Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 46, Issue 10
Displaying 1-13 of 13 articles from this issue
  • A comparison between melanotic and amelanotic tumor cells
    Takaaki SAITO, Hiroyuki OKADA, Masahiko FUKUMOTO, Hirotsugu YAMAMOTO
    2000 Volume 46 Issue 10 Pages 555-562
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Malignant melanoma, which is histologically classified into melanotic and amelanotic types, develops mainly in the skin. However, it rarely occurs in the oral and maxillofacial region. Only a few reports have examined histopathological differences between melanotic and amelanotic types. We examined biopsy specimens from three cases of malignant melanoma (melanotic: 2 cases, and amelanotic: 1 case) to determine histopathological differences between amelanotic tumor cells (AMTCs) and melanotic tumor cells (MTCs). Studies included histopathological, immunohistochemical, and electron microscopical. analyses. Pathological examination showed that AMTCs lacking melanin granules proliferated mainly at the front of tumor invasion, whereas many MTCs were located at the center of tumor nests. Immunohistochemically, AMTCs had a higher PCNA-positive-cell rate (71.6%) than MTCs (48.8%). On electron microscopical examination, a melanosome-like structure without melanin production was observed in AMTCs, whereas melanosomes with melanin production were found in MTCs. These findings suggest that AMTCs are more immature and have more aggressive potential than MTCs. Moreover, AMTCs might invade the surrounding area before MTCs and change into MTCs.
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  • Kazuya YOSHIDA, Ryuji KAJI, Tadahiko IIZUKA
    2000 Volume 46 Issue 10 Pages 563-571
    Published: October 20, 2000
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    Oromandibular dystonia is characterized by involuntary contraction of the masticatory and tongue muscles, causing difficulties in mastication or speech. Muscle afferent block (MAB) therapy by intramuscular injection of lidocaine and alcohol is aimed at reducing muscle spindle afferents. We treated 37 patients with oromandibular dystonia by intramuscularly injecting 5 to 10ml of 0.5% lidocaine with 0.5 to 1ml of 99.5% alcohol. The muscles for injection were chosen from among the masseter, the inferior head of the lateral pterygoid muscle, the anterior belly of the digastric muscle, the genioglossal muscle, the medical pterygoid muscle, the sternocleidomastoid muscle, and the trapezius muscle. The effect of therapy was assessed subjectively on a linear self-rating scale ranging from 0 (no improvement) to 100 points (complete cure). All patients showed clinical improvement with reduced EMG activity in the affected muscles. The mean number of injections was 10.1±5.8. The overall subjective improvement rate was 60.8±25.4%. Maximal mouth opening (26.0±7.7mm) in patients with restricted mouth opening increased significantly (p<0.0001, t test) after treatment (37.1±7.6mm). Some patients had tenderness, stiffness, or swelling of the muscles after repeated injection. The discomfort disappeared spontaneously after discontinuing therapy. MAB therapy is an effective means of treating oromandibular dystonia that has no major side effects.
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  • Yoshifumi TATEISHI, Sadako KAI, Kouichirou TATEISHI, Yuji SHIRATSUCHI, ...
    2000 Volume 46 Issue 10 Pages 572-577
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A clinicostatistical study was performed in 94 patients with type II temporomandibular disorders (TMD, capsuleligament disorders) who presented at our clinic from 1992 through 1996. The results
    were as follows:
    1. In contrast to other types of TMD, the patients with type II TMD were predominantly male. Most of the patients had unilateral symptoms.
    2. After nonsurgical treatment, such as pharmacotherapy or occlusal splint therapy, symptoms disappeared or improved in a short time (mean treatment period, 1.0 month).
    3. These results suggest that pathophysiologically type II TMD results from transient inflammation in the synovium or capsule that is caused by intrinsic trauma.
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  • Masanori NISHIKAWA, Gaku YAMAMOTO, Akio TANAKA, Toshiaki NAKATA, Yoshi ...
    2000 Volume 46 Issue 10 Pages 578-580
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Malignant tumors rarely arise in jaw cysts. We report a case of squamous cell carcinoma arising in a nasopalatine canal cyst. A 56-year old man presented with swelling in the labial gingiva at the middle of the maxilla. Oral examination showed a thumb-tip sized swelling with a smooth surface and normal color. Radiographic examination revealed a round translucent image measuring 25mm in diameter in the middle of the maxilla. This image was clearly demarcated. Under general anesthesia, ablation of the cyst was performed for a diagnosis of nasopalatine canal cyst. During operation, frozen section diagnosis was performed and revealed squamous cell carcinoma in this cyst. After operation, chemotherapy (CDDP+5 FU) and radiation treatment (50Gy) were performed. The patient has a good prognosis, with no evidence of local recurrence or metastasis.
