Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 34 , Issue 7
Showing 1-30 articles out of 30 articles from the selected issue
  • Kenji YOSHIDA
    1988 Volume 34 Issue 7 Pages 1237-1254
    Published: July 20, 1988
    Released: July 25, 2011
    This study was made in order to obtain the post-operative profile image in cases of surgical correction of mandibular prognathic patients for reference.
    The equations for predicting X, Y measurements of post-operative soft tissue points were derived by means of stepwise multiple regression on the basis of pre-and post-operative lateral cephalometric data of 100 mandibular prognathic patients (35 males and 65 females) operated on by Obwegeser-Dal Pont method.
    The profile lines were drawn by computer graphics, by passing them through the predicted post-operative soft tissue data points on the basis obtained regression equations. Then an attempt was made to prepare predicted post-operative montage photographs taken with a Minolta MONTAGE UNIT 401 P, by superimposing facial standardized photos of patients, which were taken pre-operatively as reference material on the profile lines.
    The results obtained are as follows:
    1. F values of all equations were significant (p<0.01), and high multiple correlation coefficients were obtained.
    2. Hermite Curve was considered to be appropriate for the profile lines drawn by computer graphics, passing through the predicted post-operative soft tissue data points.
    3. The author succeeded in preparing post-operative montage photographs very similar to the lateral photos taken 6 months post-operatively. It seems that the clinical application of such montage photos to surgical correction cases will provide useful information for treatment planning.
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  • Kazuhisa NAKAYAMA
    1988 Volume 34 Issue 7 Pages 1255-1274
    Published: July 20, 1988
    Released: July 25, 2011
    Experiment was conducted on 96 Wistar rats to estimate the clinical utility of the lyophilized nerve which has advantages of being enduring of and easy for long-term storage. After implanting to the unilateral sciatic nerve trunk a piece of lyophilized homograft of the sciatic nerve of 10mm in length, the nerve and the muscles (soleus, extensor digitorum longus and gastrocnemius) were examined from different aspects and were compared with the results after fresh nerve homografting.
    The results were as follows:
    1. Macroscopic observations;
    i) In both the lyophilized and fresh homografts the initial form was well maintained during the observation period of up to 48 weeks. The fresh homografts tended to show stronger adhesion to the surrounding tissues due to intense proliferation of the connective tissue.
    ii) The muscles were atrophic and pale. Recovery started around the 8th postoperative week, and was almost complete within 48 weeks.
    2. From the 8th postoperative week electromyographic responses could be evoked by stimulating the sciatic nerve trunk. The latency of the evoked EMG became progressively shorter at a similar pace in both the lyophilized and fresh nerve-grafted groups.
    3. The wet weight of the muscles in the operated side was lowest on 4th week and showed a gradual recovery to reach a level of 65-83% of the contralateral homonymous muscles. No marked difference was found between the lyophilized and fresh nerve-grafted groups.
    4. Histological observation revealed no significant difference between the lyophilized and fresh nerve grafts in terms of the overall time course of the progressive regenerated axons entering into the graft. The inflammatory response was more intense in and around the fresh nerve grafts. The number of regenerated axons of the fresh nerve grafts increased more than the lyophilized nerve grafts.
    5. The degree and the time course of the change in the concentration of the nerve and muscle-related proteins were not much different between the both groups.
    It can be concluded that the homograft of the lyophilized nerve can be substituted for the fresh nerve homografting for restoration of the nervous and muscular functions, and is even superior to the latter in that it can be easily stored for a long time and causes less inflammatory responses.
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  • Yuetsu ONOE, Noriaki MAEDA, Toshiaki ISHIKAWA, Wataru YOSHIOKA, Sadami ...
    1988 Volume 34 Issue 7 Pages 1275-1282
    Published: July 20, 1988
    Released: July 25, 2011
    Previously we reported the essential characters which are requested for the proper mouthguard materials and shapes. In this report we show the results of our field studies on the mouthguard made from the proper materials.
    Thirty-four rugby football players were chosen for this study. Individual mouthguards were made by taking personal impressions.
    The players were interviewed before and after using the mouthguards comparing the old one. 59% of the players have never worn any mouthguard because of ill fit and trouble in speaking and/or had not any chance to get them.
    The mouthguards made by our instruction were tested on the following points: Fitting, ability to speak, taste and thickness.
    We have checked the above points at periods of 1 month, 3 months and 6 months. These mouthguards were accepted by almost 90% of the players in every point but a few complainedof the thickness.
    They needed more thickness than we planned at the labial side of the anterior teeth but this minor trouble was corrected according to each person in later technical processes.
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  • Masashi SHIMAHARA, Katsumi ONO, Norihiro HASHIGUCHI, Tomoko ISHIBASHI, ...
    1988 Volume 34 Issue 7 Pages 1283-1291
    Published: July 20, 1988
    Released: July 25, 2011
    We studied the healing process of unilateral fracture of the condylar process of the mandible after 1-week intermaxillary fixation in cases of displaced bone flaps.
