Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 41, Issue 7
Displaying 1-18 of 18 articles from this issue
  • Association with metastasis to regional lymph nodes
    Tetsuo SAITO
    1995 Volume 41 Issue 7 Pages 585-592
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We studied the localization of heparan sulfate glycosaminoglycan (HS-GAG) inoral squamous cell carcinoma (SCC). Frozen tissue sections prepared from 39 patients withoral SCC were immunohistochemically stained (ABC method) with monoclonal antibodiesagainst HS-GAG (Hep SS-1) to assess the relation between the localization of HS-GAG in SCC and metastasis to the regional lymph nodes.
    HS-GAG was expressed on the site corresponding to the basement membrane (BM) of thetumor and/or the cytoplasm of the tumor cells in the following patterns: 1) Severallayers of tumor cells adjacent to the stromal tissue are negative, while the BM and other cells arepositive for staining (Type 1); 2) Both the BM and all tumor cells are positive (Type 2); 3) The BM is positive, and all tumor cells are negative (Type 3); 4) The site correspondingto BM of the tumor is negative, and all tumor cells are positive (Type 4).
    Statistical analysis indicated that the incidence of metastasis to regional lymph nodes incases positive for Hep SS-1 staining in the cytoplasm of all tumor cells (Types 2 and 4) washigher than that in partially positive (Type 1) or negative cases (Type 3). Immuno-histochemical expression of HS-GAG on the BM in SCC specimens was not related to inci-dence of metastasis. Although the role of HS-GAG is not clearly understood, these resultssuggested that the expression of HS-GAG bound to Hep SS-1 in the SCC cytoplasm may con-tribute to metastasis to regional lymph nodes.
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  • Ken OMURA
    1995 Volume 41 Issue 7 Pages 593-610
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The parapharyngeal space is frequently invaded by head and neck cancer throughdirect extension, lymph node metastasis, and neural spread.
    “Parapharyngeal dissection” is a method for en bloc resection of theparapharyngealspace.
    To clarify the incidence, pattern, and risk factors of parapharyngeal involvement, 75 pa-tients (Stage II: 8, Stage lII: 22, Stage N: 45) who underwent parapharyngeal dissection inconjunction with ablation of the primary tumor and radical neck dissection were studiedclinicopathologically. In addition, the clinical usefulness of parapharyngeal dissection wasevaluated.
    The results were as follows:
    1. Tumor involvement of the parapharyngeal space was histologically confirmed in 46 pa-tients (61.3%). The primary sites of their tumors were the oral cavity in 27 patients (61.3%), the oropharynx in 9 (60.0%), the major salivary glands in 7 (50.0%), and othersites in 3 (100%).
    2. The histologic patterns of the parapharyngeal involvement were direct extension of theprimary tumor in 24 patients, nodal involvement in 8, neural spread in 3, direct exten-sion combined with nodal metastasis in 10, and nodal involvement combined with neural spread in 1.
    3. The risk of direct extension was significantly related to the T category, clinical stage, growth pattern, depth of invasion, and lymphatic invasion of the primary tumor.
    4. There were six routes of direct extension of the tumor into the parapharyngeal space: anteromedial inferior, anteromedial superior, medial central, anterolateral, postero-lateral, and inferior.
    5. Nodal spread was histologically observed in the parapharyngeal nodes, retropharyngeal nodes, and the extended nodes of Kiittner.
    6. The risk of nodal involvement was significantly related to the clinical stage of the tumor.
    7. Neural spread occurred via the lingual and hypoglossal nerves, and the risk of spread wasrelated to perineural invasion by the primary tumor.
    8. Based on X-ray CT scans perfomed preoperatively in 69 patients, direct extension was cor-rectl ydiagnosd in 73.9%, nodal involvement in 98.6%, and neural spread in 0 %.
    9. The 5-year locoregional control rate was 82.0% in this series, and 77.4% in patients withhistogically positive parapharyngeal involvement. The cause-specific 5-year survivalrate was 66.1% in this series, and 56.9% in patients with histologically provenparapharyngeal involvement. These results suggested that parapharyngeal dissection wasery useful in the management of patients with parapharyngeal involvement.
