title: Management of Large Maxillomandibular Osteofibrous Dysplasia as Part of a Humanitarian Mission.
abstract: OBJECTIVE
  Maxillomandibular ossifying fibroma is a benign tumor that affects young adults. Complete excision can allow satisfactory management with no recurrence. During a humanitarian mission, one is confronted with many types of damage from these fibromas. Their management requires wide resection (mandibulectomy interrupter or maxillectomy) and free flap reconstruction. However, technical conditions during a humanitarian mission might not allow the performance of a free flap reconstruction. How can such patients be managed? Should these patients receive a straightforward intervention performed on site during the mission or should they go to another country with a technical platform suitable for microsurgical reconstruction?
  
  
  METHODS
  During a humanitarian mission in Ouagadougou, Burkina Faso, 6 patients with large ossifying fibromas traveled to France to undergo wide excision of the lesion and free flap reconstruction using the fibula. The Enfants du Noma paid for the travel and medical costs.
  
  
  RESULTS
  No flap was lost. Four patients (67%) had local (disunity of scar or local infection) or general (malaria) complications that quickly resolved.
  
  
  CONCLUSIONS
  Most teams agree that free flaps should not be performed during humanitarian missions, and only 1 German team practices in Sokoto, Nigeria. Therefore, medical travel is an attractive solution that allows optimal management and requires financial assistance from humanitarian organizations.
authors.affiliation: Maxillofacial Surgeon and PhD Student, Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen; UNICAEN, EA4652 Equipe BioConnecT, Caen; Medicine Faculty of Caen, University of Caen Basse Normandie, Caen, France. Electronic address: alexis.veyssiere@hotmail.fr.
authors.forename: Alexis
authors.initials: A
authors.lastname: Veyssière
authors.affiliation: Maxillofacial Surgeon, Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen; Medicine Faculty of Caen, University of Caen Basse Normandie, Caen, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Ambroise
authors.affiliation: Maxillofacial Surgeon, Department of Maxillofacial Surgery, National Center of Dentistry and Oral Surgery, Bamako, Mali.
authors.forename: Hamady
authors.initials: H
authors.lastname: Traoré
authors.affiliation: Maxillofacial Surgeon, Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Chatellier
authors.affiliation: Maxillofacial Surgeon, Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen; Medicine Faculty of Caen, University of Caen Basse Normandie, Caen, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Caillot
authors.affiliation: Maxillofacial Surgeon, Professor and Department Head, Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen; UNICAEN, EA4652 Equipe BioConnecT, Caen; Medicine Faculty of Caen, University of Caen Basse Normandie, Caen, France.
authors.forename: Bénateau
authors.initials: B
authors.lastname: Hervé
mesh_terms: D000293:Adolescent; D000328:Adult; D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002050:Burkina Faso; D002648:Child; D006801:Humans; D007571:Jaw Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D063175:Mandibular Reconstruction / Q000379:methods; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008493:Medical Missions; D014057:Tomography, X-Ray Computed; D055815:Young Adult