    Method: Wistar rats weighing 120g were used in the experiment. The surface of the neck of the mandible was uncovered and transected horizontally together with the medial periosteum using a No.698 Fischer bar. The small bone flaps were artificially displaced about 60° toward the median. Then the incision was sutured. After grinding off 1mm of the edge of the mandible incisors, a perforation was made mesiodistally using a No.1/2 round bar. A 0.2mm ligature wire was then passed through the hole to achieve fixation. Fixation was continued for 1 week. During this period, the rats were fed by introducing food directly into the stomach. After fixation, they were fed with pulverized Oriental solid feed for 3 days, which afterwards was available ad libitum.
    Results:(1) The medially dislocated small bone flaps and the articular disk tended to recover normal position due to the physiological movement of the jaw for 1 week after the removal of intermaxillary fixation, (2) Inflammatory reaction at and around the fractured parts was relatively mild. (3) Some cartilage formed at the fracture. This was more common in displaced cases than in non-displaced cases. (4) Bone repair at the fracture was observed from the 1st week to the 2nd week after the removal of intermaxillary fixation (2nd week after fracture). Both cartiliginous ossification and intramembraneous ossification were observed with the latter primarily taking place. (5) Shirinkage of the head of the mandible was observed in almost all cases after removal of fixation. (6) Bone remodeling was observed in the region from the neck of the mandible to the fracture until the 6 th week after fracture, or the 5 th week after removal of fixation. However, by the 6 th month was healed and returned to normal. (7) In the cases of mal-union, a to shallow mandibular fossa, thickening of the articular disk and the fibrous perichondral layer of the head of the mandible, and the appearance of small lingulalike structures in the upper and lower articular cavity were observed. However, no separate, isolated body was observed. It is suggested that these changes were related to the period of intermaxillary fixation, (8) No abnormal findings were observed in the head of the mandible of the unaffected side.
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  • Toshihiko KANAI
    1988 Volume 34 Issue 7 Pages 1292-1311
    Published: July 20, 1988
    Released: July 25, 2011
    Discussions were made on whether muscular activities of the limbs would be an index to the objective evaluation of anxiety and fear at the time of dental and oral surgery. Furthermore, electrophysiological and psychosomatic investigations were made as to differences in anxiety and fear between normal adults and patients with odontophobia. As stress stimuli, stimulus by presentation of a video showing tooth extraction, electrical stimulation of teeth and stimulus by local anesthesia were used.
    1. EMGs were measured in the masseter muscle, orbicularis oculi muscle, trapezius muscle extensor digitorum muscle and peroneus longus muscle at times of stimulations as mentioned above. The integral value of the EMG of these muscles showed an increase during the stress stimulus period as compared to the vest period.
    2. The rate of increase in the EMG integral value was higher in patients with odontophobia (early treatment group) than in normal adults, the former showing strong muscle tension under stress.
    3. Among patients with odontophobia, those for whom the behavior therapy centered treatment had progressed showed changes in EMG integral value at times of stimulation only in the same degree as normal adults, suggesting the effectiveness of behavior therapy.
    4. DAS, as a criterion for evaluating anxiety at the actual scene of dental treatment scored 9.05±3.06 in normal adults, whereas it scored high, 15.57±3.10, in patients with odontophobia (those at the early stage of being treated). DAS was lower, 8.33±3.78, in those patients at the advanced stage of being treated.
    5. With regard to MAS, the proportion of those with great anxiety was estimated as 0% in normal adults, whereas it was estimated as 50% or more in patients with odontophobia. Thus, individuals predisposed to chronic anxiety were presumed to be more prone to odontophobia.
    These results suggested that that muscular activity could be an index to the objective valuation of the degree of anxiety and fear at the time of dental and oral surgery.
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  • Kouji MATSUMURA, Tatsuo TSUJI, Kohsuke SASAKI, Fumihiko SHINOZAKI
    1988 Volume 34 Issue 7 Pages 1312-1315
    Published: July 20, 1988
    Released: July 25, 2011
    Immunohistochemical localization of SCC antigen was investigated to evaluate its usefulness as a tumor marker in salivary gland disease. SCC antigen levels were measured in both sera and tissues from 14 salivary disease patients. SCC antigen was confirmed to be localized in cancer cells of mucoepidermoid tumors and adenoid carcinomas, but was not present in adenoid cystic carcinomas. In pleomorphic adenoma, SCC antigen displayed interesting localization patterns; the antigen localized in the ducts, squamous epithelium and keratin formations. However, it was absent in the myxomatous area and myoepithelium cells. Therefore, SCC antigen was found to be impractical as a tumor marker in salivary gland tumors for two reasons;(a) There was no localization in adenoid cystic carcinoma, and (b) Serum SCC antigen levels were low in salivary malignant disease patients. On the other hand, this study suggests that the investigation of tissue SCC antigen can be useful for differential diagnoses of salivary gland diseases and also in the application of the study of their origin and differentiation.
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  • Hiroyuki ISHII, Hiroshi HIRANO, Yasuharu TAKENOSHITA, Makoto SHIMADA, ...