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  • Mitsunobu ONO, Ken OMURA, Shigehito WADA, Fumiyuki SHIMADA
    1995 Volume 41 Issue 7 Pages 611-615
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Multiple primary malignancies (MPMs) were found in 55 (9.3%) out of 591 patients with oral cancer treated between 1972 and 1994 at Chiba Cancer Center Hospital. There were 43 men and 12 women. The mean age of the patients with MPM was 63.4 years, with a range of 42 to 87 years. MPMs occurred frequently in patients with cancers of the upper gingiva (15.4%) and floor of the mouth (14.9%). Additional malignancies developed in the digestive tract (59.3%) and respiratory system (23.7%). Thirty malignant tumors arose before oral cancer and 29 after oral cancer, and 18 MPMs developed synchronously (within 1 year). Among 29 malignancies diagnosed during follow-up of oral cancer, 11 were asymptomatic, 16 symptomatic, and 2 unknown whether they were asymptomatic or symptomatic. In a few patients, oral malignancies were treated palliatively due to other MPMs. The prognosis of patients with MPMs was poor: 9 died of oral cancer, and 12 died of other subsequent cancers. During both treatment and follow-up of oral cancer, synchronous and subsequent primary malignancies should be borne in mind to facilitate early detection.
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  • Yoshitaka HIBINO, Ken-ichiro HATA, Yasuo SUGIMURA, Kunio HORIE, Minoru ...
    1995 Volume 41 Issue 7 Pages 616-622
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Many clinical studies have demonstrated the usefwness of cultured epithelial grafts. Recently, cultured epithelium has been preserved by freezing and successfuly grafted after thawing. However, few papers have described morphological changes that occur after freezing cultured epithelium. We studied the morphological changes of cultured mucosal epithelial sheets and cultured epidermal sheets after freezing. In our freezing procedure, glycerin and dimethyl sulfoxide (DMSO) were used as cryoprotectants. Each epithelial sheet was stored for 3 weeks at -80°C or -196°C.
    The structures of both types of epithelial sheets were generally maintained after freezing storage. However, cultured mucosal epithelium showed mild showing vacuolation around the nuclei after freezing with DMSO.
    The results indicated that cultured mucosal epithelial sheets can be stored by freezing and that their structure can be maintained by using glycerin.
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  • Lianq-Horng CHEN, Sadami TSUTSUMI, Yukiharu YOKOTA, Tadahiko IIZUKA
    1995 Volume 41 Issue 7 Pages 623-628
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This study was designed to develop a computer-aided-design (CAD) system for orthognathic surgical procedures. The results of surgery were reviewed retrospectively by linking to a CAD simulator to provide a database for surgical simulation programs. This system allow for visual communication by using computer graphic techniques in clinical practice.
    The processes involved in this system are as follows:
    1) Aquisition of 3-D image of facial appearance
    2) Reconstruction of 3-D facial skeleton images from cephalometric radiographs
    3) Development of a visual 3-D maxillofacial model for evaluation of both soft and hard tissue images
    4) Programming and execution of simulated surgical procedures
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  • Studies of cytokeratin expression in the glandular epithelium
    Chika YANAGIHARA, Hiroyuki HAMAKAWA, Takeshi MIZUMOTO, Hiroaki TANIOKA
    1995 Volume 41 Issue 7 Pages 629-631
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Two cases of benign lymphoepithelial lesions (BLEL) are reported along with a discussion on the expression of cytokeratin.
    Case 1: A 46-year-old man was referred to our clinic with a chief complaint of swelling at the right submandibular gland. Computed tomography showed the submandibular gland as a homogeneous high density area. Gallium scintigraphy demonstrated a clear hot spot at the same region. The submandibular mass was extirpated extraorally. Pathologically, there were atrophic changes of the ducts and acini, acompanied by severe lymphoid cell infiltration.
