Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 46 , Issue 5
Showing 1-19 articles out of 19 articles from the selected issue
  • Toshinori TANAKA, Kei MURAKAMI, Tsuyoshi KISHIDA, Takatoshi ITOH, Yasu ...
    2000 Volume 46 Issue 5 Pages 251-261
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Mandibular third molars are usually located near the inferior alveolar nerve. Their surgical removal may damage the nerve and cause dysesthesia of the lower lip. Panoramic radiography is often used preoperatively to estimate the distance between the mandibular third molars and the inferior alveolar nerve. However, the buccolingual relation of these structures cannot be determined by this method.
    Three-dimensional Computed tomography (3 D-CT) is more useful in diagnosis than panoramic radiography. This study was designed to assess the diagnostic value of 3 D-CT.
    A total of 209 mandibular third molars in 138 patients were evaluated by both 3 D-CT and panoramic radiography. We classified the radiographic relation between tooth roots and the mandibular canal into 5 types. The types were recorded for each panoramic radiograph and 3 D-CT scan.
    3 D-CT findings: 49 teeth showed Type 1; 45 of 49 teeth showed exposure of the inferior alveolar nerve.
    Panoramic radiograph findings: 82 teeth showed Type 1; 38 of 82 teeth showed exposure of the inferior alveolar nerve. There was a significant difference between 3 D-CT findings and panoramic radiographic findings (p<0.05).
    Patients with loss of the superior white line of the canal on panoramic radiographs had a high incidence of nerve exposure during surgery (p<0.005). There was also a correlation between radiographic loss of the superior white line and closeness of the tooth and canal on 3 D-CT (p<0.05). These findings are clinically important.
    We conclude that 3 D-CT provides clinically useful information with respect to the relation between the mandibular third molars and the mandibular canal.
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  • Tomoe CHUUJOH, Masahito TAKADA, SUSUMU SHINGAKI, Tamio NAKAJIMA, Hidey ...
    2000 Volume 46 Issue 5 Pages 262-264
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Oral squamous cell carcinomas in 28 patients younger than 40 years of age were clinically compared with those in patients aged 40 years or older. The patients accounted for 6.9% of 408 patients with oral carcinoma treated at our hospital between 1970 and 1998. The study group consisted of 16 men and 12 women with a mean age of 33.2 years. Tumors were most commonly located in the tongue (18 cases), followed by intraosseous involvement of the mandible (4 cases), mandibular or maxillary gingiva (4 cases), floor of the mouth (1 case), and buccal mucosa (1 case). T1, T2, and T4 tumors were found in 35.7%, 39.6%, and 10.7% of the study group, respectively. Eleven patients (39.3%) had early stage carcinomas in the tongue. Lymph node metastasis was suspected in 14 patients. Histopathologically, there were 10 well differentiated, 14 moderately differentiated, and 4 poorly differentiated carcinomas, most showing diffuse to relatively diffuse invasion. Treatment consisted of surgery, chemotherapy and radiotherapy in 13 patients (46.4%), surgery in 7 (25.0%), surgery and chemotherapy in 5 (17.9%), and radiotherapy and chemotherapy in 3 (10.7%). Seven patients, including 4 with distant metastasis, died of uncontrolled disease. The 5-year survival rate was 73.8%.
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  • Jun SATO, Ken-ichi NOTANI, Masataka KIDA, Shin-ichi TANAKA, Hiroyuki H ...
    2000 Volume 46 Issue 5 Pages 265-267
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We studied clinical indications for the hemodilutional autotransfusion method in patients who underwent surgery for carcinoma and mandibular reconstruction after surgery. The study group comprised 11 patients who underwent hemodilutional autotransfusion (9 undergoing surgery for oral carcinoma and 2 undergoing mandibular reconstruction). The mean predicted blood loss was 991 ml, whereas the mean actual blood loss was 1075 ml. Two patients received homologous blood transfusions because their blood loss was more than 500 ml higher (1650 ml, 1950 ml) than the predicted blood loss. The avoidance rate of homologous transfusion was 81.8%(9/11).