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  • Yuko FUJIMORI, Yutaka YAMAZAKI, Ken-ichi NOTANI, Hiroshi FUKUDA, Masan ...
    2000 Volume 46 Issue 10 Pages 581-583
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Anaplastic large cell lymphoma (ALCL) was recently recognized as a distinct type of non-Hodgkin's lymphoma characterized by anaplastic, large cells and expression of CD30 on immunohistochemical analysis. Since oral lesions of ALCL are rare, this tumor is not well documented in the literature. We report a case of ALCL of the maxillary sinus and back in a 79-year-old man who had an extensive swelling with an ulcer, extending from the left cheek to the upper gingiva, and a subcutaneous mass of the back. Computed tomography and magnetic resonance imaging of the gingival swelling revealed a bulky tumor in the left maxillary sinus with bone destruction. Histological examinations of both lesions were performed. The lesions were both diagnosed as CD30-positive, null cell type ALCLs. Complete remission was achieved by six courses of CHOP chemotherapy. There have been no signs of recurrence 10 months after treatment; however, long-term follow-up is necessary because of a relatively high rate of recurrence.
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  • Toshifumi ANDO, Yasunori SATO, Masayuki TAKAHASHI, Hideto KUROKAWA, Yu ...
    2000 Volume 46 Issue 10 Pages 584-586
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Schwannoma of the head and neck is rare and presents as a painless submandibular mass. We encountered a case of a schwannoma arising on the right side of the submandibular region. A 46-year-old woman presented with a painless swelling in the right submandibular region. Magnetic resonance imaging, computed tomograhy, and ultrasonography were performed and were extremely useful for preoperative diagnosis. Ultrasonography showed a tumor originating from the nervus hypoglossus. We discuss the usefulness of -ultrasonography and magnetic resonance imaging. The lesion was totally excised and histopathologically showed a mixture of Antoni-A and Antoni-B patterns. The patient was observed for 3 and a half years and had no signs of recurrence.
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  • Hiroshi ASANO, Yasuyuki SHIBUYA, Shungo FURUDOI, Naruki NISHIMATSU, Ma ...
    2000 Volume 46 Issue 10 Pages 587-589
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of neurofibromatosis type 2 (NF 2) with glossal neurilemoma is reported.
    A 19-year-old woman was referred to us because of difficulty in eating. She had previously been given a diagnosis of NF 2 and had a history of bilateral acoustic neuromas. Intraoral examination revealed a welldemarcated glossal tumor on the right side. The clinical diagnosis was a glossal tumor associated with NF 2, and she underwent surgical enucleation of the tumor. The histological diagnosis was neurilemoma. She has been free from the glossal tumor for 16 months after operation.
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  • Takeshi MIYAMOTO, Ritsuo TAKAGI, Hideyuki HOSHINA, Takafumi HAYASHI, Y ...
    2000 Volume 46 Issue 10 Pages 590-592
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A 65-yearold woman was referred to our clinic in October 1997, because of a swelling at the left side of the hard palate. Clinical examination revealed a well-demarcated submucosal mass, measuring 19×18×10mm. The mass was enhanced markedly on post-contrast computed tomography (CT) in the early phase, which suggested that the tumor had a rich blood flow. The tumor was surgically removed with the patient under general anesthesia. Histologically, it was an encapsulated tumor composed of a dense proliferation of spindle-shaped cells with a scanty but quite vascular stroma. The pathological diagnosis was myoepithelioma, spindle cell type. There has been no evidence of recurrence as of 1 year 10 months after surgery. The findings of post-contrast CT are characteristic and help to differentiate between myoepitheliomas and pleomorphic adenomas, conditions that have similar clinical features.
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  • Yoshiki ISHIGAKI, Tazuko SATOH, Yasuyuki UCHIKAWA, Akihiko ARATA, Masa ...
    2000 Volume 46 Issue 10 Pages 593-595
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We descrive a case of ameloblastic fibro-odontoma.