    Case 2: A 55-year-old man complained of swelling of the right buccal region. Magnetic resonance imaging revealed a homogeneous mass showing low intensity in T1 weighted SE and slightly high intensity in T2 weighted SE at the right lower parotid region. Examination of a specimen of the extraorally excised mass showed severe lymphoid tissue infiltration interspersed with myoepithelial islands in the atrophic parotid gland.
    Immunohistochemical staining was performed to check for the expression of the cytokeratin in the atrophic salivary gland. All duct-like structures (DLSs) reacted positively against K8.13 and cytokeratin #7 and #18. On the other hand, # 8 was negative especially in small DLSs.
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  • Hiroyuki HAMAKAWA, Hitoshi TAGUCHI, Chizuru ITO, Manabu TAKARADA, Hiro ...
    1995 Volume 41 Issue 7 Pages 632-634
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Recently, multiple cancers are increasing due to progress in the diagnosis and multidisciplinary treatment of malignant disease.
    We describe a case of multiple cancer in a 66-year-old woman. Oral malignant melanoma (Stage II) was diagnosed one year after squamous cell carcinoma of the uterine cevcix (Stage III b). The patient was treated by chemotherapy with DTIC, ACNU and VCR, and underwent maxillectomy and neck dissection. However, she died of distant metastasis of the malignant melanoma to the lung one year after surgery.
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  • Narihiro HIRAHARA, Tamotsu MIMURA, Etsuro NOZOE, Tadashi NEGISHI, Mich ...
    1995 Volume 41 Issue 7 Pages 635-637
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    An unusual case of mucoepidermoid carcinoma located in the central portion of the mandible is reported.
    A 52-year-old housewife visited our hospital. Her chief complaint was swelling of the right cheek accompanied by a tumor in the right retromolar region. Radiologically, a clearly demarcated radiolucent lesion, measuring 30×20mm, was found to involve the right mandibularangle. A biopsy was performed, and the histopathological diagnosis was highly differentiated mucoepidermoid carcinoma.
    Surgical treatment consisted of a sectional mandibulectomy from the mandibular angle to the first premolar region, with immediate reconstruction using an autogenous iliac bone graft. Pathological examination of the surgical specimen showed that the tumor was located mainly in the mandible.
    Neither recurrence nor metastasis has been noted during the 9-year follow-up period.
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  • Toshihiro KAWASHIMA, Takeshi WADA, Nobuo MORITA, Kazuyuki MIYATA, Shoj ...
    1995 Volume 41 Issue 7 Pages 638-640
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of a recurrent mucoepidermoid tumor of the left retromolar triangle with multiple metastasis is reported.
    A 66-year-old man came to the outpatient clinic of our hospital with a complaint of trismus. He had undergone irradiation and resection of a tumor on the left retromolar pad region 24 years ago. There had been no signs of tumor recurrence for 24 years.
    CT scans showed a high density area in the left infratemporal fossa. He was treated by segmental mandibulectomy and resection of the tumor. Histological examination of the resected specimen revealed that it was similar to the first lesion removed 24 years ago. About 1 year later, the tumor recurred and progressed to general metastasis, followed by death.
    Although this tumor was a well differentiated type mucoepidermoid tumor, recurrence and general metastasis occurred 24 years after primary treatment.
    This experience, indicates that patients with even low grade mucoepidermoid tumors should be followedup over the long term.
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  • Akiko NARITA, Roh FUKUI, Kenichi KOMATSU, Kei HAMADA, Michiko ASHIHARA ...
    1995 Volume 41 Issue 7 Pages 641-643
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Plasmacytoma is characterized by the proliferation of neoplastic clones of plasma cells. Extramedullary plasmacytoma arising in the soft tissue of the oral region is an extremely rare disease. We report here a case of extramedullary plasmacytoma in the maxillary gingiva and briefly review the literature on this disease.
