Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 37, Issue 12
Displaying 1-30 of 30 articles from this issue
  • Mikio IHOKI
    1991 Volume 37 Issue 12 Pages 1923-1936
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The present study showed that human demineralized dentin matrix gelatin (DNIG) induced prolific hyaline cartilage in rat foetal muscle tissue in vitro, and that bone morphogenetic protein (BMP) extracted from human DMG induced bone in vivo when it was implanted subcutaneously in a rat. Extracellular matrix of the cartilage-producing tissue was histologically and histochemically investigated in tissue culture of rat foetal muscle tissue on human DMG. At the prechondrogenic stage, many fibroblastic cells developed in the area neighboring DMG and secreted extracellular matrix containing much hyaluronic acid. Then, alkaline phosphatase (ALP) activity of plasma membrane of the fibroblastic cells became higher. The extracellular matrix decreased in proportion to increase of ALP activity, and the intercellular space became smaller. Later, the fibroblastic cells secreted extracellular matrix containing much sulphated glycosaminoglycans, and the intercellular space spread again. These cells changed into ovoid chondrocytes in the area next to DMG. The chondrocytes secreted type II collagen in the extracellular space and ALP activity disappeared. Fibroblastic cells which proliferated in the surrounding area of cartilage exhibited ALP activity. ALP activity in this course is one of good indicators for predicting cartilage formation. It can be assumed that ALP activity correlates with qualitative alteration of extracellular matrix in an early stage of chondrogenesis.
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  • Hirohiko TAIRA
    1991 Volume 37 Issue 12 Pages 1937-1949
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This study evaluates the mandibular response to alveolar ridge augmentation with bioactive glass ceramic granules in adult dogs. The lower P 2, P 3, and P 4 were extracted and alveolar ridge augmentation of the mandible took place one month later; 5 to 300 days after the operation the mandible with the glass ceramic granules were extirpated.
    The results showed new bone formation from the lingual cortical bone to the bioactive glass ceramics 10 days after the operation, after which the bone formation spread to the alveolar ridge and periosteum of the mandible.
    New bone has formed over the alveolar ridge 120 days after the operation; however, there is no new bone formation from the periosteum: new bone formation is earlier and wider on the lingual side of the augmented area than the buccal side.
    There was new bone on almost all of the augmented area 300 days after the operation.
    It is concluded that the bioactive glass ceramic granules have high tissue affinity and are useful for alveolar ridge augmentation.
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  • Hideyuki HOSHINA
    1991 Volume 37 Issue 12 Pages 1950-1960
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The effects of RF hyperthermia on hamster oral carcinomas were studied in their primary sites and in their lymph node metastasis.
    Transplantable squamous cell carcinoma (O-1N) with a high metastatic potency was grown up to 8 mm in diameter in the buccal pouch of the hamster. A total of 75 tumors were served for experiments: 65 tumors were heated once by the 13. 56 MHz RF wave for 40 min (single heating group, SH) at 42, 43, and 44°C, and 10 tumors were heated at 43°C 4 times during 2 weeks (repeated heating group, RH). In the SH group, tumor size of the primary site was not significantly changed until 10 days after heating at 43 and 44°C. However, no inhibition of the tumor growth was obtained at 42°C Complete disappearance of tumor cells was confirmed histopathologically in 2 of 12 tumors (17%) heated at 43°C and 2 of 20 tumors (10%) heated at 44°C. Vascular disturbance was characteristic histology of the tumor tissue just after heating at 43°C. Tumor cell necrosis appeared focally on the first day after heating. On the second and third days, necrotic changes became extensive across the tumor site. On the fourth day, tumor nests reappeared with fibrous stroma at the periphery of the necrotic foci, and thereafter, they maintained proliferation to form larger masses until the end of the experimental course. In the RH group, the tumor growth was much more inhibited until 21 days after the first heating than that of the SH group, and complete disappearance of the tumor was histologically confirmed in 4 of 10 tumors (40%). Frequency of metastasis of the carcinoma to cervical lymph nodes was reduced to 50%(5 of 10 tumors), whereas metastasis was observed in 100 (90)% of the control groups.
    The findings suggest that our single heating system at 43°C had transient effects on the hamster carcinoma growth and that the anti-tumor effect was enhanced by the repeated heating. Hyperthermia could possibly inhibit cervical lymph node metastasis of the carcinoma.
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  • Kanji MAEDA, Tatsuo TSUJI, Yuka KIMURA, Yoshikazu HAYATSU, Kohsuke SAS ...
