Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 46, Issue 4
Displaying 1-11 of 11 articles from this issue
  • Hiroyuki HARADA, Ken OMURA, Hiroki NAGAYASU, Tohru YANAGAWA
    2000 Volume 46 Issue 4 Pages 191-195
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    To determine the optimal type of neck dissection for N0 cases of squamous cell carcinoma of the tongue, the pattern of occult metastases was evaluated.
    Between 1974 and 1997, 35 N0 cases without local recurrence were histologically confirmed to have cervical lymph node metastasis. Of the 35 patients, 4 underwent elective neck dissection (END) and the others underwent therapeutic neck dissection (TND). Recurrence in the dissected area developed in 6 patients who had received TND. In the END group, the number of positive nodes was 1 or 2, and neck involvement was located at levels I to III. In the TND group, the number of positive nodes was 1 or 2 in 28 patients and 3 or more in 3 patients. Level I to III nodes were involved in 26 patients, level IV in 2, and level V in 3.
    Supraomohyoid neck dissection can be considered a standard elective treatment for squamous cell carcinoma of the tongue. However, in patients who subsequently developed cervical metastasis, either radical neck dissection or modified radical neck dissection should be performed.
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  • Lesions occurring in the maxillary region
    Masaaki TERAKADO, Koji HASHIMOTO, Tamotsu UEHARA, Yoshinori ARAI, Hiro ...
    2000 Volume 46 Issue 4 Pages 196-204
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A small computed tomograph (CT) for dental use (Ortho Cubic Super High Resolution-CT: Ortho-CT) was developed by the Department of Radiology, Nihon University School of Dentistry. It is characterized by the small size of the unit as well as by the ability to produce high-resolution images with a low radiation dose.
    Ortho-CT is a dental multifunctional tomographic unit equipped with a small imaging intensifier (I.I.). The exposure time is shorter and the radiation exposure is lower for Ortho-CT than for conventional CT. In this study, we used Ortho-CT for the diagnosis and treatment planning of lesions arising in the maxillary region.
    High resolution images of Ortho-CT could easily identify the extent of lesions and evaluate the positional relationship with the maxillary sinus and adjacent teeth. In addition, morphometry could be performed accurately.
    Ortho-CT could reproduce three-dimensional images from any tomographic image by only one exposure. Because it provides high-resolution images, accurate diagnosis can be done. Because there were minimal differences among individual observers in interpretation of the images, this technique was useful in planning efficent treatment and shortening the treatment time.
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  • Michi-ichirou ITOH, Yoshihiro KUGA, Akio MIZUNO
    2000 Volume 46 Issue 4 Pages 205-210
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We evaluated wound healing methods during the tie-over method for repair of oral mucosal defects in rat skin. (Methods) We made epidermal defects 20mm in diameter in rat skin (the first group). After the placement of silk suture at the margin of the defect, sheets of gauze were retained (the second group). After the placement of silk suture on the healthy area 5mm outside the margin of the wound, sheets of gauze were retained (the third group). After the placement of silk suture on the healthy area 5mm outside the margin of the wound, a chitin wound dressing 20mm in diameter was applied, and sheets of gauze were retained (the fourth group). After the placement of silk suture on the healthy area 5mm outside the margin of the wound, a chitin wound dressing 30mm in diameter was applied, and sheets of gauze were retained (the fifth group). We compared these five groups. The fifth group showed the greatest epidermal regeneration, and the second group showed delayed wound healing as compared with that in the nontreated group. The second and fourth groups histologically showed delayed cauterization because sheets of gauze strayed into the dermis in the second group, and sheets of gauze and the chitin dressing strayed into the dermis in the fourth group. The fifth group histologically showed emerging thin collagen fibers in the early stage and a higher degree of cauterization than in the other groups. The rate of epidermal regeneration on postoperative day 21 in the fifth group was significantly higher than that in the fourth group. These results indicate that wound healing during the tie-over method for the repair of skin and oral mucosal defects is achieved by first placing silk suture on the healthy area 5mm outside the wound margin, and then applying a chitin sheet slightly wider than the wound, followed by sheets of gauze.
