Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 35 , Issue 6
Showing 1-37 articles out of 37 articles from the selected issue
  • Hideharu KUNIYOSHI
    1989 Volume 35 Issue 6 Pages 1373-1390
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Adult T-cell leukemia (ATL) patients are frequently associates with other malignancies. To elucidate the possible association of HTLV-I infection with the tumorigenesis of oral malignancies in Kagoshima prefecture, I analyzed the correlation between HTLV-I and the patients with oral malignant tumor (OMT). The following results were obtained;
    1) The organ distribution of oral malignancies in Kagoshima prefecture was found in the tongue most frequently. The male to female sex ratio was 2 to 1 and the age distribution of the highest incidence ranged from 60 to 80 years. The most frequently observed histopathology was the squamous cell carcinoma (74/78 cases).
    2) HTLV-I seropositivity of OMT in total, was 2. 3 times more than that of normal adults in Kagoshima prefecture and the male to female sex ratio was 4 to 3.
    3) HTLV-I provirus was detected in 5 cases of 7 peripheral blood lymphocytes (PBLs) donors of the seropositive OMT.
    4) OMT was associated with HLA-DRw8 in significantly high frequency (cp<0. 05).
    5) The strength of T-cell immune response to HTLV-I and Phytohemagglutinin P (PHA) was observed in order of normal controls > seronegative OMT > seropositive OMT. The autologous proliferative response (APR)21 of PBLs was detected in 9 cases of 14 seropositive OMT, indicating immunological abnormality associated with HTLV-I infected OMT.
    6) When T-cell subset in the seropositive OMT were analyzed after the culture of PBLs, CD4/8 ratio was segregated to 2 groups, one with an increased CD4/8 ratio (3 cases) and the other with a decreased CD4/8 ratio (7 cases). The former produced poor prognosis and the latter a good prognosis.
    In conclusion, OMT infected with HTLV-I had a tendency of less immune response to HTLV-I and PHA compared with those of seronegative controls. The CD4/8 ratio was primarily associated with the prognosis of OMT. OMT had HLA-DRw8 in significantly high frequency comparing with the normal population. Thus, HLA-DRw8 and HTLV-I infection may interact each other and modulate the host immune system against OMT.
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  • Akira KOSE
    1989 Volume 35 Issue 6 Pages 1391-1405
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Non-specific cytotoxic activity induced by Interleukin-2 (IL-2) was examined in the lymphoid tissues including the spleen, thymus and bone marrow. High cytotoxic activity against YAC-1 cells was induced by IL-2 in cells from all the lymphoid tissues but cytotoxic activity against P815 were rarely detected in bone marrow cells. In the thymocytes which contain T cells in various differentiation stages, it was demonstrated that Thy-1+ L3T4 (CD4)-Lyt-2 (CD8)- cells were induced by IL-2 to express cytotoxic activity against YAC-1 but not against P815 in the embryo and adult mice. On the contary, IL-2 induced cytotoxic activity against P815 was found in the L3T4-Lyt-2+ adult thymocytes but such activity was scarcely detectable in the same phenotype thymocytes of 15 day embryos which were induced by IL-2 during 6 day-organ culture. The Thy-1+L3T4- Lyt-2- cells obtained from nylon wool column passed spleen cells from athymic nude mice and SCID mouse thymocytes also showed high cytotoxic activity against YAC-1 but low activity against P815.
    These results suggest that IL-2 can induce cytotoxic activity in the immature thymocytes against NK sensitive and the L3T4- Lyt-2+ mature T cells against both NK resistant and sensitive cells.
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  • Kenichi SASAKI, Hiroyasu NOMA, Hitachi MASAKI, Yoshito TAKASAKI, Hidey ...
    1989 Volume 35 Issue 6 Pages 1406-1414
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The artificial nerve structure should be similar to the natural nerve structure. We consider that regeneration of peripheral nerve fibers is dependent upon to contact guidance theory and nerve growth factor (N.G.F.). Polyglycolic acid (P.G.A.) fibers (1, 100-4, 300 fibers) were inserted in silicone tubes and grafted on the siatic nerves of Sprague Dawley rats. The length of P.G.A. fibers was set 10 mm and that of silicone tubes to 14 mm. The other side of siatic nerve was grafted with the autogenous nerves. Morphological changes were examined at each period (in 4, 8, 12, 16, and 28 weeks after surgery). The diameters and numbers of regenerated nerve fibers were examined. P.G.A. fibers had affinity to the axon. Schwann cells proliferated and lined along P.G.A. fibers. Axon regrows contacting with P. G. A. fibers and Schwann cells. Both their diameters and numbers increaed and they were correlated to the duration after grafting. P.G.A. grafting was inferior to autogenous nerve grafting in early stage of regeneration.
    But 16 weeks after surgery, we could not recognize the difference between P.G.A. grafting and autogenous nerve grafting. P.G.A. fibers absorbed entirely in 16 weeks. It suggests that P.G.A. fibers do not interrupt the growth of the axon. We observed the regenerating fibers more often in the wider space (>20 μm) than narrow space (<20 μm) among P.G.A. fibers. In view of this, the artificial material is necessary to add the skeletal structure of P.G.A. fibers and to maintain the space intact. This artificial material should be improved by further studies.