    1991 Volume 37 Issue 12 Pages 1961-1965
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The proliferative capacity of the oral squamous cell carcinoma (SCC) was analyzed immunohistochemically using monoclonal antibody against proliferating cell nuclear antigen (PCNA.) The PCNA-positive cell was detected in all cases of formalin fixed, paraffin embedded specimen from SCC and normal epithelium. The percentage of the PCNA-positive cells in SCC ranged from 0.8% to 23. 3%, and its mean value ± S. E. was 11.2±0.98%(n=36). In oral SCC, PCNA-positive rate correlated with the differentiation and cellular atypism of SCC, while there was'nt a significant difference in the relationship with the stage of the disease and the patient's prognosis. These findings suggest that immunostaining of PCNA is a convenient and important new method by which to estimate the cellular proliferation rate of oral cancer.
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  • Ataka ITO
    1991 Volume 37 Issue 12 Pages 1966-1980
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    In our previous study, we showed that irradiation, by low power laser, of the stellate ganglion of patients suffering from facial pain, trigeminal neuralgia, and facial palsy had an ameliorative effect. The method is safer than injecting anesthetics. However, basic research on the mechanism of this treatment procedure is not numerous. In this study, the author examined the validity of two hypotheses explaining the physiological phenomena F Itin. 1. ffoni laser irradiation., namely the nerve block-like effect hypothesis and the acupuncture-like effect hypothesis. The stellate ganglions of 15 healthy subjects were irradiated with low power Nd: V AG laser (300 mW), and the following were examined:
    1) Changes in temperature of the skin of the face and hand dorsum.
    2) Pulse rate and blood pressure.
    3) Plasma catecholamin (adrenaline and noradrenaline).
    4) Peripheral autonomic surface potential (PASP).
    Tin results were as follows.
    1) Although only one stele was irradiated, the skin temperature rose on both sides of the face and hand dorsum.
    2) systolic pressure fell significantly in the irradiated group.
    3) The noradrenalme level became lower at 15 minutes-irradiation in the irradiated group.
    4) The PASPs did not show significant change either in latency or amplitude.
    It is concluded that the effects of irradiation occur reflectively through the central nervous system, by lowering the tension of the sympathetic nervous system.
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  • Norimasa SHIMAMURA
    1991 Volume 37 Issue 12 Pages 1981-1994
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    Utilization of bone morphogenetic protein (BMP) new bone production and regeneration after a bone defeet is urgently needed in clinical treatment. Sell curing hydroxyapatite (HAP) cement has a poss'bility to be a useful material as an effective BMP delivery system. In the present report, BMP-HAP compositions were implanted into femur tone defects of ICR mouse to examine the usefylness as an augumcntation materal and a delivery system with BNIP in the clinic.
    Materials and Methods:
    BMP was made by the method that was discovered by Urist in 1984. Crude BMP (c-BMP) was extracted from fresh bovine cortical bone.
    Five mg of freeze dried c-BMP and 20 mg of HAP cement were mixed and shape d as φ 3mm×5 mm cylindrical type of BMP-HAP composition. As the experimental group, the BMPHAP compositions were implanted into 5 mm length of regional bone and periostA urn defections which were splinted with Kirschner wire (K-wire) used for a space retainer on f femur bones of ICR mice. Tissue specimens were taken from animals at 1, 2, 3, 4, 6 weeks post-implantation to examine for histopathological evaluation. Only K-wires were put the same way as an experimental group for the sham control, and only HAP cement blocks were implanted into same region for comparisons with BMP-HAP composition.
    Results:
    1. In the wire Group, the bone defects between both bone edges of the femur bone were filled with connective tissue as a non-union at 4 weeks post-implantation.
    2. In HAP Group, the bony bridges were identified with a new bone from the surface of the existing bone were at 6 weeks post-implantation.
    3. In BMP-HAP composition group, the bone formations from the surface of existing bone to the implanted material were more active than the HAP group, but the bone inductions surrounding the implanted BMP-HAP composition were not so reactive.
    According to these results, I want to suggest that HAP cement is a u, eful matdrial as an atigumentation material and delivery system with BMP.
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  • Isao MIZUNO, Arichika NAMIKAWA, Michio KAWAI, Hideki MIZUTANI, Minoru ...
    1991 Volume 37 Issue 12 Pages 1995-1999
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    It is generally accepted that the presence of poorly controlled diabetes very likely contributes to the incidence and severity of infections.
