8/68), A (3/33), and C (2/52). Free bone flaps and alloplastic implants represent good reconstructive options in terms of postoperative ocular parameters

Ameloblastic fibrosarcoma of the mandible: case report and literature review

Introduction: Ameloblastic fibrosarcoma is a rare malignant odontogenic tumor. Over 50% reported cases have histological evidence of ameloblastic fibroma at the same site. The mortality rate of the tumor is 19% and its recurrence rate is 37%, which mandates a total resection along with long-term follow-up. Observation: We present the case of a 14-year-old male diagnosed with ameloblastic fibrosarcoma, who underwent multiple stages of treatments and was followed up over 8 years. The initial management consisted of a total tumor resection with chemoradiotherapy. Then, for bone, soft, mucosal, and dental restoration after resection, mandibular reconstruction with a fibula free flap, onlay iliac graft, iliac graft fixation, facial lipofilling treatments (two), vestibular deepening procedures (two), and implant-supported dental prosthesis were performed. Comments and conclusion: This is the first case reported in the literature for the global management of mandibular ameloblastic fibrosarcoma, from oncological treatment to functional and aesthetic long-term rehabilitation

IL-7 receptor blockade following T cell depletion promotes long-term allograft survival

T cell depletion is commonly used in organ transplantation for immunosuppression; however, a restoration of T cell homeostasis following depletion leads to increased memory T cells, which may promote transplant rejection. The cytokine IL-7 is important for controlling lymphopoiesis under both normal and lymphopenic conditions. Here, we investigated whether blocking IL-7 signaling with a mAb that targets IL-7 receptor α (IL-7Rα) alone or following T cell depletion confers an advantage for allograft survival in murine transplant models. We found that IL-7R blockade alone induced indefinite pancreatic islet allograft survival if anti-IL-7R treatment was started 3 weeks before graft. IL-7R blockade following anti-CD4- and anti-CD8-mediated T cell depletion markedly prolonged skin allograft survival. Furthermore, IL-7 inhibition in combination with T cell depletion synergized with either CTLA-4Ig administration or suboptimal doses of tacrolimus to induce long-term skin graft acceptance in this stringent transplant model. Together, these therapies inhibited T cell reconstitution, decreased memory T cell numbers, increased the relative frequency of Tregs, and abrogated both cellular and humoral alloimmune responses. Our data suggest that IL-7R blockade following T cell depletion has potential as a robust, immunosuppressive therapy in transplantation

Jaw osteosarcoma models in mice: first description

Abstract Background Osteosarcoma (OS) is the most common cancer of bone. Jaw osteosarcoma (JOS) is rare and it differs from other OS in terms of the time of occurrence (two decades later) and better survival. The aim of our work was to develop and characterize specific mouse models of JOS. Methods Syngenic and xenogenic models of JOS were developed in mice using mouse (MOS-J) and human (HOS1544) osteosarcoma cell lines, respectively. An orthotopic patient-derived xenograft model (PDX) was also developed from a mandibular biopsy. These models were characterized at the histological and micro-CT imaging levels, as well as in terms of tumor growth and metastatic spread. Results Homogeneous tumor growth was observed in both the HOS1544 and the MOS-J JOS models by injection of 0.25 × 106 and 0.50 × 106 tumor cells, respectively, at perimandibular sites. Histological characterization of the tumors revealed features consistent with high grade conventional osteosarcoma, and the micro-CT analysis revealed both osteogenic and osteolytic lesions. Early metastasis was encountered at day 14 in the xenogenic model, while there were no metastatic lesions in the syngenic model and in the PDX models. Conclusion We describe the first animal model of JOS and its potential use for therapeutic applications. This model needs to be compared with the usual long-bone osteosarcoma models to investigate potential differences in the bone microenvironment

Donor site sequelae and patient satisfaction after head and neck reconstruction with a radial forearm free flap

International audiencePurpose Radial forearm free flap (RFFF) being a workhorse flap in head and neck reconstruction, we investigated its donor site delayed consequences. Methods Multicentric case series evaluating 189 patients who underwent RFFF for carcinologic reasons at least 6 months before. Patients and surgeon's appreciation regarding the aesthetic and functional consequences of the flap harvest on their daily life were evaluated by questionnaires using likert scales. Medical data were collected from patients' charts retrospectively. Results Thirty percent of patients had at least one sequelae. Experiencing a graft necrosis did not worsen long-term results. Cosmetic satisfaction was significantly worst for women, according to patients' and surgeons' opinion. For 81% and 92% patients, respectively, the flap harvest had no impact on daily life nor sport practice. Ratio between the benefits of reconstruction and the sequelae at the donor site was judged ``excellent'' for 77% patients. Conclusions Although objectively important, RFFF morbidity has little impact in head and neck cancer patient's life

European Maxillofacial Trauma (EURMAT) in children: A multicenter and prospective study

Objective. The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. Study Design. The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years. Results. The most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures. Conclusions. Falls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after 10 years may be a reason to increase the use of mouthguards and other protective equipment. Finally, the mandible (and in particular the condyle) was confirmed as the most frequent fracture site