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Abstract: Recent advancement of head and neck surgery has been marked by the development of endoscopic and video-assisted minimally invasive surgery. This study reports the feasibility of endoscopic submandibular gland resection in human cadavers. Twelve submandibular gland resections were performed in six human cadavers. A 30° angle endoscope and conventional surgical instruments were inserted through two 15mm submandibular incisions. Dissection was carried out bluntly with scissors in an avascular plane superficial to the gland. No insufflation was needed since transcutaneous sutures lead to effective retraction. Facial vessels, the lingual nerve and Wharton''s duct were identified and protected. Vascular ligatures were performed using surgical miniclips. After the procedure, an open submandibular dissection was performed to control the integrity of the anatomical structures. In all cases, the resection of the submandibular gland was successful without the need for an additional incision. Injuries of the facial artery and lingual nerve occurred when the procedure was carried out initially. The operative time decreased with training, from 120min for the first cases to 35min for the later ones. In conclusion, endoscopic submandibular gland resection is possible without major difficulty. Training and experience reduce the operative time and the complication rate. [Copyright &y& Elsevier]

Abstract: Reconstruction of radionecrosis of the lower lumbar area is a challenging problem because of the difficulty of mobilization of the irradiated local tissues, absence of a reliable locoregional procedures and prolongation of the receiving vessels of the free flaps. The ideal treatment is a wide excision of the irradiated tissues and an immediate reconstruction in one step, which is better to be done by using a musculocutaneous flap. The latissimus dorsi musculocutaneous flap is ideal for this indication. The authors prefer to do the revascularization of the latissimus dorsi flap by its''thoracodorsal pedicle because of the possibility to have a high pressure blood flow which allow to use long venous bypass, the exposure of the recipient vessels at the same time of dissecting the flap and to have the anastamosis site away from the irradiated tissue. The authors are presenting their experience in treating a case of radionecrosis in the lower lumbar region with exposed vertebrae by a latissimus dorsi musculocutaneous free flap with exposed vertebrae by a latissimus dorsi musculocutaneous free flap with the lengthening of its''pedicle by two 30 cm interposition saphenous vein grafts. [Copyright &y& Elsevier]

The commisures are the two extremities of the mouth. They make a big complex in their architecture and their function. Their repairing should have an important attention to their final shape and function. The frequency of the retraction of the scarring tissue imposes additional muscular exercise which has to be premature, intense, and prolonged. [Copyright &y& Elsevier]

The attractive color of the red lip must be the object of very meticulous reconstruction in their form and pigmentation. This can be done only by using the buccal mucosa. The graf is less indicated. There are multiple local flaps that have been proposed using the same lip, the jugal mucosa and the tongue. The authors will show the principal procedures found in the literature. [Copyright &y& Elsevier]

Labial ageing process combining relaxation, distension and ptosis is aggravated by underlying structure modification: dental and bony. If the inferior lip moves back and collapses, the superior lip will go down and widen. The authors analyse the different ageing process components (intrinsic and extrinsic) as well as therapeutic principles. [Copyright &y& Elsevier]

The labial balance appreciated by statics and movement is the guarantee of morphology, bilabial competence and symmetry in function (ou bien in movement?). The restoration of the lips aims for this balance, the basic axiom is “to repair the lip by the lip”. Three main technical forms meet these requirements: forward movement, rotation and transposition. [Copyright &y& Elsevier]

The full-thickness tissue loss of the lip leads to the loss of lip continuity. The classic principle is to repair a lip with a lip, giving the best results. Although the size of tissue lost can force to use local flaps, these could be naso-labio-jugal, labio-mental or submental. Even though the microsurgical labial replantation is the technique of choice, unfortunately, most of the time it cannot be done as a result of the situation and the conservation of the avulsed fragment. [Copyright &y& Elsevier]

The aetiologies of the labial desequilibrium are multiple. They respond to the anomalies of the position and the dimension. The authors will enumerate the different variety and their etiology. [Copyright &y& Elsevier]