    A 45-year-old male was referred to our hospital with a temporal-occipital abscess and a defect of the temporal skin. He has been suffering from DM for 6 years, and insulin treatment was tried as a control for it.
    The inflammation probably originated from acute pericoronitis of the left lower third molar, and it extended to the pterygomandibular space, pterygopalatine fossa and infratemporal fossa. The patient was admitted for probable surgical incision and drainage, systemic antibiotic treatment and the control of DM.
    If increasing findings of infection are present in a diabetic patient, it is important to strive for normal blood sugar level in addition to the usual treatment with appropriate antibiotics and adequate drainage.
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  • Hemostasis of the superior posterior alveolar artery injury caused by extraction of the upper third molar
    Haruo SAKAMOTO, Kazunari KARAKIDA, Akihiro KANEKO, Takesi MORISIMA, Sa ...
    1991 Volume 37 Issue 12 Pages 2000-2005
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We have experienced a lot of hemorrhage by injury of the superior posterior alveolar artery during extraction of the upper third molar. we tried hemostasis and the first attempt was unsuccesful. A gauze tampon was used, but it pushed out the sinus mucosa through the large bone defect. Our second attempt was succesful in attaining hemostasis of the superior posterior alveolar arterial hemorrhage. The method used was selective arterial embolization by angiography. We used the zeruform powder and the microcoil as the embolizing materials. It has made significant contributions to the management of patients with superior posterior alveolar arterial bleeding.
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  • Hisao SHIGEMATSU, Kuniya FUJITA, Seiji SUZUKI, Yoshiaki SHIGEMATSU, Ki ...
    1991 Volume 37 Issue 12 Pages 2006-2014
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Granular cell tumor of the tongue in a 67-year-old woman is reported including details of histochemical, immunohistochemical, and ultrastructural findings.
    The patient had a chief complaint of a painless nodule that was located slightly right of the midline of the tongue. The nodule, about 4 mm in diameter and having a distinct border, palpated hard-elasticity, and adhered to the muscle layer. Clinically, this tumor was suspected to be benign. The nodule was excised with the surrounding tissue under local anesthesia. The postoperative course is uneventful at present without any evidence of recurrence. The tumor was characterized by acidophilic granules in the cytoplasm. Marked pseudoepitheliomatous hyperplasia of the overlying epithelium was not present. Pathological diagnosis was a granular cell tumor.
    Histochemically, intracytoplasmic granules were faintly positive in the PAS staining, which was diastase resistant, and negative in the Sudan III and Sudan Black stainings. Immunohistochemically, the tumor cells were moderately positive by reacting with antiserum against S-100 protein, Electron microscopically, granules of various sizes in the cytoplasm of the tumor cell, which was bound by a basement membrane, were revealed, and occasionally myelin figures were noted. According to these results, the tumor cells were suspected to be neurogenic in origin.
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  • Junko UENO, Yutaka HASHIMOTO, Manabu TAKARADA, Hiroaki TANIOKA
    1991 Volume 37 Issue 12 Pages 2015-2018
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Total parenteral nutrition (TPN) for 92 cases of maxillofacial diseases was reviewed in order to improve the nutritional management at Department of Oral and Maxillofacial Surgery, Ehirne University Hospital. It was concluded that: 1) TPN is effective for the adequate hydration and nutrition of preoperative or postoperative patients, who are impossible to take the water and food. 2) Patients, who have experienced TPN before, prefer that to the feeding tube. 3) A central venous catheter is also useful for the continuous administration of intravenous morphine for cancer pain control. 4) The education and cooperation of the staff and patients are important to prevent the sepsis, which is the most frequent complication due to TPN.
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  • Minoru MATSUYAMA, Kenji NAKATA, Yoshihiro SAWAKI, Minoru UEDA, Toshio ...
    1991 Volume 37 Issue 12 Pages 2019-2025
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Plasmacytoma is the disease with tumor-like growth of plasma cell or of their cognate, and often generates in the bone tissues of the entire body as multiple myeloma. Also, unusually, it develops in soft tissue as extramedullary plasmacytoma.
    We present a case of extramedullary plasmacytoma which originated in the upper lip, which might be the first case to be reported in Japan.
    A 33-year-old woman had been aware of the tumor developing on the inner side of upper lip for two months, and then visited us with a complaint of its discomfort. Upon pathological examination, this tumor was completely excised and was suspected of being plasmacytoma.
