Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 59, Issue 12
Displaying 1-10 of 10 articles from this issue
Preface
Invited review article
Case reports
  • Eiju SATO, Hiroshi HASEGAWA, Reo TSUCHIYA, Tetsuharu KANEKO, Etsuro TA ...
    2013 Volume 59 Issue 12 Pages 765-769
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Peripheral osteoma arising in the mandible is relatively rare. We report two cases of a solitary peripheral osteoma located in the buccal aspect of the mandibular body and subcondylar region. The first patient was a 30 -year-old woman presenting with a peripheral osteoma near the mental foramen of the mandibular body. She had been aware of a swelling on the right side of the mandible since approximately 1998 and visited our hospital in 2001. She refused resection at that time, but the tumor enlarged slowly, and she therefore returned to us in 2009. Enlargement of the neoplasm on a computed tomographic scan was significant as compared with the size at 8 years of age. It was removed surgically via an intraoral approach with the patient under general anesthesia. The second patient was a 68-year-old woman with a peripheral osteoma arising in the subcondylar region. She had noticed swelling of the right buccal region 20 years earlier. Computed tomographic examinations revealed a bony mass located in the right subcondylar region. It was excised with a trans-parotid gland approach, involving a preaural incision under general anesthesia. In both cases, the histopathological diagnosis was a compact osteoma. Both patients were satisfied esthetically and have remained free of recurrence postoperatively at a follw-up of 48 and 56 months, respectively.
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  • Yukinobu OHMURA, Takayuki ONO, Toshitaka NAKAOKA, Tomio HAYASHI, Mutsu ...
    2013 Volume 59 Issue 12 Pages 770-775
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Eosinophilic granuloma of bone is a lesion of unknown cause that shows abnormal proliferation of histiocytes and infiltration of eosinophils. In the oral cavity, this lesion most commonly affects the mandible. This report describes a case of monostotic eosinophilic granuloma in the mandibular condyle. The patient of the 38 years old woman was given a definitive diagnosis of eosinophilic granuloma of bone on the basis of open biopsy findings. One year 3 months after the diagnosis, panorama X-ray films and magnetic resonance imaging revealed satisfactory formation of new bone, suggesting spontaneous remission of the lesion. As previously reported, monostotic eosinophilic granuloma of bone can heal spontaneously. However, follow-up is necessary after definitive diagnosis on biopsy because monostotic eosinophilic granuloma of bone may evolve into multiple lesions.
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  • Noriyuki SUKA, Seishi MAGOSHI, Yuka OKU, Hisao SHIGEMATSU, Yoichi TANA ...
    2013 Volume 59 Issue 12 Pages 776-780
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Thyroglossal duct cyst (TGDC) generally arises from the remnant of the thyroglossal duct that connects the foramen cecum of the tongue to the thyroid gland. We describe a rare case of TGDC associated with small calcification grains in the cystic cavity.
    A 39-year-old man was referred to our hospital for further evaluation of a tumor in the submental region. At presentation, the tumor, which measured 4 cm in diameter, was found in the subhyoid region as a rounded, well-circumscribed, painless, mobile, and elastic-soft mass. He had no clinically significant family or medical history of TGDC. Ultrasonography demonstrated a poorly-demarcated cystic lesion about 2 cm in diameter with a heterogeneous internal echo pattern that was partly hyperechoic. Computed tomography and magnetic resonance imaging also showed a demarcated and round cystic mass with a diameter of 2 cm. A clinical diagnosis of TGDC was made, and we performed surgical removal of the tumor with the Sistrunk procedure under general anesthesia. Histopathologically, the cyst was covered with pseudostratified ciliated columnar epithelium within stratified squamous epithelium in some areas. In addition, lamellar-structured small calcification grains were found within the cystic cavity. A histopathological diagnosis of TGDC was made. These small calcification grains apparently developed by a process similar to the generating mechanism of a sialolith. Recurrence of the original TGDC was not found 3 years or more after surgery.
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  • Hiroshi NOZAWA, Shinya WATANABE, Junko NAKAJIMA, Kaoru MURAKAMI, Hid ...
    2013 Volume 59 Issue 12 Pages 781-785
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Pleomorphic lipoma, a variant of lipoma, is a rare benign lipomatous tumor mainly located in the subcutaneous tissue of the neck and shoulders in elderly men. However, it is extremely rare in the oral cavity. To our knowledge, only 9 cases, including the present case, of pleomorphic lipoma in the oral cavity have been reported in the English-language and Japanese literature. We describe a case of pleomorphic lipoma arising in the buccal mucosa of a 35-year-old woman. Physical examination revealed a tender, smooth, well-demarcated mass, measuring 25 × 20 mm in the left buccal mucosa. The mass was surgically removed with the patient under general anesthesia, and the histopathological diagnosis was pleomorphic lipoma. There were no signs of recurrence 14 months after the operation.