    No patient had serious complications. We conclude that hemodilutional autotransfusion is useful provided that the actual blood loss is less than 1200 ml in patients with oral carcinoma.
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  • Keizo KATO, Seiji TANIGUCHI, Hiroyasu TAMAKI, Hiroshi TAKEUCHI
    2000 Volume 46 Issue 5 Pages 268-270
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We report a rare case of poorly differentiated adenocarcinoma arising in a minor salivary gland at the tongue apex. The patient was 77-year-old man who complained of a painful swelling at the tongue apex. On palpation, there was an elastic hard mass measuring 12 mm in diameter. Because of chronic renal failure, the patient had received hemodialysis for 7 months. Under a tentative diagnosis of a tongue tumor, the lesion was removed with the patient under general anesthesia. Histological examination revealed an adenocarcinoma with a tubular pattern. No serious complication occurred during treatment, but the patient died of pneumonia 3 months postoperatively.
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  • Motoshi NARITA, Taku MURATA, Shinnosuke NAKAMURA, Madoka INUI, Toshiro ...
    2000 Volume 46 Issue 5 Pages 271-273
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This report describes a rare case of double cancer involving oral malignant melanoma and thyroid papillary carcinoma.
    A 51-year-old man was referred to our clinic because of malignant melanoma of the palate. Partial maxillectomy and right radical neck dissection were performed. During radical neck dissection, frozen section examination of the lymph nodes showed metastatic occult thyroid papillary carcinoma. After the operation, right hemithyroidectomy and regional lymph node dissection were performed by otolaryngologists.
    The patient has had no recurrence of tumor, and his clinical course has been uneventful for 4.5 years.
    We also review the literatures and discuss the characteristics of double cancer involving oral neoplasms and thyroid cancer.
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  • Shinnosuke NAKAMURA, Minoru NAKASE, Taku MURATA, Madoka INUI, Toshiro ...
    2000 Volume 46 Issue 5 Pages 274-276
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Transcatheter arterial chemo-embolization (TACE) is mainly used to treat hepatocellular carcinoma and renal carcinoma. This technique has been rarely used to treat oral malignancy. We present a case of metastatic osteosarcoma arising in the maxilla that was eradicated by TACE and radiation.
    The patient was a 22-year-old woman who presented with gingival swelling of the right upper incisor region. She had a medical history of osteosarcoma of the left fibula. Radiographic examination revealed resorption of the right maxilla with nodular opacity of both lungs. Histopathologic examination confirmed the presence of metastatic osteosarcoma in the maxilla, and an incisional biopsy of the lung revealed malignant thymoma. TACE with Co60 radiation therapy resulted in marked regression of the tumor, and no recurrence was detected during the year before the patient died of respiratory failure.
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  • Toshihiro OKAMOTO, Hiroyuki KANEKO, Keika HOSHI, Takashi YAMAZAKI, Nob ...
    2000 Volume 46 Issue 5 Pages 277-279
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Subcutaneous leiomyosarcoma is a malignant neoplasm that arises from smooth muscle of blood vessels. This tumor usually occur in the extremities and very rarely arises in the head and neck region.
    We report a case of subcutaneous leiomyosarcoma of the cheek. A 31-year-old woman noticed a swelling of the left cheek in November 1990. Excisional biopsy was carried out at the Department of Dermatology, Tokyo Women's Medical University in November 1990, and leiomyosarcoma was diagnosed. As we were requested to do a wide excision, we performed an additional excision with D-P flap reconstruction in December 1990. There has been no local recurrence or metastasis as of 9 years after operation. In addition to these clinical findings, we discuss histopathological findings of immunohistochemical studies with vimentin, desmin, SMA, EMA, and S-100 antibody and review the literature.
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  • Hitomi SENOO, Suguru HAMADA, Masahiro NAKASHIMA, Eiichiro MIYAMARU, No ...