    General examinations followed, which denied the possibility of multiple myeloma. Furthermore, we investigated an excised sample by immunohistological examination, and identified it as extrameduallary plasmacytoma with IgA and κ-chain. In order to prevent its recurrence and metastasis, chemotherapy with Cyclophosphamide, Vincristine, Doxorubicin, and Predonisolone was done, and after a year and two months she is still in excellent condition.
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  • Hideo IMAMURA, Eiro KUBOTA, Jiang-lin FAN, Mitsuo KATANO, Hiroyuki KUR ...
    1991 Volume 37 Issue 12 Pages 2026-2034
    Published: December 20, 1991
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    Malignant tumor consisting of elk, r. cells is often seen in the kidney and several other organs. This tumor, however, rarely occurs in oral and, maxillofacial regions. We recently experienced a huge clear cell carcinoma in a 79-year-old female, which putatively originated in the mandible, and o expansile into the right maxilla. zygoma, temporal bone, orbital, and partially into the cranium. Lymphnode (LN) metastasis was observed in the right submandibular LN.
    Histopathologically, the tumor was primarily composed of large sheets and islands of uniform vacuolated and clear cells separated by a mature fibrous connetive tissue. The tumor contained no glandular epithelial cells or myoepithelial cells. PAS positive and diastase digestable granules were observed in a small number of tumor cells.
    Immunohistochemical examination revealed that the tumor cells focally showed positive reaction to keratin (KT) and epithelial membrane antigen (EMA), but completely negative for actin, S-100, vimentin, and myosin.
    Ultrastructurally, the tumor cells were characterized by the presence of abundant cytoplasm and lack of intracellular organelles. Tonofilaments and desmosomes were, however, occasionally observed. From all of these findings, it is considered that the tumor cell may be derived from the odontogenic epithelium and mimick to clear cell odontogenic tumor.
    More interestingly, it was found that the tumor partially showed squamous cell differentiation after chemotherapy and immunotherapy. It is likely that the clear cell tumor may transform into squamous cell during differentiation process or vice versa, or the tumor may initially consist of two different kinds of tumor cells.
    The histogenesis of the tumor and its potential possiblility to differentiate into squamous epithelium are discussed.
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  • Yoichi TSUBOI, Yukitada HYO, Yoshihiko YOKOE, Tadahiko IIZUKA
    1991 Volume 37 Issue 12 Pages 2035-2040
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Bacterial meningitis caused from odontogenic foci is extremely rare in this era of advent and advancement of antibiotics. This report is a case of a 13-year-old girl treated for upper incisor abscess, then infection spread into the paranasal sinus and unfortunately developed to meningitis accompanied with a brain abscess.
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  • Study of arthroscopy and double contrast computed tomography of the temporomandibular joint
    Kayoko OHTSUKI, Masatoshi OHNISHI, Izumi TAKEI, Yu NAKAMURA, Tokuo WAK ...
    1991 Volume 37 Issue 12 Pages 2041-2046
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    In recent years, acute suppurative temporomandibular joint arthritis has rarely been encountered and is thus not well documented. Recently, we encountered a case of such joint inflammation and presented mainly clinical signs and symptoms, Ga schintigram findings, and double-contrast computed tomograms, arthroscopic findings, and arthroscopic surgical procedures of the temporomandibular joint.
    The patient, a 46-year-old man, visited our hospital with the chief complaint of pain in the right face, left-directed mandibular deviation, and malocclusion in April, 1988.
    Mouth opening was limited to 12 mm.
    X-ray revealed that the mandibular head and moved in front of the fossa mandibulars, despite the fact that the mouth was closed. Antiinflammatory therapy was instituted. This was followed by intra-articular joint puncture; 5 ml of pus was aspirated.
    Concurrently performed double-contrast CT of the joint revealed joint cavity enlargement and abscess cavity formation. Ga scintigram revealed pronounced accumulation in the right temporomandibular joint. Subsequent management included temporomandibular joint arthroscopy and arthroscopic biopsy (histopathological diagnosis: synovial tissue calcification and fibrillation) and intra-articular washing with an antibiotic. Post-curative rehabilitation by means of mouth-opening training was perfomed. The double-contrast CT of the current time after a lapse of 28 months revealed joint cavity disappearance, but the clinical course has been good and mouth-opening range is 43 mm. Thus, such rehabilitation as mouthopening training and others are important in curing high-grade inflammation manifesting in a joint accompanied by intra-articular organic change.