    The patient was a 70-year-old woman who visited our hospital for swelling of the maxillary gingiva. Under a clinical diagnosis of “benign tumor of the gingiva, ” the tumor was totally removed. Histopathologically, a massive infiltration of atypical plasma cells suggested the possibility of an extramedullary plasmacytoma. We therefore examined the bone abnormalities of the whole body, the M protein in serum by immunoelectrophoresis, and the Bence-Jones' protein in urine. However, the roentgenologic and laboratory findings were entirely normal.
    Immunohistochemical study, however, with immunoglobulin staining by and-human IgG antibody and light-chain staining by and-human immunoglobulin λ-chain antibody showed that tumor cells were stained intensively positive. The final diagnosis was IgG-A type extramedually plasmacytoma.
    The clinical course after operation has been fairly good. However, long-term follow up is required because this disease has a risk of lymph node metastasis or transition into multiple myeloma.
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  • Masamichi KOMIYA, Jiro ISHIDA, Yoshiaki AKIMOTO, Masahiko FUKUMOTO, Hi ...
    1995 Volume 41 Issue 7 Pages 644-646
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This report describes an unusual case of chondrolipoma of the tongue and presents a review of the pertient literature. A 28 year-old woman presented with a firm, painless mass (1.6× 1.6× 0.9cm) on the posterior portion of the left dorsum of the tongue. She had been aware of the lesion for 28 years, but it was completely asymptomatic except for slow growth. The lesion was easily enucleated under GOE anesthesia. Histopathologic examination of the surgical specimen revealed a lipoma with cartilage formation. The lesion was diagnosed to be a chondrolipoma. As of 2 years after operation, there have been no signs of recurrence.
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  • Kaori YAGO, Youichi TANAKA, Eisaku SUSAMI, Hideyuki SHIBA, Yutaka OKAD ...
    1995 Volume 41 Issue 7 Pages 647-649
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of myxofibroma in the area of the anterior maxilla is reported.
    The patient was a 24-year old woman.
    She complained of a depression in her palatal mucosa.
    Radiographs showed a unilocular radiolucent area in the 1 2 3 4 region.
    The tumor was extirpated under general anesthesia.
    Histopathologic examination revealed the presence of islands of odontogenic epithelium in fibromatous tissue.
    There is no evidence of tumor recurrence as of 20 months after operation.
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  • Masakazu AKIBA, Mutsuhiro SEKI, Hiroaki KUJIRAOKA, Hiroyuki SAKAMAKI, ...
    1995 Volume 41 Issue 7 Pages 650-652
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Ameloblastoma is a tumor that originates centrally within the jaw bone, and may very rarely occur in a peripheral area. A 54-year-old man presented with a growth on the gingiva of alveolar ridge just behind the lower left canine. The clinical characteristics of the lesion were compatible with those of a papilloma: it was approximately 7mm in diameter and comparatively hard. Radiography showed a foamy image of the superficial alveolar ridge with a shallow fovea just under the lesion. Examination of a biopsy specimen revealed the lesion to be an ameloblastoma. Operation was performed under local anesthesia with a suffient safety margin, i. e., the tumor was excised en bloc from the mesial side of the canine to the distal side of the first molar, extending inferiorly to the root apex of the canine. Pathological examination showed that tumor cells invaded into bone and destroyed the tissue, which suggested that the tumor was potentially malignant. The postoperative course is good, but long-term observation must continue.
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  • Shuhei SUMIYOSHI, Tsunehisa SHIMODA, Takeshi HONDA
    1995 Volume 41 Issue 7 Pages 653-655
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A 62-year-old woman was referred to our clinic because of pain in the left TMJ on chewing and maximal mouth opening. She had had difficulty in closing her mouth immediately after yawning three months ago. Subsequently, posterior open bite persisted on the left side, and she underwent occlusal treatment. At the first visit to our clinic, maximal mouth opening was 38 mm with slight pain in the left TMJ but intense pain during centric occlusion. Magnetic resonance and double contrast arthrotomographic examination showed findings of bony changes and posteromedial disc displacement without reduction of the left TMJ.
