Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 59, Issue 3
Displaying 1-10 of 10 articles from this issue
Preface
Invited review article
  • Hideto SAIJO, Yoko KAWASE-KOGA
    2013 Volume 59 Issue 3 Pages 148-158
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Abstract: The treatment of patients with cleft lip and/or cleft palate, which occurs in relatively high incidence anong congenital disorders, requires long-term follow up from birth to adulthood. Moreover, it needs a multidisciplinary approach by oral surgeons, plastic surgeons, pediatric doctors, otolaryngologists, orthodontists, prosthodontists, and speech pathologists. Some departments of oral and maxillofacial surgery work actively with obstetrics departments that have been performing the prenatal diagnosis. Sinceinfant patients force the problem of milk consumption, some institutions use the palatal plate and incorporate orthognathic treatment. Furthermore, surgical treatment is essential for the functional and aesthetic improvements of patients. Numerous techniques for primary treatment of cleft lip and cleft palate have been described in the literature. This paper describes the typical surgical techniques for patients with the cleft lip and cleft palate at prenatal stage to initial treatment.
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Secondary publication
  • Yusuke ZUSHI, Kazuma NOGUCHI, Masahiro URADE
    2013 Volume 59 Issue 3 Pages 159-171
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Oral squamous cell carcinomas (OSCCs) are considered to arise from human oral keratinocytes. DNAs of human papillomaviruses (HPVs), predominantly types 16 and 18, etiological agents of cervical cancers, have been detected in approximately 25% of OSCCs. In accordance with the established roles of E6 and E7 in inactivating p53 and pRb, respectively, mutations of p53 and inactivation of p16INK4a are frequently observed in HPV-negative OSCCs. In addition, other alterations such as overexpression of epidermal growth factor receptor (EGFR) are often observed in both HPV-positive and -negative OSCCs. However, the causal relation between accumulation of these abnormalities and multistep carcinogenesis is not fully understood. To elucidate underlying processes, we transduced either HPV16 E6/E7 or a mutant CDK4 (CDK4R24C), cyclin D1, and human telomerase reverse transcriptase (TERT) into primary human tongue keratinocytes (HTK), and obtained immortal cell populations, HTK-16E6E7 and HTK-K4DT. Additional transduction of oncogenic HR AS or EGFR together with MYC into HTK-16E6E7 and dominant negative p53 expressing HTK-K4DT resulted in anchorage-independent growth and subcutaneous tumor formation in nude mice. These results indicate that either HRAS mutation or activation of EGFR in cooperation with MYC overexpression play critical roles in transformation of HTKs on a background of inactivation of the pRB and p53 pathways and telomerase activation. This in vitro model system recapitulating the development of OSCCs should facilitate further studies of mechanisms of carcinogenesis in the oral cavity.
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Case reports
  • Hiroshi WATANABE, Kou KAWAHARA, Kou ISHII, Mitsuo GOTO, Hitoshi MIYACH ...
    2013 Volume 59 Issue 3 Pages 172-176
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    A deep neck abscess is a serious condition that rapidly spreads by bacterial infection in facial planes and spaces of the neck, as well as in surrounding tissues. We report the case of a deep neck infection triggered by teeth extraction in a very elderly patient. A 95-year-old woman presented with severe neck pain and swelling that progressed rapidly over 3 days following teeth extraction at a local private dental clinic. Laboratory studies on the first visit showed acute inflammatory responses: the white-cell count was 35,200 /mm3, and the C-reactive protein level was 38.72 mg/dL. Contrast-enhanced computed tomographic images revealed that an abscess had spread widely into the neck and caused internal jugular vein obstruction. The patient therefore immediately, underwent surgical drainage through both neck and intraoral incisions under general anesthesia on the day of arrival. Airway management with intratracheal intubation was required for 5 days in the intensive care unit, with the administration of antibiotics. The patient was discharged from our hospital after complete recovery with no complications in 43 days. Prompt diagnosis and surgical drainage were key to successful treatment.
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  • Kenjiro IWANAGA, Akihiko BASUGI, Yoshihiro YAMASHITA, Ayataka ISHIKAWA ...
    2013 Volume 59 Issue 3 Pages 177-181
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Abstract: Primar y intraosseous mucoepidermoid carcinoma of jaw bones is commonly seen in the posterior part of the mandible; its occurrence in the anterior part of the maxilla is rare. We report a case of mucoepidermoid carcinoma suspected to arise in the maxilla intraosseously. The patient was a 55-year-old man with a swelling in the right maxillary region. The tumor, measuring 25 × 20 mm, was located in the anterior portion of the right maxillary region. The tumor was diagnosed as an intermediate-grade mucoepidermoid carcinoma on histological examination of a biopsy specimen. Under general anesthesia, the tumor was surgically removed with surrounding healthy tissue. Histological examination showed an intermediategrade mucoepidermoid carcinoma including few mucous cells. There has been no evidence of recurrence or metastasis after 3 and a half years of postoperative follow-up.
