Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 47, Issue 4
Displaying 1-13 of 13 articles from this issue
  • Kosaku ABE, Akira YAMAGUCHI, Kohzo TSUCHIKAWA
    2001 Volume 47 Issue 4 Pages 225-231
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    To find an effective way to control postoperative pain, we focused on pre-emptive analgesia and assessed postoperative pain in patients given analgesic agents with different mechanisms of action before operation. The subjects were 38 patients who underwent radical maxillary sinus surgery under general anesthesia. Lidocaine hydrochloride, ketamine hydrochloride, and flurbiprofen axetil were used. The patients were divided into four groups: a local anesthesia group (LA group), a ketamine hydrochloride group (KH group), a flurbiprofen axetil group (FA group), and a control group. Each drug was administered before surgery. Postoperative pain was assessed on the basis of pain scores on a visual analogue scale and postoperative analgesic requirement time.
    1. The pain scores 1 and 2 hours after returning to the room were significantly lower in the KH group and the FA group than in the control group. Postoperative pain was well controlled in both groups, and it was better controlled in the FA group than in the KH group.
    2. The interval until the first postoperative analgesic was significantly longer in the LA, KH, and FA groups than in the control group, and postoperative pain was better controlled in the treated groups. Significant differences were not seen among the three groups.
    3. Postoperative pain control continued longer than the duration of analgesic effectiveness in the LA, KH, and FA groups. This finding suggested the involvement of pre-emptive analgesia.
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  • Tsutomu KADENA, Yasuharu TAKENOSHITA, Seiji NAKAMURA, Masanori SHINOHA ...
    2001 Volume 47 Issue 4 Pages 232-235
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Mucoepidermoid carcinoma occasionally arises in the mandible, and the retromolar region is a common site. We describe an unusual case of central mucoepidermoid carcinoma in the mentum of the mandible that had a strong tendency to invade the mandible and metastasize to lymph nodes.
    A 56-year-old woman was referred to our hospital because of a painlessly protruding mentum and hypoesthesia of the right lower lip. Radiological examination showed an ill-defined radiolucent lesion. A biopsy specimen histopathologically showed poorly differentiated mucoepidermoid carcinoma. For primary treatment, a sectional mandibulectomy, bilateral neck dissection, and reconstruction with a titanium plate and flaps were performed after induction radiochemotherapy. Pathological examination showed that the tumor was located mainly in the body of the mandible. Metastases to the paratracheal, subaortic, and para-aortic lymph nodes were found about 1 year after primary treatment, and radiation therapy was performed. However, the patient died of airway obstruction 1 year after radiation therapy.
    The case is reported with some comments based on review of the literature.
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  • Tetsuhito KAWASE, Yoshiaki KAZAOKA, Atsushi SHINOHARA, Hajime KUNO, At ...
    2001 Volume 47 Issue 4 Pages 236-239
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We describe a 55-year-old man in whom salivary duct carcinoma developed in the maxilla. He was admitted for evaluation of dysesthesia in the left buccal region. Magnetic resonance imaging revealed a 2×2cm mass in the left side of the maxilla. Biopsy of the lesion was performed under local anesthesia, and histological examination showed a malignant adenocarcinoma. The tumor originated in the minor salivary glands of the maxilla. The patient underwent maxillectomy and reconstruction with a vascularized fibula flap under general anesthesia. The postoperative histopathological diagnosis was invasion of the maxillary nerve, so the base of the skull was operated on. The patient was postoperatively given irradiation (60Gy) and chemotherapy (5 FU, CDDP). Two years later, he died of intracranial recurrence. Histopathological examination revealed comedonecrosis of the tumor nests, and the lesion was diagnosed as a salivary duct carcinoma.
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  • Yasuhiko TSUYAMA, Tomoaki EGUCHI, Noriko HATANO, Toru OGASAWARA, Yoshi ...