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  • Jouji NOMURA
    1989 Volume 35 Issue 6 Pages 1415-1427
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Osteosarcoma is high malignant neoplasm and the prognosis is poor. We established transplantable strains of nude mouse derived from human osteosarcoma originating in mandible (HOSMN-1) and experimented on anticarcinoma activity of Rhodamine-123, a mitochondrial specific dye, and the following results were obtained.
    (1) Histologically, HOSMN-1 consisted of atypical spindle, polygonal cells and bizarre multinucleated giant cells, and collagen fibers were also identified. In some places, storiform like pattern was revealed.
    (2) Both alkaline phosphatase (ALP) and acid phosphatase (ACP) stains showed positive granules in the tumor cells.
    (3) In chromosomal analysis, it was confirmed that HOSMN-1 was of the human origin. We have maintained the tumor cells for about 2 years for 10 serial passages, but up to date, no malignant osteoid was identified. HOSMN-1 hadn't revealed any differentiation or dis-differentiation.
    (4) On anticarcinoma activity of Rhodamine-123, a group administered 15 mg/kg × 4 times (i.m.) had significantly showed a growth inhibition effect in comparison with a control group, and the disappearance of tumor in 30% was observed.
    (5) Ultrastructurelly, in a group administered Rhodamine-123, especially, mitochondrial expansion, distortion and disappearance of crista were markedly seen. These findings supported the contention that Rhodamine-123 is a specific mitochondrial dye.
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  • Toshirou TAGAWA, Yoshio HIRANO, Madoka INUI, Hiroshi SAITO, Jouji NOMU ...
    1989 Volume 35 Issue 6 Pages 1428-1435
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Retrospective clinico-statistical observation of 119 cases with malignant tumors in the oral and maxillofacial regions at the dental and oral surgery clinic of the Mie University Hospital during 11 years from 1976 to 1987 was presented.
    The ratio of male to female was 1. 3: 1. Patients past the age of 70 years ccounted for about 31. 9% and the mean age was 62. 4. Of all cases, 52. 0% were referred by dental practitioners. In 105 cases of primary carcinomas, 96 cases (91.4%) were histologically diagnosed as squamous cell carcinoma, more were involved in the gingiva (34.2%) than in the tongue (25.7). Multiple primary cancers were 5. 8%. Most cases were treated by surgery (S) +chemotherapy (C) or S CA-radiation.
    The 5-year cumulative survival rate was 60. 9% in the primary oral carcinomas and 61. 3% in the squamous cell carcinoma.
    It has been suggested that surgery in combination with other treatment is an excellent therapy.
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  • Hideaki SAKASHITA, Masaru MIYATA, Morimoto HAYASHI, Kiyohide FUJITA
    1989 Volume 35 Issue 6 Pages 1436-1442
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Adenoid cystic carcinoma accounts for about 3. 8 to 10 percent of salivary tumors, and it occurs more often in the submandibular gland and the palate. Histologically, the tumor is characterized by a cribriform pattern of tumor nests, but tubular and solid patterns were also found occasionally. Usually, a tumor with a prominent solid pattern has a poor prognosis. A case of this tumor arising from the soft palate and showing insidious invasion to both the nasal side and the oral side of the hard palate without bone destruction was reported.
    The patient, a 44-year-old man, was referred to our hospital with the chief complaint of painless swelling at the left side of the soft palate. Radiological examination showed no evidence of bone destruction. The impression was a benign salivary gland tumor of the palate. Excisional biopsy was performed and the pathological examination revealed a picture of an adenoid cystic carcinoma with section line invasion. Part of the soft palate, hard palate, nasal septum and lateral wall of the pharynx were resected, and it was reconstructed by a mucoperiosteal flap from the contralateral palate. Because of a small necrosis of the flap, an oro-antral fistula occurred. Pathologically, the tumor spread along both the nasal side and the oral side of the hard palate and no bone destruction was noted.
    No recurrence was noted for four years and two months after the operation.
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  • Yasuaki OKUMURA, Tadashi OKUTOMI, Takashi OKUDA, Iwao HYODO, Takayuki ...
    1989 Volume 35 Issue 6 Pages 1443-1448
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The clinical results of electron beam therapy using intraoral cone in 8 cases of primary and recurrence carcinoma of tongue (T 1 and smaller T 2) were reported. The primary and recurrence cases were 5 and 3, respectively. In the 5 cases, a total dose of 10-30 Gy external radiation therapy were combined prior to electron beam therapy.
    The total dose of electron beam therapy varied from 40 to 60 Gy. In all cases, tumor showed good response and disappeared clinically. Radiation stomatitis, pain of the tongue with masticatory disturbance due to tenderness were complicated in all cases. These complications gradually disappeared 2 to 6 months after treatment. However, loss of body weight and bone exposure were not recognized in any case. Intraoral-cone electron beam therapy is thought to be available and has less complications comparing interstitial irradiation therapy from the review of literature. Within 6 months after radiation, submandibular lymphnode metastasis occured in 2 patients and radical neck dissection was performed. During the follow up period (from Feb. 1986 to Oct. 1988), 6 out of 8 cases are now NED (no evidence of disease).
