巻号一覧
55 巻, 12 号
選択された号の論文の7件中1～7を表示しています
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巻頭言
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瀬戸 晥一2009 年 55 巻 12 号 p. 621
発行日: 2009年
公開日: 2013/08/09
ジャーナル フリーPDF形式でダウンロード (148K)
原著
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平島 惣一, 吉岡 泉, 土生 学, 古田 功彦, 國領 真也, 岩永 賢二郎, 兒玉 正明, 福田 仁一, 冨永 和宏2009 年 55 巻 12 号 p. 622-628
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーThe control of neck lymph node metastasis in oral cancer is an important determinant of the prognosis. However, the effectiveness of prophylactic neck dissection has long been debated, without reaching a clear consensus.
Although our department performed prophylactic neck dissection before 1995, the use of this procedure has decreased markedly since then. Currently, we perform therapeutic neck dissection in patients with metastasis. Prophylactic neck dissection in the pure sense, excluding procedures involving reconstruction, has not been performedsince April 1997.
This study was designed to investigate the effectiveness of prophylactic neck dissection in Stage I and II oral squamous cell carcinoma. Ninety-one patients with primary Stage I and II disease treated in our department between 1992 and 2002 were retrospectively evaluated according to whether they underwent prophylactic neck dissection or not.
1. In Stage I, the 5-year cumulative survival rate was 88.9 % in the group that underwent prophylactic neck dissection and 91.4 % in the group that did not.
2. In Stage II, the 5-year cumulative survival rate was 93.3 % in the group that underwent prophylactic neck dissection and 86.4 % in the group that did not.
3. By closely following up patients and performing therapeutic neck dissection as soon as possible for neck lymph node metastasis, our results suggest that prophylactic neck dissection at initial surgery is not necessarily required in patients with stage I and II oral squamous cell carcinoma.抄録全体を表示PDF形式でダウンロード (1844K)
症例報告
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黒柳 範雄, 宮地 斉, 落合 栄樹, 出原 絵里, 岸本 大, 下郷 和雄2009 年 55 巻 12 号 p. 629-633
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーPanfacial fractures are defined as fractures involving at least three of the five facial segments（frontal, upper midface, nasoorbitoethmoid（NOE）, lower midface, and mandible）. Because of the complex anatomy neighboring the anterior cranial fossa and other existing injuries, these fractures may often be misdiagnosed or inadequately treated. Early reduction and accurate repositioning undoubtedly produces the best results, but primary repair may not be possible in severely injured patients. The optimal timing for operative management of facial fractures remains controversial. We treated a case of severe panfacial fracture with no evidence of skull base injury. The clinical findings, including the results of 3-dimensional computed tomography, revealed bilateral Le Fort I ＋ II fractures, a sagittal fracture of the upper jaw, NOE fractures of Markowitz’s type II, and a mandibular symphysis fracture. By reconstructing the facial buttresses, the facial esthetics and function were restored. Open reduction and fixation through a coronal incision produced good functional and esthetic postoperative results.抄録全体を表示PDF形式でダウンロード (2220K) -
森 宏樹, 古原 優樹, 花井 眞希, 田中 宏和, 横江 義彦, 飯塚 忠彦2009 年 55 巻 12 号 p. 634-638
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーMost patients with microgenia undergo mandiblar advancement by orthognathic surgery, but complications such as temporomandibular joint disorders, skeletal relapse, and progressive condylar resorption (PCR) commonly occur after surgical mandibular advancement by sagittal splitting ramus osteotomy.
Obstructive sleep apnea syndrome (OSAS) is related to a long face and clockwise rotation and retrusion of the mandible, whereas microgenia and retrognathism are often associated with condylar disorders.