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  • Shoko TSUJIMURA, Hiroto KIMURA, Mitsugu SUZUKI, Yoshitaka TAKACHI, Mas ...
    1991 Volume 37 Issue 12 Pages 2047-2053
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In the oral-maxillofacial region, there are many reports concerning on bone diseases, so called renal osteodystrophy. We have experienced a chronic renal failure patient with remarkable enlargement of jaw bones. This patient has been treated with hemodialysis therapy for over 10 years complicated by secondary hyperparathyroidism.
    This paper reports the clinical findings and the components of jaw bone analysed by Fourier transform infrared spectroscopy (FT-IR). In this study, we used synthetic apatites and alveolar bone of a patient, who did not have metabolic bone disease, as controls. The transmission spectra of the patient's alveolar bone was compared to those of the controls. Moreover, the subtraction spectra studies were carried out between the patients sample and the controls.
    Pathohistological findings were widely bone absorption replaced by fibrous tissues. The transmission spectra of the patient's sample was different from those of the hydroxyapatite and carbonate-containing apatite. However, the absorption intensity of the patient's sample in the area of PO3-4 and CO2-3 were similar to, but somewhat stronger than, that of the cortical bone of the control. These differences among the samples were confirmed by the analysis of subtraction spectra.
    These findings suggested that the alveolar bone of the patient was formed by the fibrous and osseous tissues with hyper-calcification.
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  • Kazuyuki MINOWA, Satoru ABE, Yoichirou HOSOKAWA, Keiichi OHMORI, Michi ...
    1991 Volume 37 Issue 12 Pages 2054-2059
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We examined whether magnetic resonance imagings (NIRI) after gadolinium-DTPA administration were clinically more useful than nonenhanced MRI in 17 patients with paranasal sinus noeplasm. Seventeen patients underwent MR I both with and without gadolinium-DTPA, and CT. Six of the seventeen cases demonstrated coexisting neoplasm and mucoceles, polyps. Though nonenhanced MRI enabled correct differentiation of 3 of these 6 lesions, gadolinium-enhanced MRI enabled correct differentiation of all 6 lesions.
    We concluded that gadolinium-enhanced MRI was useful for differentiating neoplasms and mucoceles or polyps in the paranasal sinuses.
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  • Satoru SHINTANI, Tomohiro MATSUMURA, Reiko NAITOH, Yosiya UEYAMA
    1991 Volume 37 Issue 12 Pages 2060-2067
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    Clinical, histological, and immunohistochemical studies were carried out for 19 cases of adenoid cystic carcinoma arising from the major and minor salivary glands. The cases were classified clinically (UICC-TNM system, 1987) and histologically (Szanto et al., 1984). For immunohistochemical detections, monoclonal antibody against c-myc gene product, v-H-ras gene product and EGF-receptor, and poloclonal antibody against c-erb B2 gene product were used.
    The prognosis of the patients with the tumor of stage IV and/or grade III were poor. Six out of eight patients of stage IV and 4 out of 5 patients of grade E died due to the tumor. c-myc gene product was detected in 16 out of 19 cases (84.2%), without histological grading correlation. In most cases, c-myc gene product was detected in the nucleus, however, in some cases it was shown in either the nucleus and cytoplasm, Ras p 21 protein and c-erb B2 gene product were frequently detected in grade I and II cases, so it was suspected that the expression of these proteins were closely related to tumor cell differentiation.
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  • Akihiro ISHIKAWA, Nagahisa FUJIMURA, Hideaki NAGURA, Shoji ENOMOTO, No ...
    1991 Volume 37 Issue 12 Pages 2068-2074
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    Thirty oral lipomas and eight extra-oral lipomas were investigated clinically and histopathologically.
    The most common site of the oral lipoma was the buccal mucosa, followed by the tongue and gingiva. The extra-oral lipomas occurred in the cheek, submandibular region, and neck. Most of the oral lipomas were found in patients over 40 years old. Extra-oral lipomas were found in patients in each generation, including lower ones. The sexual difference was not noticed in either lipoma. The only symptom was a painless mass in all cases. The time between the initial discovery and removal was rather long; the mean time of the oral lipoma was two years and the mean of the extra-oral was two and a half years. The size of the oral lipomas was rice-size to 40 mm and the size of the extra-oral was 30mm to 70×75 mm. The extra-oral case included larger tumors. The CT was useful in the diagnosis. ifistopathologically, 30 oral lipomas included 24 simple lipomas, 5 fibrolipomas and one lipoma with cartilaginous formation, and all eight extra-oral lipomas were simple lipomas.