    2000 Volume 46 Issue 5 Pages 280-282
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Mucormycosis is an acute opportunistic infection caused by a saprophytic fungus found in soil, decaying fruits, and vegetables. Mucormycosis is relatively rarely encountered in oral and maxillofacial surgery. We describe our experience with a patient who hadmucormycosis with maxillary sequestration. A patient who had acute myeloblastic leukemia presented with right cheek edema with mobility of the right upper molars. We diagnosed sinusitis and maxillary osteomyelitis. We performed extraction of 765 and sequestrectomy. Microscopic examination of the sequestrum (×200) revealed numerous nonseptate hyphae of mucormycosis. High doses of antimycotic agents were administered before and after surgery, and the infection was successfully controlled.
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  • Tomohiro YOSHIKAWA, Yasuyuki SHIBUYA, Hiroshi MASAGO, Hiroshi ASANO, M ...
    2000 Volume 46 Issue 5 Pages 283-285
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A case of carotid body tumor (paraganglioma) is reported. The patient was a 68-year-old woman with a submandibular mass on the right side.
    Magnetic resonance imaging revealed a mass located at the right carotid bifurcation. The mass showed low signal intensity on T1-weighted images that were enhanced by gadolinium-DTPA and high signal intensity on T2-weighted images.
    The histologic diagnosis of a biopsy specimen was benign carotid body tumor. Carotid angiography showed a highly vascularized tumor with feeding vessels arising from the external carotid artery. The tumor was dissected in the capsular adventitial plane and removed en bloc, preserving the internal carotid artery. Five months postoperatively, the patient was doing well, with no evidence of recurrence.
    One hundred forty-two cases of carotid body tumor were reviewed. Of the total, 113 tumors were benign and 29 were malignant. Among 100 patients for whom adequate information was available, tumor extirpation alone was performed in 87 and tumor extirpation with resection of the carotid artery in 36.Most of the tumors smaller than 4cm in diameter were resected.
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  • Masatsugu ISOBE, Yutaka KOBAYASHI, Mariko FUJIMOTO, Yasushi HIRATA, Ya ...
    2000 Volume 46 Issue 5 Pages 286-288
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    We clinically analyzed 12 patients with granular cell tumors of the oral cavity, treated between 1981 and 1998.The female: male ratio was 1: 1. Age ranged from 23 to 69 years, with a mean age of 40.0 years.Of the 12 granular cell tumors, 10 were found in the tongue, 1 in the buccal mucosa, and 1 in the floor of the mouth. The duration of the lesion ranged from 2 weeks to 10 years. The size of the tumor ranged between 4 and 16mm. The tumors were firm lesions, with white or normal mucosal colors and well-defined margins. There was pain in two patients, and tumor enlargement in four. Local excision, including the surrounding normal tissue, was curative for granular cell tumors. Histologically, there was no evidence of encapsulation in any patient. In the overlying mucosa, two cases showed acanthosis, and two showed pseudoepitheliomatous hyperplasia.
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  • Eisaku IMAMURA, Norihiko TAKADA, Kaoru KOBAYASHI, Akihisa HORIE, Kazut ...
    2000 Volume 46 Issue 5 Pages 289-291
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    This report describes a case of chondroma of the tongue and presents a review of the literature.
    A-30-year-old man presented with a firm, painless mass (30×15×15mm) on the left lateral edge of the tongue. He had been aware of the lesion for 10 years, but it was completely asymptomatic except for slow growth. Because of the large size of the tumor, we considered that magnetic resonance (MR) imaging would be useful in making a preoperative diagnosis. A T1-weighted MR image scan of the tongue tumor showed low signal intensity areas, whereas T2-weighted images showed areas with both low and high signal intensities. Consequently, the tumor was excised with the patient under general anesthesia. The histological diagnosis was chondroma of the tongue. The tumor was larger than previously reported cases.
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  • Hiroki MIYATE, Kazushi NAMIOKA, Yoshiyasu FUKUTA, Noriaki TAKAHASHI, H ...