    The patient was a 6-year-old girl who consulted a dental clinic because of delayed eruption of right lower first molar in June 1996. X-ray films showed a radiolucent area with an irregular radiopaque mass extending from the molar region to the ramus of mandible. The patient was referred to this hospital for further evaluation. X-ray films revealed a nearly round unilocular radiolucent image with well-defined margins in the area from the molar region to the ramus of the mandible. Although the right lower first molar was observed near the lower part of the lesion, the presence of the second molar could not be confirmed.
    On the basis of these findings, compound odontoma was diagnosed.
    On July 29, the tumor was excised under general anesthesia. The right lower first molar was preserved because of its possibility of eruption. The patient made favorable progress after the surgery.
    On the basis of the results of histopathological examination, ameloblastic fibro-odontoma was diagnosed.
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  • Narikazu UZAWA, Yasushi HIRATA, Masashi YAMASHIRO, Akihide NEGISHI, Te ...
    2000 Volume 46 Issue 10 Pages 596-598
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Granular cell odontogenic tumor is a rare lesion consisting of densely packed granular cells with numerous scattered strands of odontogenic epithelium interspersed throughout the tissue. A case of this tumor arising in the mandible of a 51-year-old man is reported. Radiological examination revealed a welldefined unilocular radiolucency in the left side of the mandibular body. Marginal resection of the mandible was performed under general anesthesia. Histopathologically, the tumor was composed of large, round cells with abundant cytoplasm containing eosinophic granules and nests of odontogenic epithelium. On the basis of these clinical and histopathological findings, we made a diagnosis of granular cell odontogenic tumor of the mandible. We also discuss the pathogenesis of these granular cells.
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  • Nobuoki SAKAI, Yuki TOKUNAGA, Junichi SATO, Kazuki HAYASHI, Kanichi SE ...
    2000 Volume 46 Issue 10 Pages 599-601
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of nonclostridial gas-producing phlegmon in the mouth floor and neck of a young healthy patient is reported. A 24-year-old man had swelling and pain on the right submandibular region. Two days before admission to our hospital, he had pain and swelling of right lower molar region. On the next day, a swelling and spontaneous pain developed at the right submandibular region with pyrexia after 6 had been extracted by the patient himself. A clinical diagnosis of oral floor phlegmon was made. Antibiotic treatment was initiated intravenously. Three days later, he complained of dyspnea. Computed tomography (CT) revealed extension of gas bubbles in the soft tissue. Emergency tracheostomy and surgical drainage were performed. He recovered uneventfully and was discharged after 45 days.
    Early detection of gas bubbles by CT, complete surgical drainage and administration of antibiotics are considered the most important factors in treating gas-producing phlegmon.
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  • Ichiro SETO, Hitomi TODA, Takashi MORIYAMA, Yusuke NAKAJIMA, Yoshimasa ...
    2000 Volume 46 Issue 10 Pages 602-604
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Congenital insensitivity to pain with anhydrosis is very rare. We describe a case of congenital insensitivity to pain with anhydrosis, associated with unusual healing of a buccal ulcer, which occurred in a patient with no teeth. The patient presented with swelling of the left cheek. An ulcer with induration was found on the left buccal mucosa. The pathological diagnosis was fibromatosis. Because of recurrent swelling, we extirpated the buccal ulcer and the mass behind it. Only 3 days after operation, we found a pedicle mass at, the same location. The secondary lesion was extirpated, and pathological examination showd fibrous tissue overgrowth. Altough the wound opened after operation, it healed completely 15 months later.
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  • Use of splints to prevent relapse of open bite after intermaxillary elastic traction treatment
    Yoshiaki NAKAMURA, Chihiro KOGA, Fuminori RYU, Toshiyuki KIHARA, Kazuh ...
    2000 Volume 46 Issue 10 Pages 605-607
    Published: October 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report on a patient who had TMJ rheumatoid arthritis associated with regression of the mandible and an open bite. She was treated successfully by intermaxillary elastic traction followed by placement of a separate-type splint appliance, without relapse.
    Case: A 49-year-old woman who had rheumatoid arthritis since 1989 visited our clinic in 1994 because of trismus and an open bite. The open bite was 3.5mm and the trismus was 30mm. Open bite improved to 0mm after elastic traction of the anterior part of the mandible cranially. Traction was applied by using intermaxillary splints for 43 days as well as a mandibular advancing positioner (MAP), common by used to treat sleep apnea syndrome (SAS).
    We recommend the use of MAP as conservative treatment to prevent relapse after anterior traction of the mandible.
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