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  • Takuya ASAKA, Shujiroh MAKINO, Masashi TAKANO, Takahiro ABE, Yoshihiro ...
    2013 Volume 59 Issue 3 Pages 182-186
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Recently, segmental mandiblectomy has been increasingly used to treat advanced cases of bisphosphonate-related osteonecrosis of the jaws (BRONJ), and titanium plates have been recommended for mandibular reconstruction. To date, only a few patients have undergone immediate reconstruction with a free- bone flap. We describe a patient with refractory osteomyelitis of the jaw caused by oral bisphosphonates in whom immediate reconstruction with a free-fibula flap was performed after segmental mandiblectomy. At present, 19 months after the operation, there has been no clinical or radiographic evidence of recurrent osteomyelitis or BRONJ, and computed tomography showed good osseous integration.
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  • Rieko DOI, Takashi NARAI, Soh WATANABE, Satoshi YOKOGI, Isamu KODANI, ...
    2013 Volume 59 Issue 3 Pages 187-191
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Sakoda complex is as a distinctive disease entity characterized by sphenoethmoidal meningoencephalocele, agenesis of the corpus callosum, and cleft lip, cleft palate, or both. The etiology remains unclear. However, this characteristic congenital malformation complex may be explained by embryological restriction of the cephalic neural crest and improper separation between the neurectoderm and the surface ectoderm after neural tube formation. We describe a patient with anomalies consistent with the Sakoda complex. The patient's extraoral findings included bilateral orbital proptosis, left exotropia, a right accessory auricle, and incomplete medial cleft lip, and intraoral findings included medial cleft jaw and upper labial frenum. MR imaging of the brain showed enlargement of the posterior horns and an Azygos-type anterior cerebral artery. He had life-threatening symptoms such as obstructive respiratory problems, but showed improvement in accordance with growth. About 7 months after birth, we performed an operation to close the cleft lip. During and after the operation, the infant had transient abnormalities of thermoregulation due to a pituitary disorder, but the condition was not so serious. In patients with a good prognosis, lip plasty and palatoplasty are necessary not only to improve aesthetic problems and feeding disorders, but also to protect the meningoencephalocele.
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  • Itaru SONODA, Narikazu UZAWA, Satoshi YAMAGUCHI, Masashi YAMASHIRO, Ki ...
    2013 Volume 59 Issue 3 Pages 192-196
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    We report the case of an 8-years-old child with hereditary angioedema who required oral surgery.
    Hereditary angioedema (HAE) is a rare autosomal dominant hereditary disease caused by a functional disorder of C1 inhibitor (C1-INH) or a low level of C1- INH protein. HAE is characterized by repeated localized edema of submucocutaneous tissues. Attacks are caused by trauma, drugs, infection, or mental stress. Dental treatment and oral surgery in patients with HAE can trigger fatal laryngeal edema.
    To prevent angioedema attacks, we injected C1-INH before surgery in a child with HAE. She underwent tooth extraction and cystectomy of the left side of the mandible under general anestethia. No HAE-related complications occurred during or after surgery, and perioperative management went well.
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  • Akira KIMOTO, Hiroaki SUZUKI, Shungo FURUDOI, Junichiro TAKEUCHI, Tomo ...
    2013 Volume 59 Issue 3 Pages 197-201
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    Abstract: Patients with rheumatoid arthritis often receive methotrexate (MTX). Recently, it has been shown that MTX can cause B cell lymphoma, non-Hodgkin's lymphoma. B cell lymphoma caused by MTX is referred to as a methotrexate-associated lymphoproliferative disorder (MTX-LPD) and is recognized by the World Health Organization and included among immunodeficiency-associated LPD. We describe a rare case of MTX-LPD with osteonecrosis of the jaw of maxilla and mandible in which spontaneous complete remission was achieved.
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  • Hidenao OGI, Yoshihiro YOSHITAKE, Takuya TANAKA, Masakazu YONEDA, Masa ...
    2013 Volume 59 Issue 3 Pages 202-207
    Published: March 20, 2013
    Released on J-STAGE: November 29, 2014
    JOURNAL FREE ACCESS
    A 70-year-old woman with multiple oral cancers received concurrent chemoradiation therapy with S-1 (50 mg/day). The patient received S-1 for 33 days and a total radiation dose of 66 Gy. The patient complained of a mild fever after therapy. She was treated in the department of pulmonary medicine in this hospital for subsequent dyspnea and hypoxemia. Computed tomography (CT) showed extensive groundglass opacity and diffuse consolidation changes in both lungs. She required endotracheal intubation, ventilator support, oxygen therapy, and steroid pulse therapy. These treatments remarkably improved her symptoms, and the abnormal findings on CT also resolved. A drug-induced lymphocyte stimulating test for S-1 demonstrated a positive reaction. These findings indicated a diagnosis of lung injury with acute respiratory distress syndrome induced by S-1. Drug-induced lung injury should to be considered in the differential diagnosis when patients treated with S-1 therapy present with fever and dyspnea.
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