    1988 Volume 34 Issue 7 Pages 1316-1324
    Published: July 20, 1988
    Released: July 25, 2011
    Sagittal splitting osteotomy of the mandibular ramus (Obwegeser Dal-Pont method) was performed on 13 patients with mandibular prognathism. The periodical changes in the position of the temporomandibular joint (TMJ) after the operation were examined by Mento Vertex (M-V) and P-A cephalometric projection.
    The results obtained were as follows.
    1) In 9 patients received bilateral operation, the condylar angulation at M-V projection increased significantly soon after operation and then showed a tendency to decrease gradually.
    2) In 3 patients received unilateral operation, the changes of the condylar angulation on the non-operated side (large bone segment side) were larger than ones the operated side.
    3) In the cases with different distance bilatellaly of backward movement, the changes of the condylar angulation on small movement side showed a tendency to be larger than on large movement side.
    4) There was no significant change of the distance between the rami ends after the operation, and after the removal of intermaxillary fixation.
    5) The condylar angulation and the ramus inclination at P-A cephalometric projection showed no definite tendency.
    6) There were no cases with symptomatic TMJ after the operation except for one case with temporarily clicking.
    Consequentry, we could suggest that TMJ had a considerable capacity to adaptation significant adaptation capacity
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  • Yasunori TOTSUKA, Akira SAWADA, Takeyuki NAKAMURA, Tetsuro TSUSHIMA, S ...
    1988 Volume 34 Issue 7 Pages 1325-1337
    Published: July 20, 1988
    Released: July 25, 2011
    This study was undertaken in order to evaluate the effectiveness of treatment for anterior disk displacement without reduction (closed-lock). Of 61 patients who had been clinically diagnosed as having closed-lock of the TMJ, 28 were treated with splint alone, 14 with mandibular manipulation followed by splint and 19 with manipulation assisted by pumping. In addition, 8 patients in whom non-surgical treatments had failed to be beneficial were treated by surgery.
    The conclusions are summarized as follows:
    1. In 41 of 61 patients, signs and symptoms of closed-lock disappeared after the initial treatment. Although 13 patients suffered a relapse of closed-lock, 7 were improved again by splint therapy and 37 (57%) were finally improved from closed-lock by non-surgical treatment
    .2. The results of each non-surgical treatment were almost equal. However, the patients who were treated by manipulation assisted by pumping had a tendency to improve faster from closed-lock but easily suffered relapse. On the other hand, the splint treated patients had a tendency to resist the treatment but did not suffer a relapse.
    3. The results of non-surgical treatment were closely related to the duration of closed-lock. 65% of the patients who had been suffering closed lock for less than 6 months were improved, but only 25% of the patients suffering for more than 6 months were improved. In the patients who had recovered from closed-lock by mandibular manipulation or manipulation assisted by pumping, 60% of the patients who had closed-lock within one month were improved finally, and all patients who had closed-lock over one month suffered a relapse.
    4. Seven out of 8patients who had undergone TMJ surgery recovered from limited mouth opening and pain of the TMJ, but 3 patients had a deflection of the mandible on maximal opening.
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  • Manabu OKAMOTO, Satoru OZEKI, Yoshinori HIGUCHI, Hideo TASHIRO
    1988 Volume 34 Issue 7 Pages 1338-1347
    Published: July 20, 1988
    Released: July 25, 2011
    The effect of concurrent combined treatment with 22.5 Gy of radiation and 110 mg of bleomycin or 55mg of peplomycin on oral carcinoma involving the mandible was examined histologically.
    In 14 of 18 patients who had mandibles resected after this combined treatment, bone invasion by carcinoma was observed histologically. According to Shimosato's classification of histological effects, 3 belonged to Grade III/IV, 4 to II b, 3 to II a and 4 to I. The formation of new bone that was considered to be reparable was observed in the marked effective patients.
    In 4 patients the Grade II b, residual surviving cancer cells were observed in the mandible.
    Accordingly, excision was needed in the area of radiologic features of mandibular infiltration. But it is considered that although the excision scope for the patient who has received the preoperative treatment is the same as that for the patient who has not, it is advantageous for the former patient that a wider safety region is obtained.
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  • Manabu OKAMOTO
    1988 Volume 34 Issue 7 Pages 1348-1365
    Published: July 20, 1988
    Released: July 25, 2011
    Eighty-two previously untreated patients with squamous cell carcinoma arising from the oral mucosa were treated by concurrent combined treatment with 22.5 Gy of radiation and 110mg of bleomycin or 55mg of peplomycin at our department from 1976 to 1985. Therapeutic effects were examined clinically and histologically, and the role as a preoperative treatment was discussed.Moreover, a statistical analysis was performed to determine the factors related to the histological effects.
    1. The ratio of complete response was 42.7% and the ratio of partial response was 89.0%.
    2. 59 patients had subsequent treatment with surgery.Step sections were prepared from surgically resected specimens and examined microscopically.
    1) According to Shimosato's classification of histological effects, 19 belonged to Grade IV, 15 to II b, 13 to II a and 12 to I/0.