    The advantages of this therapy should constitute; 1) less exposure of irradiation in another site, and 2) less complications comparing external beam therapy and interstitial irradiation. However, indications were limited according to the site and size of the tumors.
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  • Kasuke NAKASHIMA, Masamichi IDA, Fumihiko SHINOZAKI
    1989 Volume 35 Issue 6 Pages 1449-1453
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The recent improvement in engineering of artificial vessels and progress in microsurgery techniques has led to rapid and effective advances in the field of vascular transplantation.
    However, questions concerning the immunology of artificial vessels are not yet settled and the survival period of transplanted vessels is not known. Assuming sound operative technique, transplantation of autogeneous vessels seems to be comparatively safe.
    The neck dissection is performed during the surgical treatment of maxillofacial malignant tumor. If the internal carotid artery remains amputated after ligation of the external carotid artery, which provides nourishment to the tumor, the resulting clinical symptoms will be the same as those following ligation of the common carotid artery.
    These symptoms, such as confusion, occur due to hypovolemia of the orbital and cerebral region, resulting in death in severe cases.
    Therefore in this case of oral cancer in a 71-year-old woman in which the internal carotid artery was replaced with the great saphenous vein.
    Details of the successful transplantation are as follows.
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  • Makoto TSUCHIMOCHI, Izumi MATAGA, Kohzo TSUCHIKAWA, Joji KATO
    1989 Volume 35 Issue 6 Pages 1454-1461
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Clinical course of a case of malignant melanoma of the uvula is presented. The tumor was classified as stage 11 (UICC, 1978).
    The primary tumor was treated with intra-tumoral BCG vaccine which was effective on the injected area. On the other hand, this local BCG immunotherapy could not prevent systemic metastases retrospectively. Granulomatous hepatitis was complicated by this BCG therapy.
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  • Yukiko MATSUDA, Takashi SHIRANO, Teruhiko ISHII, Hiromitsu YAMANOI, Ya ...
    1989 Volume 35 Issue 6 Pages 1462-1468
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We have described two cases of ossifying fibroma in this paper.
    The first one was a recurrent case which occurred in a 52 year-old male patient. Tumor masses were found in the lower rim of mandible and in scar tissue close to previously operated areas. Histopthological examination revealed that tumor masses were composed of a proliferation of spherical and trabecular bones and dense fibrous tissue with a high cellularity.
    The second one was a case observed in a 26 year-old female patient. Histopathological examination revealed that the majority of tumors consisted of a proliferated fibrous tissue and a few immature fibrous bony tissues that were scattered at the peripheral region of this fibrous tissue.
    Although the enucleation of tumor or marginal resection of mandible were recommended for the treatment of ossifying fibroma, more extensive continuous resection of mandible should be applied to the cases which small tumor nests were scattered throughout the mandible such as case 1.
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  • Koji EBATA, Minoru SHIBATA, Toshio KANEDA
    1989 Volume 35 Issue 6 Pages 1469-1475
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of arteriovenous fistula of the mandible was reported. A 54 year old man visited our hospital and complained of mobility of left lower molar. On the first visit he had a diffuse swelling at the left mandibular gingiva but gingiva showed healthy color.
    Orthopantomography showed extending radiolucent lesion from 1 to 6, and it was suspected to be cyst or some benign tumor. We carried out biopsy at P gingiva and then severe hemorrhage occurred. Tamponade and some hemostatic techniques were not effective. Emergency operaion of ligation of external carotid artery was carried out under local anestheisa, so hemorrhage stopped. Clinical diagnosis was hemangioma in mandible.
    At 4 weeks after operation, gingiva was swelling again, and partial resection of the mandible was performed and reconstructed with A-0 reconstruction plate. The postoperative course was entirely good and without recurrence.
    The pathological diagnosis was arteriovenous fistula.
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  • Michihiko ENOMOTO, Masahiko FUKAYA, Kazunori MORI, Syuhei MATSUMOTO, M ...
    1989 Volume 35 Issue 6 Pages 1476-1481
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We experienced good results for mandibular reconstruction by using the external pin fixation system.
    Case 1: We presented a case of a 35-year-old man with a cementifying fibroma in the 26 region. We used HR (the initial of Hajime Hayashi) type pin system and Kirschner wire (diameter 3. 0 mm) for fixation of mandibular resection end.
    Case 2: We presented a case of a 51-year-old man with an amelobalstoma in the 64 region. We used HY (the initial of Hayashi Yamanaka) type pin system before mandibula resection. Mandibula reconstructed by using iliac bone graft and A-O plate. The results were excellent in both cases.
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  • Masanobu SATOH, Atsumi SUZUKI, Kazuo OBATA, Katsuhiko YUKI, Saburo SEK ...
