Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 54, Issue 1
Displaying 1-5 of 5 articles from this issue
  • Shigeyuki TAKATSUKA, Kan YOSHIDA, Kiyomasa NAKAGAWA, Etsuhide YAMAMOTO ...
    2008 Volume 54 Issue 1 Pages 2-7
    Published: January 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Arthroscopic surgery using radio-frequency electrocautery was carried out on 23 temporomandibular joints (TMJs) in 13 patients. Because these patients did not respond to conservative therapy, surgery was indicated. Preoperative MRI showed anterior disc displacement without reduction in all patients. Disturbed translation was also recognized in all of the discs and mandibular condyles. Intraoperative arthroscopic examination showed severe fibrous adhesion in the upper joint compartment and disc displacement. Four joints showed perforation between the disc and retrodiscal tissue. Postoperative findings included an increased range of vertical maximal mouth opening and decreased pain on mandibular movement. Analyses of postoperative MRI indicated recovery of disc and condylar translation. These results suggested that the introduction of arthroscopic surgery using radiofrequency electrocautery would significantly reduce the number of patients with osteoarthritic TMJ disorders
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  • Michiko TERADA, Wakae SUDA, Akira SATOH, Ken-ichi NOTANI, Masanobu SHI ...
    2008 Volume 54 Issue 1 Pages 8-11
    Published: January 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    A 30-year-old woman was referred to our hospital because of severe trismus, which had beenpresent for 14 years. At presentation, she complained of a mass with tenderness in the left masseter muscle, and mouth opening was limited to 15 mm. Panoramic radiograpy showed a periapical radiolucency at the left lower second molar. CT disclosed erosion and destruction of the buccal surface of the cortical bone and sclerosing changes of the left ramus, suggesting osteomyelitis of the mandible. CT also showed a mass inside the masseter muscle adjacent to the cortical bone defect. On MR the mass was confirmed to be a tumorous lesion with T1-low and T2-high signal intensity. Although the left lower second molar was extracted, symptoms did not improve, and mouth opening decreased to 5 mm. The patient underwent surgical therapy, including excision of the scar tissue, incision of the masseteric fascia, and abradement of the temporal muscle, which led to a good clinical course with mouth opening of more than 40 mm. On the basis of the clinical course and histopathological findings, the definitive diagnosis was trismus due to intramuscular chronic inflammation, which was caused by odontogenic infection followed by longstanding osteomyelitis, and cicatricial contracture of the masseter.
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  • Norihiro HASHIGUCHI, Masashi SHIMAHARA, Yoshihiro KIMURA, Noriko NAGIS ...
    2008 Volume 54 Issue 1 Pages 12-15
    Published: January 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    A lipoma is a common benign tumor that generally arises in soft tissue, and rarely occurs in bone. Although some cases of intraosseous lipoma have been reported, lipoma of the jaw bones is extremely rare. We report a rare case of lipoma occurring in the mandible. A 24-year-old woman was referred to our department because of a radiolucent lesion in the right side of the mandible.
    Clinically, the lesion was diagnosed as a cyst, and extirpation of the lesion was performed with the patient under general anesthesia in April 2001. The lesion consisted of 14 smaller tumors, which were elastic, yellow, capsulated, and soft. Theprognosis was good, and there was no sign of recurrence at an examination 80 months after the operation.
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  • Yuhsuke ABE, Shigeyoshi FUJIWARA, Ichiro OH-IWA, Masahiro UMEMURA, Aya ...
    2008 Volume 54 Issue 1 Pages 16-19
    Published: January 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    Microcystic adnexal carcinoma (MAC) is a rare malignant tumor of skin appendages. This tumor arises most commonly in the upper lip in the maxillofacial region. MAC is characterizedby a relatively slow clinical course, a strong tendency toward infiltration, and a low frequency of remote metastasis. Recently, we treated a case of MAC arising in the labial subcutaneous region. The patient was a 54-year-old man who noticed a mass in the right upper lip nearly 20 years ago. Since the tumor gradually became larger, he was referred to our hospital by a nearby clinic. At presentation, an extremely hard and immovable induration (20×15mm) was discovered at the upper lip. A benign tumor derived from a skin appendage was diagnosed on the basis of the clinical course of 20 years. Surgery was recommended, but the patient refused. He therefore underwent follow-up observation. When the tumor rapidly enlarged in March 2005, squamous cell carcinoma was diagnosed on the basis of a biopsydone in June. The tumor was resected with the patient under general anesthesia. Histopathological examination revealed no relation between the tumor and the skin, and imaging studies revealed continuous infiltration to the deep muscular layer. Proliferation of atypical basal cell-like squamous cells was found with microcystic lesions in the parenchyma of thetumor. On the basis of these findings, MAC was diagnosed. Neither local recurrence nor remote metastasis has been detected as of 2 years after resection.
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  • Atsushi TAKADA, Nobuaki HANAUE, Shigeki MORISAKI, Mitsuaki MORIMOTO, Y ...
    2008 Volume 54 Issue 1 Pages 20-24
    Published: January 20, 2008
    Released on J-STAGE: April 22, 2011
    JOURNAL FREE ACCESS
    We report a case of mucous membrane pemphigoid (MMP) limited to the oral mucosa that was associated with myelodysplastic syndrome (MDS). A 72-year-old man had gingival erosion and tenderness for 3 months. He was referred to our hospital on January 15, 2000 because the lesions did not improve. Physical and nutritional status was good. No abnormalities were noted on the skin. Gingival redness and tenderness were present throughout the oral cavity. Gingival erosion had developed in the maxillary anterior tooth and left mandibular molar regions. Laboratory examinations showed a high IgG level, but no other abnormalities were detected. Direct immunofluorescence studies showed linear deposits of IgG and C3in the basal membrane region. Indirect immunofluorescence studies using 1 M NaC1 split skin showed linear IgG on the epidermal side. Immunoblotting revealed autoantibodies to the C-terminal domain of BP180. Therefore, the patient was given a diagnosis of MMP.
    Daily treatment with 900mg nicotinamide and 900 mg erythromycin slightly improved the oral condition. However, nasal and oral hemorrhage started in May 2000.
    Platelets markedly decreased to 1000/μl.
    The patient was given a diagnosis of MDS on the basis of chromosomal tests.
    To our knowledge, MMP is very rarely associated with MDS.
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