    2000 Volume 46 Issue 5 Pages 292-294
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A rare case of neurilemoma arising in the center of the mandible is reported. The patient was a 19-year-old woman who had no symptoms, except for diffuse mild bony swelling on the buccal side of the right mandibular molar region. Panoramic radiographic examination showed a well demarcated, unilocular radiolucency involving the non-resorbed roots of the mandibular right second premolar and first molar. Microscopic examination revealed Antoni type B tissue dispersed between Antoni type A tissue. Immunohistochemically, the cytoplasm of the tumor cells was stained by S-100 protein and vimentin. The lesion was easily separated from bone and enucleated with a part of the inferior alveolar nerve.
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  • Kiyoshi HARADA, Kazunori OHKURA, Hisanobu YONEZAWA, Seiko MORISHIMA, Y ...
    2000 Volume 46 Issue 5 Pages 295-297
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Postoperative stability of the maxilla was evaluated after Le Fort I and horseshoe osteotomies in two patients undergoing two-jaw surgery.
    Stability of the maxilla in 2 patients who underwent combination (Le Fort I and horseshoe) osteotomy was compared with that in 10 patients who underwent non-combination (Le Fort I) osteotomy for maxillary advancement.In all patients, the maxilla was fixed with four Luhr plates.In addition, bilateral sagittal split ramus osteotomy of the mandible and titanium screw fixation were performed.Lateral cephalograms were obtained 5 days, 3 months, 6 months, and 1 year after surgery.The changes in anterior-nasal-spine (ANS), A-point, U1, and posterior-nasal-spine (PNS) or point of maxillary tuberosity were examined.
    Postoperative changes in the two patients who underwent combination osteotomy were almost within the ± 1SD range of the average values in the patients who underwent non-combination osteotomy for maxillary advancement.
    Our results suggest that postoperative stability of the maxilla after combination osteotomy is comparable to that after non-combination osteotomy for maxillary advancement.
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  • Masayuki IMAI, Yuji SHIRATSUCHI, Noriaki MATSUKI, Masamichi OHISHI, Ta ...
    2000 Volume 46 Issue 5 Pages 298-300
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Two methods for the fixation of split bone segments in sagittal splitting ramus osteotomy were compared with respect to the postoperative stability of the mandible as assessed on lateral cephalograms in patients with mandibular prognathism. Wiring was used in 16 patients (group W) and mini-screw fixation was used in 21 patients (group S). The following results were obtained: 1) In both groups, the mandible had a tendency to rotate clockwise postoperatively. The degree of rotation was significantly greater in group W than in group S (p<0.05). 2) In both groups, postoperative stability was similar and was unrelated to open bite. 3) Overjet was significantly more stable in group S, in which the amount of mandibular setback was less than 10mm (p<0.05).
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  • Daiji EIRAKU, Yuji SHIRATSUCHI, Masayo MORIFUJI, Masamichi OHISHI, Tad ...
    2000 Volume 46 Issue 5 Pages 301-303
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    An allergic reaction to poly-L-lactide acid (PLLA) extracts in a patient with mandibular prognathism is reported. A 17-year-old girl visited our clinic in 1995 because of mandibular prognathism and facial asymmetry. Since a metal allergy was suspected from her medical history, a metal patch-test was done preoperatively, and reactions to Ni, Co, Hg, Au, and Pt were positive. Accordingly, the Quick Change Method (QCM) system was used for preoperative orthodontic treatment, and sagittal split ramus osteotomy using PLLA screws was scheduled.However, PLLA screws could not be used because we found that the patient was also allergic to PLLA extracts on a PLLA patch-test.Finally, sagittal split ramus osteotomy was carried out with the use of pure titanium screws.There was no allergic reaction to the titanium screws, which were removed 6 months postoperatively.To detect allergic reactions to new biomaterials, such as PLLA, it is important to perform careful preoperative examinations and postoperative follow up.
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  • Keiko KUME, Eiji HAYASHI, Masaaki TAKECHI, Kazuhito SATOMURA, Kenji FU ...
