title: [Orbital congenital nevi: Principles of treatment about 51 cases].
abstract: BACKGROUND
  The incidence of congenital nevi is one over 20,000 newborns per year, 14 % of them are located in the head and neck area. Nevi of the orbital region are particularly difficult to handle on the aesthetic and functional side. The objectives of this study were to conduct an analysis of different clinical presentations of congenital nevi of the eyelid orbital region in children to establish a treatment algorithm.
  
  
  METHODS
  We realised a bi-centric retrospective study including 51 children with orbito-palpebral congenital nevi. We analysed the different clinical presentations, their treatments and their results.
  
  
  RESULTS
  Nineteen underwent direct suture excision; three a total skin graft; 15 a combination of treatments, among them four underwent tissular expansion and 14 patients were not operated and clinically followed-up. The average follow-up time was 6.6 years. In 33 cases residual nevic area was still present. The postoperative sequelae were: dyschromia (n=17), anatomical deformation of the eye (n=10), nevi outbreaks (n=8), internal canthus deformation (n=5) and ectropion (n=1).
  
  
  CONCLUSIONS
  The results of our study show that therapeutic abstention is preferred when the aesthetic wrong is accepted by the patient and when there is not a higher risk of malignant degeneration. In order to minimise the risk of postoperative sequelae, we propose a therapeutic algorithm for the management of congenital orbital nevi.
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Adjadj
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Debelmas
authors.affiliation: Service de chirurgie plastique, CHU de Reims, 51000 Reims, France; UFR de médecine, université de Reims-Champagne-Ardennes, 51000 Reims, France.
authors.forename: C
authors.initials: C
authors.lastname: Franois-Fiquet
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France.
authors.forename: P-A
authors.initials: PA
authors.lastname: Diner
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Buis
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Franchi
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Chrétien-Marquet
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France.
authors.forename: M-P
authors.initials: MP
authors.lastname: Vazquez
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Picard
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France. Electronic address: natacha.kadlub@nck.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Kadlub
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004954:Esthetics; D005142:Eyelid Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009506:Nevus / Q000151:congenital* / Q000601:surgery*; D009918:Orbital Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000151:congenital* / Q000601:surgery*; D016038:Skin Transplantation; D013536:Suture Techniques; D015626:Tissue Expansion; D055815:Young Adult
keywords: Chirurgie pédiatrique; Congenital nevi; Nævus congénital; Orbito-palpebral; Orbito-palpébral; Pediatric surgery