    1989 Volume 35 Issue 6 Pages 1482-1486
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    An autopsy case of osteosarcoma derived from the right mandible was reported.
    The case was a 64year-old-female who received radiotherapy (60Co) for Hodgkin's disease in the right neck 15 years prior to the development of her osteosarcoma.
    By autopsy findings, large nodular growths in the right facial region and the lung metastases of the osteosarcoma were remarkable. No recurrence of Hodgkin's disease was revealed by autopsy.
    The authors considered that right mandibular osteosarcoma were suspected to be radiationinduced according to the long latent interval and the development of the sarcoma derived from the same location of the irradiation field.
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  • Tomomoto HASHIBA, Mamoru TAKAHASHI, Shigenobu SATOH, Taketoshi SAKAOKA ...
    1989 Volume 35 Issue 6 Pages 1487-1495
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This paper reports on reconstructive surgery with aluminum oxide prosthesis performed on three hemimandibulectomy cases. Secondary reconstruction was performed on two cases earlier affected with central fibroma or odontogenic calcifying cyst, and the third was operated on immediately after hemimandibulectomy as treatment for dentigerous cyst.
    The shapes and sizes of the prostheses had been designed by means of analysis of X-ray photographs and computed tomography, and the prosthesis was fixed to the mandible by aluminum oxide screws.
    The postoperative course of each case showed fine prosthesis stability and improved facial appearance. In the immediate reconstruction case, the function of the temporomandibular joint was well preserved, and the occlusion shows only a slight change.
    From the viewpoint of prognosis with aluminum oxide prosthesis and with consideration to the postoperative scar and the preexisting malocclusion in the secondary operated cases, immediate reconstruction is regarded as superior to the secondary operation.
    Although aluminum oxide has the properties of good tissue acceptance and chemical stability to the bone tissue, shapes and sizes of the prosthesis should be carefully designed, and well managed fixation is indispensable.
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  • Haruhiko SAKAMOTO, Yutaka IMAI, Yukihiro YOKOKURA, Reiko HOSOYA, Tomoa ...
    1989 Volume 35 Issue 6 Pages 1496-1508
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Thirty female patients having xerostomia were each given one tablet of Metharmon-F, a metabolic hormone agent, per administration on a thrice daily basis for 8 consecutive weeks. We evaluated the clinical effects of Metharmon-F treatment and the following results were obtained:
    1) Subjective symptoms were improved as follows: feeling of oral dryness was relieved in 30.0% of all the patients; saliva viscoid in 35.7%; intraoral pain (other than tongue) in 50.0%; dietary disorder in 37.0%; speech disorder in 50.0%; sleep disorder in 50.0%; taste abnormality in 41.7%; tongue pain in 53.3%; and strange sensation in the pharynx in 60.0%. As for objective symptoms, lingual conditions were effectively improved in 47.6% of all the patients.
    2) Overall improvement was observed as follows: 3.3% of the total patients remarkably improved; 36.7% moderately improved; 50.0% slightly improved; and 10.0% remained unchanged. No deterioration was observed. In patients who had already been receiving artifi cial saliva, salivary gland hormone, or vitamins, the concomitant administration of Metharmon-F resulted in a higher improvement rate.
    3) The effect of treatment is considered to appear approximately two weeks after the start of administration, Six-week consecutive administration may be required. In the Cornell Medical Index, a more favorable effect was obtained in patients with slight symptoms for items M to R.
    4) Adverse effects, i. e. symptoms of slight hyperaesthesia of limbs, were observed in only one case. However, no abnormal clinical findings were noted in other patients. Therefore, it was concluded that Metharmon-F is essentially safe in clinical application.
    Based on the results described above, Metharmon-F tablets were determined to be highly useful in treating xerostomia.
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  • Hideki HANAFUSA, Masaru HOSODA, Michio FUKUDA, Sumihisa KOWAKA, Tsuyos ...
    1989 Volume 35 Issue 6 Pages 1509-1513
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A 1. 4-year-old child presented to our clinic complaining of an infraauricular mass. After admission, we performed CT scan, PPD testing, Ga-scintigraphy and ultrasound. The final diagnosis was based on the histological findings of the surgical specimen and on the PPD test. The treatment was superficial parotidectomy and antibiotic therapy.
    Combination therapy with INH, RFP and SM was administered for six months, and no recurrence has been noted to date.
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  • Kazuyuki MIYATA, Nobuo MORITA, Takeshi WADA, Masakazu HARADA, Hiroyuki ...
    1989 Volume 35 Issue 6 Pages 1514-1521
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Sixty cases of salivary gland tumors at the Department of Dentistry and Oral Surgery of Wakayama Medical College during a 22-year period are reviewed. The diagnosis of individual tumors was based on the World Health Organization classification.
    1) 28 cases were benign tumors, and pleomorphic adenoma (27 cases) was the lesion most frequently encountered. In the group of malignant tumors (32 cases), mucoepidermoid tumor (12 cases) was the most frequently encountered lesion.
