This report proposes a simple classification for maxillary hard-soft palate defects (6-4 classification) that can be used by surgical oncologists and maxillofacial prosthetists to describe the type and extent of maxillary defects. This classification can also hopefully be used to predict the functional result of maxillofacial prosthetic treatment. This classification is simply based on the defect area compared with the total area of the hard palate-alveolarregion and that of the soft palate. The total area is expressed as a fraction of 6 for the palate-alveolar region and asa fraction of 4 for the soft palate region. A questionnaire survey of head and neck surgeons, maxillofacial surgeons, and other specialists indicates thatthis 6-4 classification can be used easily and correctly. Our classification will hopefully promote better communicationsamong multidisciplinary specialists, including maxillofacial prosthetists.
Laugier-Hunziker-Baran syndrome is characterized by multiple and melanin pigmentation of the lips, oral mucosa, and fingers. There is no risk of development of oral malignancies or malignant melanoma. However, it is important that Laugier-Hunziker-Baran syndrome is diagnosed correctly to rule out other differential diagnoses (i.e. Peutz-Jeghers syndrome, Addison disease, and Albright syndrome). A 69-year-old man presented with multiple pigmented spots of the mouth and lips; these spots appeared 3 yearspreviously. His right fingers had brownish spots 2-3 mm in diameter. Similar spots were present on the buccal mucosa, lips, palate, and gingiva. The patient had no history of gastrointestinal disorders or generalized skin disorders. A biopsy specimen takenfrom a site of the lower lip with melanotic pigmentation showed increased pigmentation of the basal cell layer ofthe epithelium. No malignant features were noted in the specimen.
A glandular odontogenic cyst (GOC) is a rare odontogenic cyst, classified as a new developmentalodontogenic cyst by the WHO in 1992. It frequently arises in the anterior region of the mandible. Histopathologically, GOC is lined by epithelium of varying thickness, which contains mucous cells and vacuolations. Some casesshow clinically invasive growth, leading to a high rate of recurrence despite surgical excision. Some studies haveestimated that the overall recurrence rate is 27%. We report a case of GOC arising in the right mandibular third molar region. The patient was a 34-year-old man.Surgical excision was performed. One year 4 months after the operation, the prognosis was good, with no signs of recurrence.
Leiomyoma is a benign tumor derived from smooth muscle. It occurs mainly in the uterus and alimentarytract. We report a case of leiomyoma developing in the hard palate of a 48-year-old woman who had a swellingin the left side of the palate. The lesion measured 9×10mm and had a clearly demarcated border and elastichardness. The clinical diagnosis was a benign tumor, and excisional biopsy was performed under local anesthesia.The histopathological diagnosis was leiomyoma. There has been no evidence of recurrence.
Basaloid squamous cell carcinoma (BSCC) is a histologically distinctive variant of squamous cell carcinomathat was first reported by Wain in 1986. BSCC has been reported to be biologically aggressive and carriesa poor prognosis because of frequent lymph node metastasis and distant metastasis. We report a case of BSCC of the oral floor. The patient was a 61-year-old man with erythroplakia of the caruncularegion. The histological diagnosis of a biopsy specimen was BSCC. Surgical excision was performed under generalanesthesia. There have been no signs of recurrence or metastasis as of 3 years after the operation.
We present a case of pyogenic granuloma arising in the dorsum of the tongue in a 1-month-old boy with cleft palate. Pyogenic granuloma was apparently caused by chronic mechanical irritation to the tongue caused by sucking an artificial nipple. The observation of his tongue movements while nursing were examined with an X-ray TV system to determe how the irritation developed.
To investigate social effects of the “disposable wooden chopsticks accident, ” reported in July 1999, onchildren brought to the emergency room, we surveyed emergency visits during nights and weekends. Emphasiswas placed on palatal trauma in children. A 3-year period before and after the “disposable wooden chopsticksaccident” was surveyed. Of 4, 013 patients who visited our clinic for emergencies during night duty, 300 with trauma of soft tissues in theoral cavity were 6 years or younger, including 49 with trauma of the palate. The number of patients 6 years or younger with trauma of the palate increased by 3 times after the report of the “disposable wOoden chopsticks accident, ” as compared with that before the accident. Most cases involved mildinjuries such as abrasions and shallow wounds. Our findings may have reflected changes in awareness of palatal trauma by both parents and medical staff.