    2000 Volume 46 Issue 5 Pages 304-306
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Tetanus is a disease with a high mortality rate. Early diagnosis and treatment are necessary for a good outcome. We report a case of tetanus.
    A 68-year-old woman, a farmer, was referred to our hospital because of limited mouth opening. Clinical examinations showed severe trismus with a maximum mouth opening of 5 mm, stiffness of the masseter and neck muscles, and dysphagia. The patient had no recent history of trauma. She was admitted immediately and given antibiotics. However, muscle stiffness became more serious, and opisthotonus was noted. These finding led to a suspected diagnosis of tetanus.
    The patient was given penicillin and antitetanus serum. After 5 days, she was transferred to the department of internal medicine and successfully treated. She discharged on the 37th hospital day, without any complications.
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  • Nobuo INOUE, Taihiko YAMAGUCHI, Jun SATOU, Chiharu SATOU, Kazuyuki MIN ...
    2000 Volume 46 Issue 5 Pages 307-309
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    A 26-year-old woman was referred to our clinic on December 22, 1993, because of limited mandibular movement. Minor restriction of mouth opening was first noticed at 10 years of age, during a dental health examination. The patient became aware of pain and swelling of the right masseter region with decreased jaw movement at the end of November 1993.
    Clinically, the patient had a square face with prominent masseter muscles and mandibular angles. The interincisal opening was 22mm, with limitated lateral and anteroposterior mobility. A dense band of tissue, which became taut on maximal opening, was palpable along the anterior border of each masseter muscle.
    The clinical diagnosis was restricted mouth opening due to bilateral hyperplasia of the masseter muscle aponeuorses. Masseter muscle myotomy with aponeurectomy was performed bilaterally by an intraoral approach on May 18, 1995. The aponeuroses extended for three quarters of the length of the masseter muscles, down to the inferior borders of the mandible. The mouth opening improved to 46mm on incision of the aponeuroses.
    An examination of the patient 3 years after surgery revealed an interincisal opening of 38mm without strain.
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  • Osamu IWAMOTO, Hirotsuna KANEGAE, Fuminori RYU, Jingo KUSUKAWA, Tadami ...
    2000 Volume 46 Issue 5 Pages 310-312
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Renal osteodystrophy (ROD) is one of the severe complications of chronic renal failure. We describe a case of extensive jaw bone resorption in a patient with renal osteodystrophy. A 15-year-old boy was referred to us because of severe jaw bone resorption. He had been undergoing continuous ambulatory peritoneal dialysis to treat chronic renal failure since the age of 10 years. He had a childish face.Intraoral examination revealed malocclusion and M1 to M3 mobility of all teeth.Radiologically, there was extensive resorption of the jaw bones and teeth. Anemia, acidosis, and hyperphosphatemia were revealed by blood examination. The serum PTH level, which had been markedly elevated, was normal on initial examination. The patient is being followed up regularly, without further treatment. Resorption of the jaw bones is continuing, and six teeth were lost during 8 months of follow up.
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  • Michiyo SAITOH, Yoshinori HIGUCHI, Hiroko KOUZUKI, Takeshi MITSUYASU, ...
    2000 Volume 46 Issue 5 Pages 313-315
    Published: May 20, 2000
    Released: July 25, 2011
    JOURNALS FREE ACCESS
    Congenital epulis (CE) is a rare lesion, and CE associated with an impacted tooth is very rare. We encountered a case of CE attached to an impacted supernumerary tooth germ. The patient was a 1.5-year-old boy, and his parents noticed a pedunculated mass on the left anterior palatal gingiva from the time of birth. CE was diagnosed clinically. As the CE grew gradually during follow up, the mass was excised in toto. At surgery, we found CE contiguous with an impacted tooth germ, which we extracted at the same time. A radiographic examination 7 months after surgery revealed that the extracted tooth germ was a supernumerary tooth. The histopathologic diagnosis was fibrous overgrowth. Although the CE was contiguous with the tooth follicle, we found no histological evidence of CE arising from the tooth germ.
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