    2001 Volume 47 Issue 4 Pages 240-242
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report a very rare case of undifferentiated sarcoma of the tongue in a pregnant woman. Cancer will develop in 1 per 1000 to 1500 pregnant women. Although malignancies including uterine cervical cancer, breast cancer, gastric cancer, and leukemia have been reported during pregnancy, head and neck cancer is rare. The patient was a 34-year-old pregnant woman referred to our clinic because of a painless mass in the right side of the tongue. Examination of the oral cavity revealed a 25×20mm, nontender, elastic soft mass in the right side of the tongue. A T 2-weighted magnetic resonance image showed areas of high signal intensity. Resection of the tumor and skin grafting were performed under general anesthesia at 27 weeks' gestation. There has been no local recurrence or metastasis as of 29 months after operation. Histopathologically, the tumor was composed of small histiocyte-like cells and large round cells with myxomatous components, but without any differentiating features. Immunohistochemically, the large tumor cells stained positively only for vimentin. On the basis of these findings, the tumor was diagnosed as an undifferentiated sarcoma.
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  • Takaho KUWAZAWA, Toshihiro OKAMOTO, Takashi YAMAMURA, Yousuke OGIUCHI, ...
    2001 Volume 47 Issue 4 Pages 243-246
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Multiple primary cancer involving amelanotic malignant melanoma and other malignant tumors rarely arises in the oral cavity. We describe a case of multiple primary cancer involving gastric cancer and maxillary amelanotic malignant melanoma. A 27-year-old man had previously undergone resection of gastric cancer. The patient was referred to our hospital because of a mass arising in the palate mucosa. A slightly depressed ulcer measuring 38×15mm was noted in the right side of the palate. The lesion was slightly tender. Most of the overlying mucosa was bright red and pigmentation was very slight. We performed a right maxillary partial excision with right radical neck dissection for a diagnosis of amelanotic malignant melanoma. There has been no local recurrence or metastasis of either gastric cancer or amelanotic malignant melanoma as of 9 years after ope
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  • Yoshinori YONEMOTO, Yasuhiro NAKAYAMA
    2001 Volume 47 Issue 4 Pages 247-250
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Myoepithelioma is a rare salivary gland tumor found mainly in the palatal, parotid, and submandibular glands, rarely in mouth floor. We reported an extremely rare case of this tumor arising in the mouth floor.
    The patient was a 33-year-old woman with a painless swelling of the mouth floor. The tumor, measuring 15×25mm, was located at the left side of the mouth floor. The tumor was surgically removed under a clinical diagnosis of a benign tumor. Histologically, the tumor was composed of plasmacytoid cells that showed positive reactions for S-100 protein, keratin, and vimentin. The pathological diagnosis was myoepithelioma.
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  • Minoru KOBORI, Yuuichi SASAKURA, Usyaku LEE, Hitoshi KAMATA, Junichi S ...
    2001 Volume 47 Issue 4 Pages 251-254
    Published: April 20, 2001
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    This paper describes a case of lymphoepithelioma. The patient was 78-year-old man, and his chief complaint was swelling of the right submandibular region. The lesion was extirpated for a clinical diagnosis of chronic lymphoadenitis. The swelling was lymph node metastasis from lymphoepithelioma. The origin of the tumor could not be determined by CT, MRI, 67Ga scintigraphy, or optical endoscopy of the head and neck region. The extirpated lymph node measured 35×22×24mm, and the cut surface of the tumor was solid and yellowishwhite. Histopathologic examination revealed epithelial tumor cells with light or eosinophilic cytoplasm. Large nucleoli were observed clearly in almost all epithelial tumor cells. Many tumor cells showed mitosis, indicating severe atypism. Numerous lymphocytes infiltrated the stroma. On serological examination, anti-VCA-IgG, anti-VCA-IgA, and anti-EBNA antibodies were 320, 80, and 160 fold (cut off value: below 10), respectively. The EBV-gene was detected in the nuclei of tumor cells by in situ hybridization. A new tumor developed between the temporal muscle and lateral pterygoid muscle on the right side 2.5 years after presentation. The histopathological features were identical to those of the previous tumor. The patient died of lung metastasis 4.8 years after presentation.
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  • Masaru HARASHIMA, Izumi ASAHINA, Makiko HIGASHINAKAGAWA, Kaori YOSHIDA ...
    2001 Volume 47 Issue 4 Pages 255-257
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Nerve sheath myxoma is a benign tumor derived from peripheral nerve sheaths that rarely occurs in the oral cavity. We encountered a case of this tumor arising in the left side of the lower lip of a 52 year-old woman. She presented with swelling of the lower lip in June 2000. We excised the tumor under local anesthesia. Histopathologic examination showed a nodular lesion. The nodules were composed of spindleshaped or stellate cells embedded in an abundant mucopolysaccharide matrix. Immunohistochemical examination showed that most tumor cells were positive for S-100 protein. A diagnosis of nerve sheath myxoma was made on the basis of these findings. There has been no sign of recurrence as of 6 months after operation.
