Search

Introduction: Sialendoscopy and sialo-MRI enable diagnosis of salivary gland obstructive pathologies, such as lithiasis, stenosis and dilatations. Therefore, a classification of these pathologies is needed, allowing large series comparisons, for better diagnosis and treatment of salivary pathologies., Material and Methods: With help from people from the European Sialendoscopy Training Center (ESTC), the results of sialographies, sialoMRI and sialendoscopies, a comprehensive classification of obstructive salivary pathologies is described, based on the absence or presence of lithiasis (L), stenosis (S) and dilatation (D) ("LSD" classification)., Discussion: It appears that a classification of salivary gland obstructive pathologies should be described. We hope it will be widely used and of course criticized to be improved and to compare the results of salivary gland diagnostic methods, such as sialography and sialendoscopy and also the results and indications for salivary gland therapeutic methods, such as lithotripsy, sialendoscopy and/or open surgery.

Introduction: Sialendoscopy and sialoMRI enables diagnosis of salivary gland obstructive pathologies, such as lithiasis, stenosis, and dilatations. Therefore, a classification of these pathologies is needed, allowing large series comparisons, for better diagnosis and treatment of salivary pathologies., Material and Methods: With help from people from the European Sialendoscopy Training Center (ESTC), the results of sialographies, sialoMRI and sialendoscopies, a comprehensive classification of obstructive salivary pathologies is described, based on the absence or presence of lithiasis (L), stenosis (S), and dilatation (D) ("LSD" classification)., Discussion: It appears that a classification of salivary gland obstructive pathologies should be described. We hope it will be widely used and of course criticized to be improved and to compare the results of salivary gland diagnostic methods, such as sialography and sialendoscopy, and also the results and indications for salivary gland therapeutic methods, such as lithotripsy, sialendoscopy, and/or open surgery.

Increasingly today, dacryocystorhinostomy seems to be the common obligatory path to functional surgery in case of traumatic lesions of the lacrimal ducts. The endonasal approach provides direct access to the nasolacrimal canal, while permitting to avoid the cutaneous approach through tissues that may be coming apart. The use of optic endoscopes renders the operation easier and provides access to the dome of the lacrimal sac, which is impossible under conventional endonasal microscopy. Monitoring and postoperative care are carried out with the same instrument, thereby improving the quality of the end result. The operation usually takes place under potentiated local anesthesia and lasts one hour, on average. The various surgical steps are described and particular attention is given to endonasal localization of the lacrimal ducts and to the technique of marsupialization.

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.

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.