    Arthroscopic surgery of the left TMJ was performed under general anesthesia. Arthroscopic examination disclosed early stages of chondromalacia at the posteromedial portion of the articular fossa, where the anterior band of the disc was displaced. No fibrous adhesion was noted. Arthroscopic anterior disc traction was successful, and the pain in the left TMJ disappeared one month after surgery. There has been no recurrence of symptoms as of 2 years 8 months after surgery.
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  • Moriyasu ADACHI, Yasuhiro ITO, Akira ISHIHARA, Yasuyuki IWATA, Masahik ...
    1995 Volume 41 Issue 7 Pages 656-658
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    EEC syndrome is a rare congenital abnormality characterized by ectrodactyly, ectodermal dysplasia, and cleft lip and palate.
    Recently, we encountered a case of EEC syndrome, and describe the case here along with a discussion of the literature.
    The patient was a 28-day-old-girl. She had bilateral split hand, bilateral split foot, and syndactyly 3/4/5 in the right foot and 3/4 in the left foot. Her symptoms of ectodermal dysplasia were light skin color, thin skin, scanty hair, and scanty eye brows. She also had blepharitis and conjunctivitis. The only congenital abnormality of the lip was complete cleft lip on the right side. In the literature, which we reviewed extensively, only 2 cases of EEC syndrome, including ours, have been described to have cleft lip without cleft palate.
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  • Yoshiki HAMADA, Akiko HAMADA, Michihiko KINOSHITA, Norihiko TAKADA, Ka ...
    1995 Volume 41 Issue 7 Pages 659-661
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Stevens-Johnson's syndrome is erythema exudativum multiforme major associated with systematic disorder, erosive stomatitis, and conjunctivitis.
    A case of Stevens-Johnson's syndrome in a 20-year-old man without typical skin lesions is reported. His chief complaint was the failure to eat because of severe ulcerative stomatitis. At first he visited a dental clinic, and then he was referred to our department.
    As a result of allergen tests, this case was attributed to Sulpyrine. This case was successfully treated by steroid therapy.
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  • Takeshi YOKOYAMA, Yoshiyuki MORI, Takahide KOMORI, Keiko YOKOYAMA, Tsu ...
    1995 Volume 41 Issue 7 Pages 662-664
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Streptococci are the most common species in the oral bacterial flora, which are divided into several groups according to the classification of Lancefield. A significant increase in the frequency of necrotizing inflammation and irreversible toxic shock, caused by Streptococci of Group A, has been recently noted. The disease appears in individuals without obvious risk factors, and often becomes serious. In contrast, inflammation caused by β-Streptococci of group F (S. anginosus), however, is usually not frequent nor serious, and has rarely been reported.
    We encountered a case of acute cervical cellulitis caused by odontogenic infection. A 20-year-old male was referred to our hospital with severe neck swelling and dyspnea. The lesion had extended promptly to the substernal area through the submandibular space and the cervical region, and S. anginosus and the anaerobic bacteria, Peptostreptococci and Clostridium, were detected.
    The lesion in this patient was managed by drainage and irrigation through incisions in the neck, and systemic antibiotic therapy was performed.
    In such severe infections, proper drainage and systemic antibiotic treatment are considered to be necessary.
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  • Mie KANEKO, Tomohiro ANDO, Hiroaki KATAUMI, Hiroyuki KANEKO, Yoshikuni ...
    1995 Volume 41 Issue 7 Pages 665-667
    Published: July 20, 1995
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In the present study, we report on a case of a lateral cervical cyst in a 57-year-old male patient. The cyst was located on the right lateral cervical region. The position of the cyst corresponded to Type M according to the classification of Baily. The results of biochemical examinations of the intracystic fluid showed high GOT, LDH, and amylase levels. The values of SCC and CEA were also extremely high. On immunohistochemical tests of the cyst wall, the results were negative for anti-amylase monoclonal antibody despite a high amylase value of the intracystic fluid, and B cells were predominant in lymphatic tissues.
    Parotid saliva was collected from 4 nomal adults, and SCC and CEA values were determined. The results were low, and no correlation with intracystic fluid was found.
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