    2) Malignant tumors occurred most frequently in the sixth decade of life, although benign tumors were equally common in all decades.
    3) The palate was the site of most often involved. The next most common site of involvement for benign tumors was the parotid gland. For malignant tumors, the next common sites were the floor of the mouth and the retromolar region.
    4) The average duration from onset of benign tumors and malignant tumors were 5.4 years and 2.2 years.
    5) Painless swelling was the most common symptom presented. Pain and ulcer formation were presented with much greater frequency in cases of malignant tumors.
    6) From the clinical behavior and end results, mucoepidermoid tumor of low-grade malignancy does not tend to recur or metastasize. Those of high-grade malignancy frequently recurred and metastasized.
    7) Adenoid cystic carcinoma exhibits a marked tendency to metastasize to lungs 7-8 years after primary treatments.
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  • Tomoaki MURATA, Kiyofumi FURUSAWA, Masahiko KIGA, Kousei IGUCHI, Masay ...
    1989 Volume 35 Issue 6 Pages 1522-1530
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Mandibular resections are generally carried out for malignant tumors or nonmalignant tumors with tendencies to recur, such as ameloblastoma. Various artificial materials have been used for major discontinuity defects of the mandible combining with autogenous bone graft. Its method is valuable to compensate for disadvantages of inability to supply bone for very large mouth defects and difficulty in providing excellent surface facial contours because of its size and bulk for situations that require artificial material replacement of large defects, as shown in each method which is suitable under different circumstances. On the other hand, morbidity related to bone grafts harvested for reconstruction of major mandibular discontinuity defects have not been studied. It is thought that too long avascularized bone may cause infection, resorption, and partial necrosis.
    The present study was designed to investigate the relation between the mandibular resection size and the amount of ilium harvested by Barsky's procedure.
    Forty Indian dry skulls and ilium were used, in which landmarks of Pogonion (Pog), Gonion (Go), mental foramina (Me), mandibular foramina imaged at the cortical bone (Ma), the most prominent point of the iliac crest (A), a point of intersection between the tangent to iliac tubercle and tangent to external labium (B) were noted. Distances were measured of Pog-Go, Pog-Me, Me-Ma and A-B along the cortical bone. Linear measurements of cephalometric radiograph were shown with Pogm-Gom, Pogm-Mem, Mem-Mam, respectively. These linear values were measured along cl. vertical line perpendicular to the mandibular plane. Of the measurements performed on the dry bones, ratios of Pog-Go: Pogm-Gom, Pog-Me: Pogm-Mem, Me-Ma: Mem-Mam were 1.17, 1.53, 1.08 respectively. Ma-Me approximates to A-B. A-B has a relatively constant length, which can utilized as a Ma-Me length for planning a mandibular resection. The plate made based upon these ratios were used for mandibular reconstruction of two cases of odontgenic keratocyst and ameloblastoma. The most satisfactory and comfortable reconstruction for the patients were obtained in both esthetic and functional aspects.
    It is pointed out that it may be possible to design mandibular reconstruction with iliac bone transplantation using cephalometric measurements for large mandibular defects.
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  • Tomoyoshi Aso, Hirofumi MURASE, Hirohiko TAIRA, Kanji KITAMURA, Kinai ...
    1989 Volume 35 Issue 6 Pages 1531-1534
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Loss of the mouth may occur in electrical burns, chemical burns, tumor excisions etc. This report describes a case of cicatricial microstomia. The patient was a 69 year old man who had suffered severe burns on the lower part of his face approximately 3 years ago. The patient found it difficult to wear dentures and eat. Elongation of the corners of the mouth was required for this reason. A modification of the method of Kazanjian and Converse for elongation of the oral fissure was applied. A vertical line dropped from the pupil of the eye was utilized to extend the oral fissure.
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  • Akihiro Kanekawa
    1989 Volume 35 Issue 6 Pages 1535-1537
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A benign symmetric lipomatosis located within the tongue is rarely reported in the literature. Presented herein is the case of 67-year-old man with this bilateral lesion on the tongue. Surgical excision was performed, and no recurrence was observed for 2 years since this operation.
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  • Masaroh MATSUURA, Kanichi SETO, Hiroaki ISHII, Yutaka SHIBATA, Motohir ...
    1989 Volume 35 Issue 6 Pages 1538-1547
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A few disadvantages of the rigid osseous fixation method of osteomized fragments in sagittal split ramus osteotomy are still being pointed out by some surgeons. One of the major problems is a disturbance of the inferior alveolar nerve caused by injury at the time of screw tightening and another is the displacement of the condyle.
    We have developed some techniques to alleviate these problems, for example, el repositioning technique of the proximal fragment of the mandibular ramus after splitting. This technique can maintain the pre-operative temporomandibular joint relationship after surgery. Another technique is the three dimensional simulation method to locate the position of the mandibular canal after movement of the distal fragment. This method can indicate the safety zone for screw tightening in the overlapping area between the distal and the proximal fragment before surgery by employing a simplified three dimensional model of the maxilla and the mandible.