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  • Katsumi MOTEGI, Yukihiro MOMOTA, Hideyuki TAKANO, Kouichi KANI, Yoshik ...
    2013 Volume 59 Issue 12 Pages 786-790
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Acquired hemophilia A is a rare disease. It is caused by the acquirement of factor VIII inhibitor. We report a case of acquired hemophilia A incidentally diagnosed on bleeding after tooth extraction. A 75-yearold woman referred to our hospital because of bleeding after tooth extraction. Hematological examination revealed a prolonged activated partial thromboplastin time (APTT) and decreased coagulation activity of factor VIII. In addition, a high level of factor VIII inhibitor was detected. Therefore, our patient was given a diagnosis of acquired hemophilia A. The patient was admitted to our hospital and received corticosteroids and bypass hemostasis using recombinant coagulation factor VII. On hospital day 42, APTT and factor VIII activity returned to the normal range. Moreover, factor VIII inhibitor disappeared. The patient was discharged and is being treated at a local general hospital.
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  • Kousuke OHKI, Koichiro SUZUKI, Toshiyuki HAGIWARA
    2013 Volume 59 Issue 12 Pages 791-795
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Osteoma is a benign osteogenic lesion consisting of mature bone tissue. We describe the case of a large peripheral osteoma arising inside the mandibular ramus.
    The patient was 64-year-old man who complained of tenderness around the right ear region. The maximum interincisal mouth opening was 40 mm, and there was no malocclusion caused by the tumor. A computed tomography (CT) scan showed a bone-like, hyperdense image with a lobulated surface located inside the right mandibular ramus. Surgical removal of the tumor was performed with the patient under general anesthesia. A modified Risdon's incision, which was extended posteriorly towards the mastoid region, was made to reach the retromandibular area. To expose the entire tumor, a vertical ramus osteotomy was carried out, and the posterior part of the ramus was swung without dislocation of the temporomandibular joint. The osteoma was cut at the base, and the resected specimen was 52 × 36 × 33 mm. Resorbable plates were used to fix in place the replaced segments of the ramus. The histological diagnosis was compact osteoma. The occlusion was stable, and no functional disturbance or tenderness has occurred as of 1 year after surgery.
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  • Kinuko OGATA, Takaharu TAKETOMI, Masayo TAKANO, Haruki TSUYAMA, Osamu ...
    2013 Volume 59 Issue 12 Pages 796-800
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    Basedow disease, which presents with hyperthyroidism, is an autoimmune disease induced by an autoantibody against the thyroid stimulating hormone (TSH) receptor. We report the case of a patient with Basedow disease found on thyroid crisis during mandibular osteotomy.
    An 18-year-old man with skeletal mandibular protrusion was scheduled to undergo mandibular osteotomy.There was no sign of Basedow disease on preoperative examination, and we could not find any particular risks associated with the surgical procedure. Immediately after the operation began, he had hypertension, tachycardia, and hyperthermia, reaching 39℃.
    Although we suspected malignant hyperthermia, characteristic findings were lacking. We therefore considered the possibility of thyroid crisis. Postoperative laboratory data showed hyperthyroidism (FT3 15.0 pg/mL, FT4 3.85 ng/dL, TSH 0.007μU/mL). Both thyroid stimulating antibody and anti-TSH receptor antibody were also positive. Therefore, Basedow disease was finally diagnosed. He was immediately treated with a β -blocker, potassium iodide preparation, and antithyroid agent. His thyroid function improved, and no further episode of thyroid crisis subsequently.
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  • Daichi KOGURE, Kazutoshi NAKAOKA, Toshikatsu HORIUCHI, Akito GOTOH, Ka ...
    2013 Volume 59 Issue 12 Pages 801-805
    Published: December 20, 2013
    Released on J-STAGE: December 22, 2014
    JOURNAL FREE ACCESS
    We report a case of suppurative arthritis of the temporomandibular joint (TMJ) followed by the development of brain abscess in a 43-year-old woman. She visited our clinic because of limited mouth opening with masseter muscle pain. The symptoms were refractory to a serial non-surgical treatment based on the diagnosis of temporomandibular disorder (TMD). We also diagnosed TMD and continued non-surgical treatments. Two weeks later, however, a diffuse swelling in the left TMJ region with progressive limitation of mouth opening and mandibular deviation to the right was observed. The patient also had a fever of more than 40 ℃ . Therefore, antibiotic treatments, including surgical drainage of the left TMJ and infra-temporal fossa, were performed for a diagnosis of suppurative arthritis of the left TMJ. Peptostreptococcus spp. was detected in the suppuration obtained from the TMJ. Although her condition gradually improved, she suddenly complained of headache and staggered. Magnetic resonance imaging of revealed 2 brain abscesses in the left temporal lobe, and surgical drainage with craniotomy was carried out by a neurosurgeon. Subsequently, she completely recovered without neurologic complications, and no recurrence was found at 20-month follow-up.
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