    2) In 7 of 15 Grade II b patients, residual survival cancer cells were not observed at the margin of the area previously occupied by tumor at the beginning of treatment.Accordingly, 44.1% (7with II b and 19 with III/IV) of 59 patients may be controlled by the more conservative surgery.
    3. 18 patients with CR received additional combined therapy alone without any further treatment.Local control rate of these patients was 66.7%.Therefore, 31 patients (these 12 patients and 19 of Grade III/ IV) could be controlled by this therapy alone.
    4. The histological effects significantly depended on the following factors of tumors;size, growth pattern, and degree of histologic differentiation.82.2% of 73 patients could be classified into good effective group or poor group accurately by the quantification theory Type II of Hayashi.It is considered that this method is useful for predicting the effects of this combined treatment.
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  • Masaroh MATSUURA, Kanichi SETO, Norihiko TAKADA, Soichiro YOSHINO, Jun ...
    1988 Volume 34 Issue 7 Pages 1366-1381
    Published: July 20, 1988
    Released: July 25, 2011
    From November 1974 to April 1986, 34 cases (36 operations) of mandibular reconstruction using iliac bone graft were performed in our department. They included 16 cases of ameloblastoma, 8 cases of carcinoma of the mandible, 5 cases of carcinoma of the floor of the mouth, 2 cases of ossifying fibroma, 2 cases of mucoepidermoid tumor of the mandible, and one case of primordial cyst.
    In twenty operations, mandibular reconstruction was conducted simultaneously with mandibular resection. In the other 16 operations, mandibular reconstruction was performed 3 to 6 months after mandibular resection (including 2 secondary reconstructions after failure of immediate reconstruction). A metal plate was used on grafted bone and the residual mandibular fragments fixed rigidly except for two cases where interosseous wiring was used.
    Good prognoses were gained in this series, but the grafted bone was removed in 4 cases because of infection. In all of these cases, immediate reconstruction after segmental resection of the mandible had been performed.
    In 24 cases, we observed absorption of the grafted bone over time after surgery using orthopantomography. Minimal absorption was observed in 11 cases, moderate bone absorption in 9 cases and in 4 cases severe bone absorption was observed. In bridging bone grafts which spanned the residual fragments after segmental resection of the mandible, minimal bone absorption was generally observed, but in free-end bone grafts after hemimandiblectomy, moderate or severe bone absorption occurred except for one case in which the grafted bone had been wrapped with the periosteum.
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  • Tatsuko AOYAMA, Goroh HIBI, Takayuki YAMAUCHI, Kanzou OKUI, Yasuhisa M ...
    1988 Volume 34 Issue 7 Pages 1382-1386
    Published: July 20, 1988
    Released: July 25, 2011
    The occurence of malignant tumors during pregnancy is relatively rare, especially in regions distant from the genital organs, such as the tongue.
    A 25-year-old woman came to us complaining of a non-healing ulcer on the tongue. She was 37 weeks pregnant at the first examination. Biopsy showed squamous cell carcinoma.
    After drug-induced delivery of a healthy female child at 39 weeks, chemotherapy (arterial infusion of Peplomycin, total 88.7mg) and irradiation (Linac, total 60 Gy) were performed for about 50 days and then immunotherapies were started. These therapies were very effective and there were no recurrences after 31 months. She is pregnant again and her first child is growing normally.
    Malignant tumors during pregnancy entail many problems: the relationship between carcinogenesis and pregnancy, maternal and fetal immunological and hormonal problems, therapeutic problems such as drug-induced malformation, and others.
    This paper discusses the above topics and reviews the relevant literature.
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  • Hideaki KATSUYAMA, Yasuharu TAKENOSITA, Minoru WAKAMORI, Atsuya YOSHID ...
    1988 Volume 34 Issue 7 Pages 1387-1393
    Published: July 20, 1988
    Released: July 25, 2011
    Mandibular fracture treatment occupies a large part of oral surgery in hospital practice, yet much confusion exists in certain basic principles of treatment.
    Mandibular angle is known to be one of the most fractured areas in oral surgery because of its configuration and the common fracturing vectors. One big problem exists in dealing with teeth on the fracture line. Some authors consider any fracture through the alveolar socket or the crypt of an impacted tooth as a “complicated” fracture and say that the involved teeth even though uninjured should be extracted promptly because they may be the cause of complications such as nonuion, osteomyelitis, cellulitis or abscess formation. On the other hand, it is suggested that with the use of antibiotics and the application of stable fixation appliances, most clinically intact teeth in the line of mandibular fracture can be retained. From 1978 to MAY 1987, we treated 57 cases of mandibular angle fractures and analyzed the data with special reference to third molar teeth on the fracture line, types of fracture line, and way of approach and treatment.
    The majority of cases consisted of males (51/57, 89.5%), and were between 10 and 20 years old (68%).
    Some researchers mentionend that treatment for third molar teeth on the fracture line, but it is rare. So we considered this matter in more details. We, furthermore, examined fracture displacements of fragments, and so on.