    In this paper, the post-operative results of 64 cases (127 rami) using both techniques and the relationship between the mandibular canal and screws applied for fixation of osteomized fragments are investigated. The success rate of avoiding contact with the mandibular canal was 87.4%(111/127 rami). In order to improve the success rate, an indicator for the screw tightening position of the upper side of the mandibular canal was devised. In 51 of the cases this indicator was used and the success rate was raised to 92. 1%. Totally 379 screws were used. Only 22 screws contacted or crossed the mandibular canal. Most of them were applied to the space on the lower part of the mandibular canal, because the screw tightening position of the upper part of the mandibular canal was pinpointed by our indicator. However, the screw tightening position of the lower part of the mandibular canal was only determined visually.
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  • Hiroaki ITO, Mitsugu SUZUKI, Hiroto KIMURA, Junichi MURAKAMI, Tamotsu ...
    1989 Volume 35 Issue 6 Pages 1548-1553
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of a 7-year-boy with ameloblastic fibro-odontoma in the mandible is reported.
    Ameloblastic fibro-odontoma is a rare odontogenic tumor composed of stands and nests of epitherial odontogenic cells within a mesenchymal stroma as observed in ameloblastic fibroma associated with dental hard structures as seen in complex odontoma.
    The patient complained of intraoral swelling.The radiographic evaluation, which included a panoramic view and a posterioanterior view, revealed a mixed radiolucent-radiopaque mass of the mandible.Radiolucent area had a sunburst configuration.As the result of the biopsy, the tumor was diagnosed ameloblastic fibro-odontoma.
    While he was under general anesthesia, the calcification was removed, and marsupializadon was performed via 41.transoral approach. After the first operation, the bone defect gradually decreased in size as the surrounding mandible bone regenerated.Then, total resection was performed by the second operation under general anesthesia.
    The clinical course is excellent, and there is no evidence of recurrence.
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  • Etsuhide YAMAMOTO, Nobuhiro ISHIKAWA, Jun-ichi SUZUKI, Hiroyoshi HIRAT ...
    1989 Volume 35 Issue 6 Pages 1554-1563
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Forty patients with mandibular deformity have undergone a modified sagittal splitting osteotomy of ramus extending to premolar area with miniplate-osteosynthesis. Results were as follows: 1) Preoperative diagnosis of these cases was 37 of prognathia with or without open bite and asymmetry, two of open bite and a case of asymmetry. 2) Average operation time and blood loss was 137 minutes and 356ml. Mandibular body after splitting was moved maximally 13 mm backward and 11 mm upward. 3) Complications were two of fracture of medial part of buccal cortex and three of injury of mental neurovascular bundle. 4) Miniplate-osteosynthesis with no skin incision and about seven-days intermaxillary fixation were performed. Postoperative course after release of this fixation was not eventful. 5) Relapse was obviously less than that in cases of circumferential wiring. 6) This method, therefore, seemed to have wide application for procedure of mandibular deformity.
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  • Gaku YAMAMOTO, Kiyotaka OKADA, Yoshiyuki OHNISHI, Syu YAMAMOTO, Hirosh ...
    1989 Volume 35 Issue 6 Pages 1564-1568
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This clinical study reported a case of trigeminal neuralgia caused by intracranial tumor. A-34-year old female was referred to our clinic with a chief complaint of fulminate pain on the gingiva at the right side of the under jaw. On oral, a carbamazepine, a herb medicine were administrated, and acupuncture was applied and as the result, pain was alleviated. However, two months later, the pain recurred and during the attack of the pain, tinnitus occurred. Intracranial tumor was suspected and CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) disclosed the presence of tumor in the right cerebellopontile angle. The tumor was removed at the Department of Neurocerebral Surgery and was diagnosed histpathologically as an epidermoid. After the operation, the pain disappeared and now after 11/6 postoperative years, she shows favorable prognosis. Since trigeminal neuralgia of unknown cause may sometimes be ascribable to tumor near the trigeminal nerve, like in the present case, it will be necessary to neurocerebral examine as CT and MRI.
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  • Kazuyoshi OZAWA, Izumi MATAGA, Kohzo TSUCHIKAWA, Joji KATO
    1989 Volume 35 Issue 6 Pages 1569-1574
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A clinical investigation was done on the external dental fistulae from twenty-six patients who had visited our OPD for the past twelve years. The age distribution was equally spread over all decades, and there was a slight female predominance. The duration from the recognition of the onset till the first visit in our OPD tended to be relatively long, the longest was 4 years and the shortest a few days. Many other departments, such as dermatology, surgery, ENT, or internal medicine, had been asked before the patients visited our OPD. The pathogenic teeth were observed more in the mandibular region than the maxillary region, especially the mandibular molars and canines. Cheek area was the commonest site of external dental fistula. The clinical courses had good result with not only care for the causative teeth, but also actual surgical intervention for the fistulae.