We describe a 30-year-old man with microgenia, bilateral condylar disorders, and severe OSAS. We performed orthognathic surgery including distraction osteogenesis (DOG), and there was no relapse of malocclusion, signs of PCR, or recurrence of OSAS 22 months after DOG.抄録全体を表示PDF形式でダウンロード (2260K) -
田中 幸, 古賀 真, 槙原 聡子, 岩本 修, 古賀 千尋, 楠川 仁悟2009 年 55 巻 12 号 p. 639-643
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーAcute respiratory distress syndrome (ARDS) is the most serious type of breathing failure, with high mortality. The mortality rate ranges from 35 % to 65 %. We report a case of ARDS occurring in a patient who had recurrent tongue cancer with chronic renal failure requiring hemodialysis.
Case: A 58-year-old man was hospitalized to receive palliative treatment for recurrent tongue cancer. The patient suddenly fell into critical condition with hypoxia on the seventh hospital day. Diffuse bilateral alveolar infiltration was seen on the chest radiograph. The PaO2/FiO2 ratio fell to 52.5 mmHg, even with an oxygen flow of 5 l /min delivered with a mask. He immediately received noninvasive positive pressure ventilation(NIPPV) and pharmacotherapy. Lung oxygenation improved to a PaO2/FiO2 ratio of 211.7 mmHg, and he was weaned from NIPPV 8 days after symptom onset. However, he died of tongue cancer progression 5 months after recovery from ARDS.抄録全体を表示PDF形式でダウンロード (2055K) -
沢井 奈津子, 飯田 征二, 相川 友直, 岸野 万伸, 辻本 育子, 古郷 幹彦2009 年 55 巻 12 号 p. 644-648
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーHeterotopic gastrointestinal cyst in the oral cavity is a rare congenital cystic lesion occurring predominantly in the anterior part of the tongue of infants 1, 2). However, this lesion has also been confirmed in adults despite its asymptomatic and slow growth 1, 2). Complete excision of the cyst wall is recommended to prevent recurrence 2).
In this report, we describe a rare case of heterotopic gastrointestinal sublingual cyst. The patient was a 21-yearold Japanese woman. A swelling in the sublingual region had been noticed since birth and was incised to discharge the internal fluid, but the swelling persisted. At age 18, the sublingual lesion was excised for a clinical diagnosis of sublingual ranula at the department of otorhinolaryngology in another hospital, but the swelling recurred. She visited our hospital because of a residual swelling and a fistula in the sublingual region. Because typical clinical and radiographic features were absent, it was difficult to make a correct diagnosis of sublingual cystic lesion, and the excised specimen was histologically diagnosed as a heterotopic gastrointestinal sublingual cyst.抄録全体を表示PDF形式でダウンロード (4036K) -
青田 桂子, 墨 哲郎, 藤田 祐生, 山本 直典, 中澤 光博, 由良 義明2009 年 55 巻 12 号 p. 649-652
発行日: 2009/12/20
公開日: 2012/08/28
ジャーナル フリーGeneralized herpes zoster with widely disseminated cutaneous lesions is caused by varicella-zoster virus (VZV) viremia. We report on a patient who received treatment for recurrent gingival cancer of the maxilla and had generalized herpes zoster with Ramsay Hunt syndrome.
A 59-year-old woman was given a diagnosis of upper gingival cancer (T3N1M0) and underwent partial maxillectomy and total neck dissection on the left side. Although a recurrent tumor was treated with chemoradiation and boron neutron capture therapy, it extended into the ethmoidal sinus and the parapharyngeal space. She had a fever of 38.5 °C while she stayed at home for a while, and disseminated skin eruption appeared 3 days later. After another 3 days, herpes zoster around the pinna, facial paralysis, and hearing difficulty developed.
She had not recently contacted patients with VZV infection, and had antibodies against VZV at the onset of the skin lesions. VZV antigen was also demonstrated in a specimen of the skin lesions. Generalized herpes zoster and Ramsay Hunt syndrome were diagnosed. She was treated with acyclovir and γ-globulin and recovered without complications.抄録全体を表示PDF形式でダウンロード (1619K)
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