    Consequently, it is suggested that there are some differences between the oral lipoma and extra-oral lipoma of the head and neck region.
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  • Takashi FUJIBAYASHI, Tadahiro YAMAMOTO, Yoshiyuki MORI, Miyuki AZUMA, ...
    1991 Volume 37 Issue 12 Pages 2075-2084
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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    Head and neck cancers that have evidence of involvement of fixed regional lymph nodes metastasis had been defined as N3 by previous criteria of UICC in 1978. Thirty-nine patients of those N3 cases treated in our clinic from 1975 to 1986 were reviewed.
    The following characteristics of N3 cases were found by comparing N3 with NO-2 cases of the same period. The most frequent primary site of N3 case was lower alveolus and gingiva showing 36% of total cases. A high incidence was observed in T4 indicating 51.3% with increasing frequency with the progress of T classification. Most of the cases were squamous cell carcinoma. No significant relationships were observed in the male to female ratio, age distribution, macroscopic tumor types, mode of invasion of the primary tumor, and histological malignancy.
    Reclassification by new N criteria of UICC in 1987 of the previous N3 revealed that the most frequent cases was 12 cases (30.8%) in N2b and 3 cases (7.7%) in new N3. Regional tumor control of the neck area was obtained in 13 out of 39 treated cases, indicating 33. 3% of the control rate. A favorable regional control was obtained by surgery or surgery after irradiation of the cervical area. Surgery with total radical neck dissection with one side combined with upper neck dissection of contralateral side showed superior control to unilateral neck dissection. Five-year cummulative survival rate was 22.2% in total cases. No significant difference of survival rate was observed by generalized Wilcoxon analysis between subdivided groups in terms of primary treatment method, mode of neck dissection, and new N classification.
    Even in those cases of N3 whose fixed lymph nodal metastasis is clinically observed in only unilateral side of the neck, the possibility of occult lymph nodal metastasis at the contralateral side can be considered to be high. Then indication of bilateral neck dissection is discussed, and tentative criteria for the indication is proposed.
    Although new N3 eases such as larger than 6 cm with huge metastatic mass just adjacent to or enveloping the carotid artery are rare by incidence, active treatment including irradiation or chemotherapy may result in a reduction of the tumor enabling treatment by surgery, also indicating immediate reconstruction of resected cervical skin using cutaneous or myocutaneous flaps.
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  • Tadao SUGIMOTO, Hidenori TOBA, Hirokuni YAMAMOTO, Taiji OOTSUKA, Toshi ...
    1991 Volume 37 Issue 12 Pages 2085-2086
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Jun KURAUCHI, Akira ISHIHARA
    1991 Volume 37 Issue 12 Pages 2087-2088
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Kazuo MIZUNO, Masaru HATTORI, Susumu MIZUNO, Hiroyuki IWATA, Kazuhisa ...
    1991 Volume 37 Issue 12 Pages 2089-2090
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Masaaki TERAKADO, Tomiyuki TAKIGAWA, Masahiko HONDA, Yoshitsugu ADACHI ...
    1991 Volume 37 Issue 12 Pages 2091-2092
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Junichiro NUKATA, Hiroyuki HAMAGUCHI, Shinji NAKAGAWA, Masahiro MICHIZ ...
    1991 Volume 37 Issue 12 Pages 2093-2094
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Moritaka ENDO, Satoshi UMINO, Susumu OHMURA, Kiyohide FUJITA
    1991 Volume 37 Issue 12 Pages 2095-2096
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Yoshikazu HAYATSU, Sadao MATSUTOMI, Akihiro MOHKO, Fumihiko SHINOZAKI
    1991 Volume 37 Issue 12 Pages 2097-2098
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Takatoshi SUGIYAMA, Kazutoshi MIWA, Makoto TOIDA, Norichika TATEMATSU, ...
    1991 Volume 37 Issue 12 Pages 2099-2100
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Hiroaki YOSHIDA, Yukio TSUKAMOTO
    1991 Volume 37 Issue 12 Pages 2101-2102
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • Tetsuroh ISHIGAMI, Kazumasa SUGIHARA, Tadashi UCHIYAMA, Tohru YAMAGUCH ...
    1991 Volume 37 Issue 12 Pages 2103-2104
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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  • 1991 Volume 37 Issue 12 Pages 2123-2162
    Published: December 20, 1991
    Released on J-STAGE: July 25, 2011
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