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  • Yoshimi ISHIKAWA, Satoshi UMINO, Shigeru ONO, Kiyohide FUJITA
    1989 Volume 35 Issue 6 Pages 1575-1583
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Resection for carcinoma in buccal mucosa and lip may be accompanied with the full-thickness cheek defect including lip and angle of mouth. Up to now, many authors have reported all kinds of the reconstructive techniques. In general cases, the results were not adequate in point of the aesthetics (color and texture match), because the extraoral defect has been repaired with distant flap.
    We reported two cases of reconstruction for the full-thickness cheek defect. In case 1, we repaired the intraoral defect with vascular pedicled forehead flap and covered the extraoral defect with double skin flap which raised from buccal to retroauricular region. In case 2, we repaired the intraoral defect with pectoralis major myocutaneous flap and covered the extraoral defect with advancement flap which raised from opposite side lip and rotation flap which raised from naso-labial region. By the use of these techniques, we succeeded in functional and aesthetic reconstruction.
    We consider that if circumstances allowed, the extraoral defect should be repaired with local flap using facial and/or cervical cutaneous tissue, (because local flap rather than distant flap) is well matching adjacent skin color and texture. On the other hand, the intraoral defect should be repaired with reliable tissues which have good blood supply for lining of the extraoral covering tissue.
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  • Tadamitsu KAMEYAMA, Yoshiaki NAKAMURA, Michio OKUSU, Shunichi TANAKA, ...
    1989 Volume 35 Issue 6 Pages 1584-1588
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We experienced an unusual case of primary herpetic gingivostomatitis having deep, beltlike ulcers developed on the upper and lower gingiva in a patient with ulcerative collitis and reported the clinical and laboratory findings of this case.
    Also, by peroxidase antiperoxidase method HSV antigen was obserbed in neurofibrill of submucosa. We may suggest that this finding demonstrated a neural spread of HSV through the intra-axon.
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  • Yoshimasa TATSUMI, Tadaaki KIRITA, Kimio MATSUSHITA, Yoshiyuki NAKATAN ...
    1989 Volume 35 Issue 6 Pages 1589-1598
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Neuroblastomas are highly malignant tumors which arise from sympathetic cells. They are found mostly in early childhood and easily matastasize to distant regions.
    A case of metastatic neuroblastoma of the mandible with chief complaint of oral symptoms was reported.
    The patient was an 8-year-old girl with bilateral lower permanent teeth mobility. The fi ndings of radiography and CT-scan suggested malignant tumor of the mandible. Pathological diagnosis of the mandibular lesion by biopsy was neuroblastoma and the primary tumor was clinically found in the right abdomen.
    Chemotherapy was started, but the patient died about two months after diagnosis.
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  • Eitaro SANADA, Toshimi HASEGAWA, Michio KOYAMA, Kazuyoshi MABUCHI, Shi ...
    1989 Volume 35 Issue 6 Pages 1599-1605
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Peripheral ameloblastoma is a rare tumor, which occurs in the soft tissue overlying alveolar bone.
    We represent an unusual case of peripheral ameloblastoma arising in the right pterygomandibular space.
    Case: The patient, a 66-year-old woman admitted to our hospital with complain of mass in the right retromandibular region. The tumor was excised under general anesthesia.
    The postoperative course was uneventful with no sign of recurrence.
    There has been some controversy concerning the relation between peripheral ameloblastoma and basal cell carcinoma.
    By the identification of immunohistochemical localization of the human type IV collagen in this tumor, we could get some knowledges of this problem.
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  • Chihiro KOGA, Tadamitsu KAMEYAMA, Shunichi TANAKA, Rika YASUTAKE, Yosh ...
    1989 Volume 35 Issue 6 Pages 1606-1610
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Lymphoepithelial cyst generally develops in the lateral cervica larea, but the same cyst sometimes develops in the oral cavity. It is characterized histopathologically as lymphoid tissue below the lining of the stratified squamous epithelium of the cyst. As weexperienced two cases of lymphoepithelial cyst in the oral cavity. We histopathologically examined serial sections of the two specimens and discussed the histogenesis of the lesion.
    Case 1. The patient, a 29-year-old woman, was presented to our department on April 27, 1988, for evaluation of a small tumor on the right floor of the mouth. She found it herself by mirror two days before. Under to cal anesthesia, the lesion was totally excised. Histopathological findings revealed a cyst with parakeratinizing stratified squamous epithelium and lymphoid tissue with follicles.
    Case 2. The same cyst was found on the right side of the ventral surface of the tongue in a 51-year-old woman presented to our department on September 20, 1985. She found it herself yesterday by mirror that because of unpleasant feeling in mouth. It was the same histopathological findings as in case 1.
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  • Isao SASAKI, Akira SASAKI, Akira OKAZAKI, Jurou OKADA, Hironori HAMAOK ...
    1989 Volume 35 Issue 6 Pages 1611-1616
    Published: June 20, 1989
    Released: September 13, 2011
    JOURNALS FREE ACCESS
    A case of Schwannoma that occurred at the right palate was reported. The clinical impression was suspected pleomorphic adenoma, and the lesion was surgically excised under general anesthesia. It was noticed during the operation that the tumor adhered to the greater palatine nerve. Histopathologically it was diagnosed as Schwannoma (Antoni A type), so it was suggested that the tumor had a close relation to the greater palatine nerve. Clinical behaviors were compared with other Schwannomas already had reported. From histological, electronmicroscopical, and immunohistochemical findings, the origin of the tumorwas also discussed.