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  • Hirofumi KISHIMOTO, Toshio HARADA, Yasuro YOSHIMURA
    1988 Volume 34 Issue 7 Pages 1394-1398
    Published: July 20, 1988
    Released: July 25, 2011
    A follicular cyst associated with a permanent tooth in the region of the jaws, is frequently encountered, but one originated from deciduous tooth is very rare.
    We presented a case of a 5-month-old infant with a follicular cyst of the first deciduous molar. The patient visited our hospital because of gingival swelling in the deciduous molar region of the left mandible on 7th May 1983.
    A hard bone like swelling (25×15×20mm) was seen from the gingiva of the left lower deciduous molar region to the left mandibular body, and in CT examination, an ovoid low density area was noticed in proximally contact with the high density mass considered to be the first deciduous molar in the left mandibular region. On the basis of clinical diagnosis of follicular cyst related with the first lower deciduous molar, marsupialization of the cyst was carried out under general anesthesia with Gas-Oxygen-Enflurance on 27 th May 1983.
    Histologically the cyst lining mainly consisted of cuboidal or squamous epithelium of mono-or double layer in major portion, and high coumnar epithelia were also observed both in the inner lining components and in the subconnective cyst wall.
    The final diagnosis was determined as follicular cyst from the first lower deciduous molar. The first deciduous molar with enamel hypoplasia erupted about one year later.
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  • Keizo MORI, Hiroyuki HAMAKAWA, Hiroaki TANIOKA
    1988 Volume 34 Issue 7 Pages 1399-1405
    Published: July 20, 1988
    Released: July 25, 2011
    The patient was a 61-year-old female that entered our hospital with a complaint of tumor formation at 3 buccal gingiva. The tumor was diagnosed clinically as epulis and was excised. Histopathological diagnosis was epulis osteoplastica. In light and electron microscopic observation, osteoblasts and collagen fibers were arranged in the same direction. Inflamatory cell infiltration was slightly. Case report, morphological findings and some discussion were presented.
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  • Kazuhisa BESSHO, Yoshio HIRANO, Nobuyuki ISHIHAMA, Masahiko FURUTA, Mu ...
    1988 Volume 34 Issue 7 Pages 1406-1413
    Published: July 20, 1988
    Released: July 25, 2011
    We studied the changes in the body and the effects on the surrounding tissues of the Champy miniature screwed plate, which is most commonly used as an implant for jaw reconstruction and obtained the following results.
    The Champy miniature screwed plate is made of SUS 316 stainless steel, a biomaterial thought to be corrosion resistant and biocompatible because the metal has a passive film of Cr2O3. However in some recent experiments, it has been found to corrode in the body. In the present SEM findings, corrosion was noted on the surface of the miniature screwed plate after clinical use, and the presence of Fe, Cr, Ni eluted from the plate was detected in the surrounding tissues by emission spectral analysis. Additionally, the implanted miniature screwed plate was encapsulated by fibrous tissues as a result of metallosis, and the adjacent bone cortex was absorbed.
    In the present study, the causative agent could not be identified, but in some cases, symptoms of dermatitis were noted due to a type IV allergic reaction to the eluted metal, a known sensitizing hapten. Moreover, induction of a tumor by a metallic implant in jaw reconstruction recently has been reported, and the eluted metal, hypertrophy of the fibrous capsule, and mechanical stimulation were considered etiologic factors.
    An obvious causal relationship has not yet been proven between tumor induction and allergic reaction of the metallic implant in jaw reconstruction, but its risk cannot be ignored and further investigation is required. At the present, for the sake of safety, the implant should be removed as soon as possible once the treatment purpose has been achieved.
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  • Tadashi KITAJIMA, Kouichi NAITOH, Tohru HATTORI
    1988 Volume 34 Issue 7 Pages 1414-1419
    Published: July 20, 1988
    Released: July 25, 2011
    A 40-year-old woman became aware of a mass in the parotid gland in October 1984. Superficial lobectomy was carried out on November 8 1984, because the mass was detected within the superficial lobe by CT scan and sialography. Frozen section in operation and postop conventional histopathological examination of the specimen revealed a trabecular adenoma which was classified into “other types” of monomorphic adenoma. Incidence of “other types” described is only 1.8% of all parotid tumors according to Thackray and Lucas. Review of the literature carried out by the authors showed that 41 cases of “other types” of parotid monomorphic adenomas were reported in the last 10 years. Among them, trabecular adenoma was identified only in 3 cases including the present case. Necrotic area seen in the central portion of the tumor in the presented specimen may suggest an initial sign of the cyst formation, which was reported in some previous publications.
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  • Shoichiro OHNO, Kunio IKEMURA, Shouichi NAKAMURA, Tosihiko FUJIWARA, R ...
    1988 Volume 34 Issue 7 Pages 1420-1425
    Published: July 20, 1988
    Released: July 25, 2011
    A case of malignant lymphoma in the.parotid gland is reported The patient was a 70-year-old female, and the excised tumor was histologically diagnosed as malignant lymphoma, follicular (and diffuse), large cell type according to L.S.G. classification. Immunoperoxidase staining (ABC method) revealed that OKT 4 positive cells were dominant (OKT 4/8=2.4). The clinical stage was stage I according to Ann Arbor classification. The patient was treated with radiotherapy (total dose 5, 040 c Gy) and then with chemotherapy (CHOP). During the follow-up period of 7 months she rermained uneventful.