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  • Takehiro KURA, Takashi UEMATSU, Fuhito KOMATSU, Hitoshi TANAKA, Minoru ...
    2001 Volume 47 Issue 4 Pages 258-261
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A case of histiocytic necrotizing lymphadenitis (Kikuchi's disease) accompanied by elevation of the serum antibody against Epstein-Barr virus (EBV)-viral capsid antigen is presented. On histopathological and immunohistochemical studies, infiltration of numerous macrophages (CD68+) and T cells (CD45RO+) was seen around the periphery of a necrotic lesion in the paracortical area of lymph nodes, showing a reduced CD 4+/CD 8+ratio. Furthermore, EBV-encoded latent membrane protein (LMP-1) was detected in the lymphocytes of involved lymph nodes. These findings suggest that this case might be related to EBV infection.
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  • Hakuzou ARAKI, Tomoari KURIYAMA, Kiyomasa NAKAGAWA, Yuko HAYASHI, Yosi ...
    2001 Volume 47 Issue 4 Pages 262-265
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We encountered two patients with severe refractory osteomyelitis of jaw caused by β-lactamase-producing bacteria. The first was a 52-year-old man with chronic osteomyelitis of the maxilla. He had undergone an operation for a cyst in the left side of the maxillary bone. After operation, he had received antibiotics and irrigation of the wound in the maxilla. However, severe osteomyelitis of the maxilla occurred and spread to left maxillary sinus. The second patient was a 52-year-old man with acute osteomyelitis of the mandible. Poor wound-healing after tooth extraction was identified as cause of osteomyelitis. Although he had received two operations and antimicrobial therapy to control the infection, the osteomyelitis spread. Remarkably, β-lactamase-producing bacteria were isolated from both cases.β-lactamases are a prime mechanism of resistance to β-lactam antibiotics. We speculated that the presence of such bacteria might have contributed to both cases osteomyelitis. Our experience with these cases suggests that antibiotic therapy should be selected on the basis of microbiological laboratory data when treating osteomyelitis of the jaw.
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  • Tadafumi ADACHI, Yoshiteru YAMAGUCHI, Yukiko KASHIMA, Juntaro NISHIO
    2001 Volume 47 Issue 4 Pages 266-269
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We report on a 3-year-old child with unilateral temporomandibular joint (TMJ) ankylosis caused by neonatal sepsis. The operative procedure involved agressive resection of the ankylotic segment and contralateral coronoid with an immediate costchondral graft intervening with a temporalis myofascial flap. An activator appliance was used postoperatively to induce maxillary down ward growth. Satisfactory results were obtained at 1-year follow-up with respect to restoration of TMJ function and aesthetic improvement.
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  • Takehiro OURA, Mutsuhiko MURAI, Hideo TANAKA, Satoshi MARUYAMA, Michio ...
    2001 Volume 47 Issue 4 Pages 270-272
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Trisomy 13 syndrome is a congenital disease with various deformities. Clinical characteristics are diverse, and the prognosis is extremely poor.
    A 25-day-old girl whose parents were Brazilian visited our department because of bilateral cleft lip and palate.
    We found bilateral cleft lip and palate, a ongenital tooth in the mandibular incisor region, and micrognathia. A chest radiograph showed spina bifida and dextrocardia. A CT scan showed cerebral hemorrhage. Chromosomal examination showed trisomy 13 with translocation.
    We describe and discuss this patient with trisomy 13 syndrome in whom we performed cheiloplasty at the strong request of the parents, despite a poor prognosis.
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  • Tadafumi ADACHI, Yukiko KASHIMA, Juntaro NISHIO
    2001 Volume 47 Issue 4 Pages 273-275
    Published: April 20, 2001
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We reported a case of congenital epulis in the mandibular gingiva of a newborn. The tumor consisted mainly of large eosinophilic granular cells (granular cell tumor) and partly of fibrous connective tissues with vascularization. Immunohistochemical studies revealed intense staining only for vimentin. These results suggested that the congenital epulis was derived from mesenchymal cells.
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