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  • Kazuhiro MORIHANA, Hiroyuki SAKIYAMA, Sigetada MURAOKA, Tutomu MINAMIK ...
    2000 Volume 46 Issue 4 Pages 211-213
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Adenoid cystic carcinomas (ACC) often occur in glands. The major and minor salivary glands in the palate, oral floor, and buccal mucosa are a common site for this tumor in the mouth. ACC is extremely rare in the gingiva because of scanty salivary glands. We describe a patient with ACC arising in the lower gum. A 47-year-old man presented with healing failure after extraction of 3 5. A clinical examination revealed gum swelling associated with periodontitis in the region from 2 to 7 and hyperplasia of granulation tissue. Pathological findings of the biopsy specimen were ACC. The patient underwent mandiblectomy with elective neck dissection. He is free from tumor 37 months after the operation.
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  • Yukihiko FUJIMORI, Akihiko IIDA, Hideyuki HOSHINA, Ritsuo TAKAGI, Shuh ...
    2000 Volume 46 Issue 4 Pages 214-216
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of malignant fibrous histiocytoma (MFH) in a 52-year-old man is reported. The patient presented with painful, diffuse swelling extending from the right cheek to the gingiva of the molar region. Examinations with X-ray, computed tomography, and magnetic resonance imaging revealed an intraosseous tumor with a pathologic bone fracture in the mandible. After a histological diagnosis of MFH was made by examination of a biopsy specimen, the tumor was surgically removed by partial mandibulectomy. Radical neck dissection was also performed. The tumor was mainly located in the mandibular bone with partial polypoid growth into the oral cavity. Histopathologically, the tumor was diagnosed as a storiform-pleomorphic type of MFH, and there was no metastasis to the regional lymph nodes. After surgery, four courses of adjuvant chemotherapy with pirarubicin, cisplatin and vincristine were administered. There have been no signs of recurrence as of 16 months after the initial operation.
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  • Junnosuke ISHII, Kunio FUJITA, Osamu TERANOBU, Yoshiki OTSUKA, Kazuhir ...
    2000 Volume 46 Issue 4 Pages 217-219
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Oral florid papillomatosis (OFP) is usually associated with progression and recurrence. Radical treatment of OFP is very difficult, although various therapeutic modalities have been proposed, including chemotherapy with anticancer drugs, surgery and radiotherapy.
    We report a case of OFP located in the right buccal mucosa in an 80-year-old woman. Clinically, a malignant tumor was suspected, although histological examination showed only hyperplasia with parakeratosis and acanthosis, and there was no evidence of malignant tumor in the specimens. The lesion repeatedly recurred after treatment with CO2 laser and retinoid (etretinate). Radiotherapy (X-ray) was finally effective.
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  • Gaku WATANABE, Yoshinobu KUBO, Yuri NAKAO, Tadashi OHKUBO, Kozo MUSHIM ...
    2000 Volume 46 Issue 4 Pages 220-222
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Nebulization is usually used to remove sputum after surgery. We report on a patient with a high fever resulting from the use of Elase® for postoperative nebulization. The patient was a 66-year-old man who had preoperatively received chemotherapy and radiation therapy for a diagnosis of left cheek mucosal carcinoma. On the 31st treatment day, Elase®; was administered for radiation stomatitis. Rhinocleisis was treated by an otoraryngologist, who gave nebulization for 2 days, but no side effects occurred. Nebulization was resumed 8 days after resection of the tumor, and a fever higher than 38°C developed. Postoperative infection was suspected as the cause of the recurrent high fever. However, the fever did not subside after altering the antibiotic regimen. No pathogen was detected on blood culture analysis. The fever resided after the cessation of nebulization. A strong positive reaction to Elase® was noted on an intradermal test. Hence, we concluded that the fever was caused by an allergic reaction to Elase®.