    Frequency and histological type of malignant lymphoma in the parotid gland, and prognosis of this disease are discussed under the review of literature. It is not clear whether this tumor originated from the parotid gland or the lymph node in the parotid gland.
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  • Hitomi RYOKE, Kazuo RYOKE, Kazumi OKAMOTO, Masaru KISHINO, Takaaki OGA ...
    1988 Volume 34 Issue 7 Pages 1426-1432
    Published: July 20, 1988
    Released: July 25, 2011
    Sclerosing hemangioma was formerly considered as hemangioma with fibrous vegetation. But recently this lesion has been believed to belong to subepidermal nodular fibromatosis which is a subtype of fibrous histiocytoma. The histological characteristics of are that many spindle cells and fine fibers present a specific storiform pattern with the arrangements around capillary nets.
    The lesions have been rarely reported in maxillofacial region. We recently encontered a mandibular bone case histopathologically diagnosed as sclerosing hemangioma. The patient was a 47-year-old Japanese male who was initially examined in our hospital May 14, 1985 with a chief complaint of painless swelling in the left side of buccal mucosa region, and pre-and infraauricular region. In extraoral findings about 6×6cm of apparently circumscribed swelling was found in the left side of pre-and infraauricular region, which was painless and elastic hard in consistency. There were not reddish spots and no sensation abnormalities such as hypesthesia on the surface of the mass.
    In intraoral findings about 3×3.5cm of diffuse swelling from the left side of buccal mucosa region to the glosso-palatine arch, which was elastic soft in consistency and indolent, was revealed.
    Some radiographs showed an apparently well-defined radiolucency in most of the left mandibular ascending ramus. The tumor was extirpated in a mass intraorally under general anesthesia. Histopathological examination with hematoxylin-eosin stain, PAS stain, silver stain and Masson stain and immunohistological examination were carried out. Consequently this lesion was diagnosed as sclerosing hemangioma. Further review of the literature on this lesion was done.
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  • Munehisa SAKA, Kanemitsu SHIRASUNA, Mikihiko KOGO, Kazuya WATATANI, Ma ...
    1988 Volume 34 Issue 7 Pages 1433-1436
    Published: July 20, 1988
    Released: July 25, 2011
    Intramuscular lipoma is an uncommon benign tumor that characteristically infiltrates skeletal muscle, while common lipomas are usually encapsulated.
    This uncommon type of lipoma occurring in the oral cavity is quite rare. In this paper, we report an intramuscular lipoma in the tongue of a 56-year-old woman. A pale yellow mass consisted of mature adipose cells surrounding and separating irregular bundles of the muscle. Electron microscopic examination revealed that the tumor was composed mainly of univacuolar adipocytes. No young forms of adipocytic differentiation were seen in this tumor, but occasional primitive mesenchymal cells contained a few lipid vacuoles located in penvascular area.
    These findings suggest that intramuscular lipoma may arise from a primitive perivascular mesenchymal cell.
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  • Yasunori SATO, Isoo NOGUCHI, Toshifumi ANDO, Masayuki TAKAHASHI, Shige ...
    1988 Volume 34 Issue 7 Pages 1437-1443
    Published: July 20, 1988
    Released: July 25, 2011
    Static bone cavities were first described by Stafne in 1942 as cystic bone cavities situated near the angle of the mandible on roentgenogram. The contents of this lesion confirmed in surgery were salivary gland tissues, connective tissues, veins, nerves, fatty tissues and lymphnode tissues. The etiology of this lesion is not established yet. Salivary gland tissues were most found in this lesion and it seems that the cavity is significantly related with salivary gland.
    We report here the results of investigation and some discussions on the static bone cavity which was diagnosed by sialography.
    The subject was a 69-year-old woman. She appeared at our clinic on 5/16/86, having been referred to us by her general dentist with X-ray findings showing radiolucent and nonradiolucent lesions of the mandible. We thought that radiolucent lesion was a static bone cavity and performed sialography. Sialogram of the submandibular salivary gland showed that some part of the gland was in the radiolucent region of the bone defect. We found the significant relation with the submandibular salivary gland, which lead us to render the diagnosis in this case. We did not perform any surgery but merely observed progress.
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  • Yasuo TAKAYAMA, Yoshinari TOHYAMA, Mitsuhiko MATSUMOTO, Masamichi ONO, ...
    1988 Volume 34 Issue 7 Pages 1444-1454
    Published: July 20, 1988
    Released: July 25, 2011
    We made clinical and statistical analysis on 20 cases of Nasopalatine duct cyst, and the following results were obtained:
    1) Among 20 cases, 11 were male and 9 were female. No significant differences could be found in frequency by sex distinctions.
    2) As for the age of patients, they were distributed from twenties to seventies, and mean age was 44.3 years.
    3) As for the chief complaint, swelling was claimed in 8 cases and pain in 4 cases, while no subjective symptom was recognized in 8 cases.