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  • Yoshiaki KOMIYA, Tadayoshi MATSUDA, Ikuhiro UTIDA, Syohei IWAMOTO, Tos ...
    1989 Volume 35 Issue 6 Pages 1617-1627
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This is an investigation of 62 cases with squamous cell carcinoma of thetongue treated at the Tokyo Metoropolitan Komagome Hospital from May, 1976 to April, 1986.
    Initial therapy of the primary site of the tongue was radiotherapy in 53 of 62 cases (85.5%), these items were Radium interstitial brachytherapy 23 of 62 cases (37.0%), combined external and interstitial radiotherapy 18 of 62 cases (29.0%), intraoral electron therapy 10 of 62 cases (16.0%), external radiotherapy 2 of 62 cases (3.2%), and operation of use together pre-operative radiotherapy and operation for 8 of 62 advance cases (13.0%).
    This report has investigated the following using the therapeutic methods of the tongue cancer:
    1) Local control rate of the primary site of the tongue cancer.
    2) Metastatic rate of regional neck lymph node.
    3) The survival rate classified by the disease stage.
    4) Osteo-radionecrosis.
    5) Double cancer.
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  • Yasunori SATO, Isoo NOGUCHI, Toshifumi ANDO, Masayuki TAKAHASHI, Shige ...
    1989 Volume 35 Issue 6 Pages 1628-1633
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Cystic lesions occurring in the submental and submandibular resions are frequently percutaneously palpable and present relatively minor difficulty to clinical diagnosis as cysts, but several supplementary methods of exploration such as computed tomography, echography, RI, and sialography, etc. are being used in order to accurately grasp its range, depth, and relationship to the surrounding tissues. However, each of these exploration methods has special characteristics and do not develop the complete information available beyond a single method of exploration. Recently, MRI has been highlighted as a diagnostic tool for obtaining images of high contrast. We have been applying magnetic resonance equipment, the MMI 150 S, manufactured by Mitsubishi Co. to 56 patients with diseases in the oral region since September, 1987. In the present paper, we report our findings on MRI data with some consideration for supplementary methods of diagnosis available in 2 patients with cysts in the submental and submandibular regions as shown in the follwing:
    In 2 patients with cysts as reported in the present paper, the morphology of the region with pathologic change was evidently depicted with markedly high intensity on T2 weighted images in qualitative terms, suggesting possible liquid content. The hyoid bone adjacent to the cyst was poorly depicted. Useful findings could be obtained for three-dimensional morphology and the positional relationship to the surrounding tissues by each tomographic image such as sagittal tomography, metopic tomography and horizontal tomography.
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  • Yuuichi UCHIZAKI, Syouichi NAKAMURA, Kunio IKEMURA
    1989 Volume 35 Issue 6 Pages 1634-1637
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    The patient was a 38-year-old female complaining of soreness of the oral mucosa. When she came to our out-patient clinic she had erythematous papular eruption on the limbs for 2 months. On the lips, tongue and fauces were well-defined, slightly raised lesions with a grayish white or erosive surface. Skin and oral lesions were suggestive of syphilis. The labial lesion histologically showed nonspecific inflammation and serologic examination confirmed syphilis.
    The patient was referred to the department of dermatology for further examination and treatment of persistent skin lesions. After the administration of Bicillin-V2®, the skin lesions disappeared for one month.
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  • Masahiko MIYAKE, Toshihiko ISHII, Yasuyuki ODA, Osamu KANEKO, Yasuo TA ...
    1989 Volume 35 Issue 6 Pages 1638-1645
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Three cases of proliferative lesions in oral mucosa that clinically appeared to be malignant were investigated histopathologically. Histopathological examination revealed that a first one was classified into oral frolid papillomatosis and the others were into leukoplakia verrucosa. All three cases were treated with a local application of 5-Fu ointment at first and after confirming the reduction of lesions, then, a first case was given by peplomycin and remaining two cases by surgical excision. Good recovary of lesions was obtained from these proceduses.
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  • Moriyasu ADACHI, Soichiro NAITOH, Hiroshi INAMOTO, Hidenori MATSUSHITA ...
    1989 Volume 35 Issue 6 Pages 1646-1649
    Published: June 20, 1989
    Released: September 13, 2011
    JOURNALS FREE ACCESS
    Neurilemmoma is a benign neoplasm believed to arise from the Schwann cell of the neural sheath. Although it may develop in any places of the medullated nerves where they exist, it is rarely seen in the oral cavity, particularly in the lip.
    Recently we experienced a case of neurilemmoma arising in the upper lip of a 73-yearold female. The tumor was diagnosed histopathologically as a neurilemmoma of Antoni A type.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1989 Volume 35 Issue 6 Pages 1677-1744
    Published: June 20, 1989
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Download PDF (68789K)
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