In the present study, microbial interactions between Streptococcus constellatus and Fusobacterium nucleatum, which are isolated frequently in odontogenic infections, were examined using an oral floor abscess model in mice. Microbial interactions between the two tested strains were observed. The culture filtrate of S. constellatus did not enhance F. nucleatum virulence. However, it appeared that the culture filtrate of F. nucleatum enhanced S. constellatus virulence. Moreover, this enhancement was observed when a heat-treated culture filtrate of F. nucleatum was injected. These findings suggest that a heat-stable substance in F. nucleatum culture filtrate may play an important role in microbial synergy between S. constellatus and F. nucleatum.
A case of spindle cell carcinoma arising in the floor of the mouth approximately3 years after treatment for squamous cell carcinoma on the contralateral side of the tongue is presented. A 78-year-old woman was initially referred to our department because of a painful white lesion on the left lateral border of the tongue, which was diagnosed pathologically as leukoplakia. Three years 3 months later, squamous cell carcinoma developed from the lesion and was successfully treated with a combination of irradiation and surgery. Three years and 3 months after completion of treatment, a polypoid mass appeared on the right side of the floor of the mouth. Biopsy revealed atypical spindle-shaped cells showing sarcomatous differentiation associated with squamous cell carcinomatous components and very frequent mitoses, leading to a diagnosis of spindle cell carcinoma. The cancer was intraorally irradiated with a remote after loading system because the patient did not consent to surgical intervention. She died of an uncontrolled tumor 7 months after radiotherapy.
Erysipelas, an acute superfacial edematous inflammatory dermatitis caused by group A streptoccus infection, is now rare owing to the development of antibiotics. Diagnostic and therapeutic problems in two patients with facial erysipelas infection during and after treatment of their maxillary malignant tumors are reviewed.
We report on a patient with multiple oncocytomas arising in both parotid glands.A 60-year-old woman visited our hospital because of a swelling of the left parotid region. Computed tomographic examination showed 6 masses in the left parotid gland, and 2 masses in the right parotid gland. First, a partial parotidectomy was performed in the left gland, followed by one in the right gland. The histopathologic diagnosis was oncocytoma with multifocal nodular oncocytic hyperplasia (MNOH) in both parotid glands. Recurrence and metastasis of malignant oncocytoma have been reported previously. Therefore, carefull follow-up is necessary.
Although neurofibroma often occurs as a local manifestation of von Recklinghausen's disease, solitary lesions are rarely found in the oral and maxillofacial region. We describe an uncommon solitary neurofibroma developing in the maxillary sinus of a 38-year-old man. Panoramic radiographs and computed tomographic examination showed a well-circumscribed cystic lesion in the left maxillary sinus. The lesion was surgically treated by enucleation with radical sinusotomy, performed with the patient under general anesthesia. Histopathological analysis revealed that the lesion was composed of spindleshaped tumor cells supported by a myxomatous stroma. Immunohistochemical examination showed that some tumor cells stained positively against S-100 antibody. Taken together, these findings were compatible with the characteristics of neurofibroma. We have followed up the patient for 3 years. No evidence of recurrence has been found so far.
Osteomas often occur in the skull and facial bones; however, peripheral osteoma in the inferior border of the mandible is relatively rare. We describe a case of peripheral osteoma arising in the inferior border of the mandible in a 21-year-old woman. She had been aware of tenderness at the angle of the left mandible for about 2 years. A clinical diagnosis of peripheral osteoma was made. The tumor was intraorally resected. The pathological specimen showed compact osteoma. There has been no evidence of recurrence as of 1 year after surgery. We examined the clinical findings of 19 cases of peripheral osteoma of the mandible reported during the past 15 years.
Fungus infections of the paranasal sinuses were considered rare, but have recently increased owing to the use of antibacterial materials, steroid hormones, and anticancer agents. We report a case of aspergillosis of the maxillary sinus that was found unexpectedly on diagnostic imaging. A 56-year-old man was referred to our hospital because of a painless tumor in the left side of the hard palate. Radiographic and computed tomographic examinations revealed two radiopaque region in the left side of the hard palate and the left sinus. They were diagnosed clinically as a benign tumor of the palate and chronic maxillary sinusitis. Resection of the tumor and radical operation of the maxillary sinus were performed with the patient under general anesthesia. The postoperative histopathological diagnoses were pleomorphic adenoma of the palate and aspergillosis of the maxillary sinus. The postoperative course has been good with no evidence of postoperative recurrence.
A pigmented nevus is defined as a hamartomatous proliferation of melaninproducing cells (nevus cells). A relatively rare case of the disease with involvement of the oral mucosa is reported. The patient was a 44-year-old woman who had a nevus on the alveolar mucosa of the maxilla for about 7 years. The nevus measured 33×23mm, but was asymptomatic. A biopsy showed the lesion to be an intradermal nevus. Because of the location of the nevus and the patient's past history of schizophrenia, the lesion was resected with the patient under general anesthesia. Postoperative healing was uneventful, and there was no evidence of recurrence as of 4 years 6 months after the operation.
We assessed the characteristics of 131 patients, with sports-related oral and maxillofacial injuries treated at the Department of Oral and Maxillofacial Surgery II, Osaka University Dental Hospital during the 10-year period from 1988 to 1997. The incidence of sport-related injuries increased significantly from 10% in 1988 to 1992 to 15% in 1993 to 1997. The ratio of males to females was 11: 1, and the majority of patients were between the ages of 10 and 29 years. The highest proportion of injuries (32.1%) occurred in the summer. Injuries were caused by 24 different sports and the most common cause was baseball (25.2%), followed by rugby (19.1%), soccer (13.0%), and skiing (11.5%). Mostrugby and soccer accidents were caused by collisions, between players and involved fractures. Most baseball accidents were caused by collisions with sporting goods and involved periodontal tissue injuries. The above results suggest the need for stronger preventive and protective measures against sports-related accidents.
The authors describe a typical case of Treacher-Collins syndrome with bilateral cleft lip and palate and polypoid lesions in the retromolar region.A 2-month-old boy had an antimongoloid slant of the eyes with colobomas, depressed cheeks, small jaws, auricular anomalies, conductive deafnesscleft lip and palate, and a hairy tongue.The family history was negative.A tracheostomy was performed 1 month after birth to manage airway obstruction due to TMJ-mandibular deficiency.A Hotz-type plate was used to improve nursing 2 months after birth.Cleft lip was repaired 6 months after birth.Bilateral polypoid lesions (20×10×7mm), in the retromolar region were removed at the same time.They consisted of unkeratinized squamous epithelium, submucosa, salivary glands, and striated muscles, similar to soft palate tissues.Treacher-Collins syndrome is generally characterized by bilaterally symmetrical abnormalities of structures within the first and second branchial arches. Polypoid lesions in the retromolar region have not been reported so far. Cleft lip is found only in 2% to 6% of patients with this syndrome.The findings in this case may have resulted from severe deformities in the first and second branchial arches.