    4) Bilateral central incisor was found in 12 cases, and among them only 3 cases showed their central incisors positive on both sides as a result of the electric pulp test.
    5) Radiogram exams revealed the following:
    i) 12 cases were round-like, 6 cases oval and 2 gourdshaped in their appearance on occlusal films.
    ii) The maximal diameter of the cyst on occlusal films measured approximately 20 nun
    iii) The cases with anterior nasal spine recognized inside of cyst shadow on the radiograms were 13 with occlusal view and 10 with conventional intraoral radiogram. So called heart-shape shadow in intraoral radiogram was seen in 3 cases.
    iv) The cyst borders were clear in 10 cases and another 10 cases were not. The latter showed a longer mean of maximal diameters than the former.
    v) The cyst was located in mid-suture region of maxilla in all cases. 11 cases appeared eccentric.
    6) As for treatment, the procedures were made from labial side in most cases, 2 cases were from the palatal side.
    7) Histopathological exams revealed the following:
    i) The kinds of epithelium of cystic wall were as follows: Pseudostratified ciliated columnar epithelium was found in 15 cases, cuboidal epithelium was in 14 cases and squamous epithelium was in 5 cases (counts are duplicated)
    ii) Cysts which have two kinds of epithelium in their walls were found in 13 cases.
    iii) Among the cases of pseudostratified ciliated columnar or cuboidal epithelium, partial squamous metaplasia was observed in 6 cases.
    iv) Relatively larger bundles of nerves and blood vessels were recognized in 10 cases.
    v) Glandular tissue was observed in 7 cases.
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  • Akira KOSE, Makoto MURATA, Gouichi MATSUMOTO, Kazuyuki MORISHITA, Yuic ...
    1988 Volume 34 Issue 7 Pages 1455-1459
    Published: July 20, 1988
    Released: July 25, 2011
    A case of adenomatoid odontogenic tumor involving the right upper lateral incisor of a 12-year-old bpy is described.
    This tumor is a benign epithelial type tumor that comprises only 3% of all odontogenic tumors. It is difficult to differentiate it from other odontogenic tumors or cysts clinically, but this can be reliably done by the histological features.
    The tumor mass in this case showed the typical tissue structure of adenomatoid odontogenic tumors, and had a cystic cavity which was partially covered with stratified squamous epithelium lining.
    In addition to this case, we analyzed 94 cases in 48 years (1939-4986) in the Japanese literature.
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  • Atsuo OKANO, Joji KATO
    1988 Volume 34 Issue 7 Pages 1460-1471
    Published: July 20, 1988
    Released: July 25, 2011
    Radiotherapy is indispensable as one of the treatments for malignant tumor in maxillomandibular and oral surgical field and the best way for preservation of functions, but it causes osteoradionecrosis in some cases.
    The incidence of osteoradionecrosis in maxillomandibular and oral surgical field is higher than in other bone sites because the mandible is included in the irradiation field in addition to the presence of teeth and various anatomical factors.
    In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained.
    1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adonoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3: 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth.
    2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases.
    3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases.
    4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws.
    5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases.
    6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect.
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  • Kohji SATOH, Goroh HIBI, Hiroharu KAWAMURA, Takayuki YAMAUCHI, Kanzoh ...
    1988 Volume 34 Issue 7 Pages 1472-1478
    Published: July 20, 1988
    Released: July 25, 2011
    In recent years, the incidence of noma-induced trismus has markedly decreased. Despite its infrequent occurrence, this condition often presents various difficult problems to the surgeons. In a 48-year-old male reported here, the presence of severe bilateral buccal contracture suggested this was the only cause of his trismus. However, after an advanced cicatricotomy followed by the grafting of four flaps of full thickness skin (6×4cm each), the improvement of jaw-opening was far from satisfactory. Careful postoperative analysis of CT and cephalographs disclosed that hyperplasia of both coronoid processes was partially responsible for the trismus. The hyperplasia most likely resulted from the longstanding trismus itself, and hence, was treated not by surgical intervention, but by active jaw-opening training. Such a functional training proved quite effective. Indeed, the interincisal distance, which measured only 28mm immediately after the cicatricotomy, increased to 44mm within a couple of months. After 11 months of follow-up, the patient retains a sufficient range of jaw-opening with satisfactory mastication by means of dentures that could not be worn previously.
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  • Tsunehisa SHIMODA, Yoshihiro KANEKO, Yoshikazu FUKUTOMI, Akira ONO, Ta ...
    1988 Volume 34 Issue 7 Pages 1479-1498
    Published: July 20, 1988
    Released: July 25, 2011
    We would like to introduce the technique of arthrography used at the upper and lower compartments of TMJ in our Department. Typical cases were represented and some discussious were made.
    (1) The number of patients suspected to suffer from internal derangements of TMJ and accepted arthrography was 33 cases (37 joints). The results were as follows: 7 normal type joints, 11 clicking type joints (6 early clicking type joints and 5 late clicking type joints), 15 closed lock type joints, and 2 incoordination type. The arthrographic findings of 4 joints were different from the clinical diagnosis. Represented separately were closed lock type 3 joints, late clicking type 1 joints.