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  • Michio KAWAI, Hiroki YAMAMOTO, Minoru UEDA
    2000 Volume 46 Issue 4 Pages 223-225
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Pemphigus vulgaris (PV) is a rare chronic autoimmune disease that often originates in the oral mucosa. If left untreated, the disease may involve other parts of the body, leading to a fatal outcome.
    The detection of PV in a patient with herpetic gingivostomatitis is reported. A 45-year-old woman complainedof a painful oral ulcer. Anti-herpes simplex virus (HSV)-I antibodies in the serum were elevated, and an intraoral biopsy specimen showed ballooning degeneration. Herpetic gingivostomatitis was diagnosed. Smears obtained by scraping the oral mucosa, however, showed the presence of Tzanck cells with no multinucleated epithelial cells. Therefore, an association of PV with HSV was suspected. Bullous lesions later appeared on the skin. A biopsy specimen of the skin lesions showed acantholysis and bullous formation just above the basal layer. Direct immunofluorescence showed deposition of IgG, and the results of indirect serologic examination of PV antibodies were positive. A diagnosis of PV was confirmed.
    Predonine 40mg/day was administered, and the dose was tapered to 20mg/day after about 3 months. Serum antiepithelial antibodies were negative 2 months later. The patient has been well without recurrence.
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  • Jun-ichi ODASHIMA, Kiyoshi SEGAWA, Katsunori SEKI, Atsushi NAKAYAMA, K ...
    2000 Volume 46 Issue 4 Pages 226-228
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report a case of pemphigus vegetans with “cerebriform tongue”. Pemphigus vegetans involving a limited area of the tongue is very rare.
    A 76-year-old man presented with pain and fissure formation of the tongue in March 1998. The left lateral border of the tongue was involved, and vegetating changes over the dorsum of the tongue showed a cerebriform pattern. Histopathological findings revealed that this was a case of pemphigus vegetans. Spray steroid (Rhinocort®) therapy of the affected site was initiated (150μg/day), and 7 months later there was considerable improvement of the tongue.
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  • Izumi YOSHIOKA, Hiroshi KAWAHARA, Toshihiro KIKUTA, Yukoh MURAKI, Osam ...
    2000 Volume 46 Issue 4 Pages 229-231
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of mandibular prognathism in a 21-year-old woman with a past history of abortive malignant hyperthermia (a-MH) is reported. She was given a diagnosis of a-MH at the age of 8 years. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Endotracheal intubation was facilitated by succinylcholine. Intraoperatively, tachycardia and metabolic acidosis occurred. Postoperatively, port-wine-like urine was noted, and serum enzyme levels increased.
    Before treatment for prognathism, Ca2+ induced Ca2+ release (CICR) was examined, and genetic tests of the 19th chromosome were done. CICR was unaccelerated, and no 19th chromosome aberrations were found.
    After prophylactic treatment with dantrolene sodium, orthognathic surgery was performed. Anesthesia was induced with fentanyl and droperidol and maintained with nitrous oxide in oxygen. Pancuronium was given to facilitate tracheal intubation. This patient had no complications.
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  • Yoshinao MATSUKI, Hideki ICHIHARA, Makoto TOIDA, Hideki FUJITSUKA, Tat ...
    2000 Volume 46 Issue 4 Pages 232-234
    Published: April 20, 2000
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Clinical and histopathological features of odontogenic keratocysts were examined in 29 cases treated at our department from 1988 to 1998. There were 20 male and 9 female patients. The patients'age ranged from 13 to 87 years (average age, 28 years). Approximately 90% of the cysts occurred in the mandible.The region from the molars to the ascending ramus was the most common site of involvement. Radiographically, 3 lesions were multilocular and 26 lesions were unilocular. Five of the 29 cases were associated with an unerupted tooth.
    Cystectomy was performed in 27 patients; 2 young patients underwent marsupialization followed by cystectomy. Recurrence occurred in 4 patients. The presence of an unerupted tooth and daughter cysts was noted in two of these patients, whereas the lesion was multilocular in one patient. The bony margins showed a scalloped appearance in two of three unilocular lesions. Therefore, long-term follow-up is essential, especially in such patients.
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