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Orthopedic or surgical repair is proposed for mandibular fractures, depending on schools and experience. We reviewed retrospectively 632 cases of mandibular fracture treated at the Poitiers University department of maxillofacial surgery between 1978 and 1997 to assess methods and outcome. We performed a global analysis and compared certain localizations with statistical tests. Different therapeutic protocols were used. The rate of complication was greater, for an equivalent initial lesion, with surgical compared with medical treatment. This was particularly true for fractures involving the jaw angle. There was no significant correlation between trauma-induced malocclusions and orthopedic or surgical preferences of the operators. Surgery did not lead to more sequelae than other techniques but did require a rigorous technique and surgical experience to limit complications. Joint fractures were associated with a high rate of complications, whatever the therapeutic method.

Purpose: To analyse retrospectively the results of different treatment regimens of carcinomas of the floor of the mouth and tongue., Materials and Methods: Between 1982 and 1992, 61 patients with carcinoma of the floor of the mouth and 30 with tongue cancer (25 stage I, nine stage II, 28 stage III, 29 stage IV) were treated in the radiotherapy department of Poitiers. Nine patients with stage I tumours were treated with 70 Gy low-dose rate brachytherapy only, without nodal dissection. Stages II and III were treated with combined surgery with neck dissection; and radiotherapy of stage II with nodal metastasis and for all stage III cases. Stage IV cases were treated either surgically if possible, or with combined chemotherapy and radiation., Results: The five-year overall survival rate was 87.3% for stage I, 68.5% for stage II, 45.3% for stage III, and 0% for stage IV patients. Most relapses appeared in the first two years after treatment. Eight patients (32%) with stage I cancer developed nodal relapses, isolated in five cases. Complications of radiotherapy were acceptable. Four cases of osteonecrosis were observed after radiotherapy. All of these appeared simultaneously with a local relapse., Conclusion: These results are comparable with reports in the literature. The remarkable observation of our study is the high incidence of nodal recurrences after local treatment of stage I tumours. Therefore, local treatment is insufficient for early-stage tumours. The question of neck dissection for the early stage is discussed.

The authors report a case of post-traumatic jugal lymphatical effusions associated to a fistula of Stensen's Duct. The lesions have healed by placing a suction drainage without modelling catheterism.

The authors report on the experiment carried out on the use of sodium nitroprusside (NPS) in otological surgery. The acknowledged advantages of NPS over hypotensors and more particularly its spécifically vascular, périphéral, swift action, rapidly reversible, are worth mentioning. Control over the achieved hypotension however, requires careful attention to avoid overdosage which could result in severe hypotension and "cyanhydric" intoxication. The recording of capillary pulse constitutes an easy and reliable solution to the difficulties arising from permanent control of blood-pressure and of peripheral arterial perfusion. The method both produces excellent results permitting bloodless surgery, and allows a reduction of NPS doses giver, without resorting to a invasive for measuring blood pressure. The method used in surgical fields other than otology has already proved very satisfactory.

The dynamic anatomy of STENSEN's duct is somewhat different from what is usually accepted. GUERRIER, COURBIER and FRANCHEBOIS had indeed admitted that the buccinator msucle acted as a passive sphincter, without however mentioning the presence of terminal siphons and canalar valvules and without drawing particular attention to their dynamic relationship. This duct should not be considered inert, as part of a theoretical bayonet-like pathway which is more topographical than functional: the buccinator muscle and STENSEN's duct with its valvules and terminal siphons should be considered together as forming the real salivation apparatus.

A patient with a bullet wound developed an initially unrecognized vascular lesion revealed after five weeks by a cataclysmic hemorrhagic complication during drainage attempts. Literature on cervicofacial ballistic injuries is reviewed and the practical attitude to adopt with these lesions discussed.