    (2) Complications as morphological disorder of TMJ's soft tissue were seen in all the joints with internal derangements as follows: 29 joints bad thickening or elongation of the disk, 4 joints folding of the disk, 3 joints perforation of the disk, 9 jointsadhesion of the disk (6 adhesion of the upper compartments, 1 adhesion of the lower compartments, and 3 adhesion of upper and lower compartments).
    (3) In almost all the cases after arthrography, the secondary complications were seen as follows: Incomplete occlusion of arthrogramed side, temporary paralysis of facial nerve, motor pain of arthrogramed side. Three cases of closed lock were discovered.
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  • Jun SHIMADA, Hiroshi AONO, Yasuyuki YAMAZAKI, Takahiro SHIMAZAKI, Yosh ...
    1988 Volume 34 Issue 7 Pages 1499-1504
    Published: July 20, 1988
    Released: September 13, 2011
    Due to the fracture of upper two thirds of the face, especially the fracture of orbital region, severe ophthalmic complication, for example, blindness, can take place as a result of direct injury to optic nerve.
    However, it is known that following distant trauma of the thorax or abdomen, but without directly affecting eyes, descrease of visual acuity occurs which is caused by retinal hemorrhages and white patches of exudation.
    Purtscher, in 1910, first described retinal hemorrhages and whitish plaques ocurring in both eyes of a patient following a fall from a roof. Since then, this disease is known as Purtscher's retinopathy.
    Recently, we encountered a patient affected with Purtscher's disease following multiple facial bone fractures which resulted in severe visual loss.
    In this paper, we presented this case and the previous report on this disease is reviewed.
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  • Kazumasa SUGIHARA, Hiroshi MUKAI, Kiyomi KAWASHIMA, Noriko YAMASHITA, ...
    1988 Volume 34 Issue 7 Pages 1505-1509
    Published: July 20, 1988
    Released: July 25, 2011
    Malignant mixed tumors are rare and reported to comprise from 3 to 10% of the total salivary gland neoplasms.This tumor is interpreted as a malignant transformation within an already existing benign pleomorphic adenoma.
    This report represents a case of carcinoma in pleomorphic adenoma in the palate which developed from benign pleomophic adenoma.
    Case: A 66-year-old female was referred to our clinic with a slowly enlarging, painless mass in the hard palate.Surgical removal of this tumor was accomplished, and histopathological diagnosis was benign pleomorphic adenoma.Two years later she revisited us complaining of rapidly growing recurrent tumor in the same palate site.Histopathological diagnosis of the surgically removed specimen was carcinoma in pleomorphic adenoma.After radical resection of the tumor the patient had no recurrence for about 9 years.
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  • Satoko OTAKE, Kenji KAKUDO, Kozo MUSHIMOTO, Rikiya SHIRASU
    1988 Volume 34 Issue 7 Pages 1510-1520
    Published: July 20, 1988
    Released: July 25, 2011
    A case of acinic cell tumor arising in the buccal mucosa of a 59-year-old man was reported. The tumor mass was 2.5×2.0×2.0cm and encapusulated.
    Histologically, the tumor was composed of serous cells. These cells contained many basophilic granules which were PAS-positive, diastase-resistant, mucicarmine negative and alcian blue negative. Ultrastrcturally, large rounded or polyhedral tumor cells contained numerous secretory granules which varied in size, shape and electron density. These cells were similar to the serous cells of the normal acini. A few smaller cells lacking secretory granules were also seen. These cells were round or cuboidal and simliar to the intercalated duct cells of normal salivary glands. Their cytoplasm was electron-lucent and contained a small amount of cytoplasmic organella. The nuclei were large and oval shape.
    In the present case, this tumor was composed of two types of cells, which were the predominant secretory cells and the intercalated ductlike cells.
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  • Takeshi UCHIYAMA, Tadashi SATO, Naohisa TAKANO, Yoko NAKANO, Chikara S ...
    1988 Volume 34 Issue 7 Pages 1521-1528
    Published: July 20, 1988
    Released: July 25, 2011
    It is generally said that the causes of velopharyngeal incompetence in the absence of overt cleft palate are paralysis of the levator veli palatini muscle, short soft palate, or deformity of the nasopharynx.
    We experienced a case of a 15-year-old girl with cleft palate-type speech caused by congenital velopharyngeal incompetence with unilateral palate muscle paresis and short soft palate.
    We inspected speech and velopharyngeal functions and precisely practised analysis of speech on auditory impression, observation of nasopharynx with fiberscope, measurements of soft palate and nasopharynx by cephalometric radiography, electromyographic evaluation of bilateral levator veli palatini muscles, biopsy of levator veli palatini muscle tissue, analysis expiration air from oral and nasal cavity during phonation by flow nasality graph, and accoustic analysis of speech sound by soundspectrograph.
    We performed a inferiorly based posterior pharyngeal flap operation in this case, and got a good result. Postoperative hypernasality was distinctly diminished and improvement of articulation was achieved.
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