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Volume 60, Issue 5
Displaying 1-12 of 12 articles from this issue
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Preface
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[in Japanese]2014 Volume 60 Issue 5 Pages 251
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSDownload PDF (769K)
Case reports
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Chikako HAYASHI, Junji KOBAYASHI, Hiroshi YAMAMOTO, Takaaki SAITO2014 Volume 60 Issue 5 Pages 252-256
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSMyxomas are rare benign mesenchymal tumors that occur in the head and neck region. It is difficult to preoperatively diagnose myxomas on the basis of clinical features because of the lack of characteristic radiographic features.
We present the case of a 62-year-old man who had a soft tissue myxoma with a painless palpable mass in the left submandibular triangle.
The mass showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images on magnetic resonance imaging.
The mass was removed with part of the muscle adhering to it under general anesthesia. Histopathologically, the mass was diagnosed as a myxoma. No recurrence has occurred as of 7 years after excision.View full abstractDownload PDF (8548K) -
A case of multiple metastases to the lateral lingual lymph nodes from carcinoma of the lower gingivaKosuke SAIDA, Yoshiyuki NAGANAWA, Masahiro UMEMURA, Hiroyuki OTO, Shin ...2014 Volume 60 Issue 5 Pages 257-261
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSA case of squamous cell carcinoma of the lower gingiva with multiple metastases to the lateral lingual lymph nodes is reported.
A 57-year-old man was given a diagnosis of moderately differentiated cT2N2bM0 squamous cell carcinoma of the left lower gingiva. Radical neck dissection, marginal mandibulectomy, and reconstruction with a metal plate were performed.
Preoperative computed tomography and magnetic resonance imaging revealed two masses 5 to 8 mm in diameter outside of the left genioglossus muscle. The masses were enucleated and suspected of be lymphoepithelial cysts on intraoperative frozen section examination.
However, the final pathological diagnosis was lymph-node metastasis. Resection of the oral floor and external radiation and chemotherapy were performed as additional treatment.
No evidence of disease was noted during more than 6 years of follow-up.View full abstractDownload PDF (2715K) -
Yuki HATTORI, Kenichi KURITA, Kohta FUKUTA, Nobumi OGI, Hidemichi YUAS ...2014 Volume 60 Issue 5 Pages 262-266
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSWe report on a patient who underwent gap arthroplasty and coronoidectomy followed by reconstruction with a dermis-fat graft and temporalis muscle and fascia flap for temporomandibular joint （TMJ） ankylosis. A 62-year-old woman was referred to our department because of limitation in mouth opening and left TMJ pain. Clinical examination revealed a 23-mm range of maximal mouth opening. A computed tomographic scan confirmed left TMJ bony ankylosis. After gap arthrotomy and coronoidectomy, the muscle with the fascia was interposed between the bony stumps, and dermis-fat was placed around the muscle graft and bony stumps.
As of 7 years after operation, magnetic resonance inaging showed that the interposed temporalis muscle and fascia flap and grafted fat had survived. A 35-mm range of motion was maintained with stable occlusion.View full abstractDownload PDF (2352K) -
Jun-ichi ISHIDA, Yuichiro IMAI, Takahiro YAGYUU, Yoshihiro UEYAMA, Kum ...2014 Volume 60 Issue 5 Pages 267-271
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSWe report a case of odontogenic myxoma in the mandible associated with schizophrenia. A 39-year-old female consulted us because of trauma to the orofacial region caused by drug-induced parkinsonism, and a myxoma was discovered incidentally on a radiographic examination. Radiographs of the lesion showed a monolocular radiolucency in the mandible. It was necessary for the myxoma to be removed, but the patient had to wait for surgery because of unstable symptoms of schizophrenia. After 3 months, the psychiatric symptoms gradually decreased, and social skills were rehabilitated. A tissue biopsy confirmed the diagnosis of myxoma. In March 2005, we performed a segmental mandibulectomy, and the mandible was reconstructed with an iliac bone graft and internal-maxillary fixation（ IMF） with elastics. Given our effort to build rapport with the patient preoperatively, there were few complaints about the IMF and pain during the perioperative period. In this patient, no recurrence has been observed as of 3 years 7 months after operation.View full abstractDownload PDF (2710K) -
Kazuyuki TSUNODA, Keisuke MITOMO, Hidekazu SATO, Jun YAMAGAMI, Taneaki ...2014 Volume 60 Issue 5 Pages 272-276
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSParaneoplastic pemphigus （PNP） is an autoimmune mucocutaneous blistering disease that occurs in association with underlying neoplasms. We report a case of orally-initiated PNP associated with thymoma. A 51-year-old man presented with erosive stomatitis affecting the floor of the mouth, buccal region, and soft palate mucosa. These lesions rapidly deteriorated, and Nikolsky phenomena with lichenoid changes was noted. A histological examination showed suprabasilar acantholysis with cell infiltration in the lamina propria. Direct immunofluorescence showed positivity for IgG and C3 in the intercellular spaces of the squamous epithelia. Indirect immunofluorescence showed IgG bound to the epithelium of the rat bladder. In addition, the patient serum reacted against 210 and 190 kDa proteins on immunoblotting. On computed tomography, a thymoma was detected in the anterior mediastinum. The patient showed severe oral blistering associated with thymoma and was finally given a diagnosis of PNP. Despite surgical excision of the thymoma, the oral symptoms persisted. To achieve remission, steroid pulse therapy, intravenous immunoglobulin therapy, cyclosporine treatment and plasma apheresis were additionally performed. We have been carefully following the activity of the oral symptoms and thymoma for 12 years. The characteristics leading to early diagnosis, including the clinical symptoms, serological test results, and diagnostic criteria of PNP, are discussed.View full abstractDownload PDF (2924K) -
Hironori ENDO, Kazuki HASEGAWA, Hideo MIYAMOTO2014 Volume 60 Issue 5 Pages 277-281
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSWe describe a patient who underwent bone augmentation for dental implant placement in the atrophic posterior mandible by sandwich osteotomy, focusing mainly on surgical technique. A 46-year-old woman was referred to our hospital because of alveolar bone atrophy in the posterior mandible. She had bone necrosis after the placement of three dental implants at a dental clinic. The patient hoped for dental rehabilitation supported by dental implants. Therefore, we performed bone augmentation by means of sandwich osteotomy with cancellous bone harvested from the iliac crest. The superior segment was elevated up to 7 to 8 mm after vertical and horizontal osteotomy. The graft bone was placed between the segment and the basal bone, and was then fixed with microplates. Although the patient had postoperative infection transiently, alveolar bone augmentation was accomplished successfully. Thirteen months after bone augmentation, two dental implantswere placed. At the 1 year 7 month follow-up after dental implant placement, the postoperative course was uneventful, with no bone resorption. This procedure was considered to be a very reliable and effective method for vertical bone augmentation in the atrophic posterior mandible.View full abstractDownload PDF (6256K) -
Ken-ichi AOYAMA, Yoshihide OTA, Takayuki AOKI, Toshihiro ARAI, Yuya DE ...2014 Volume 60 Issue 5 Pages 282-285
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSSeveral anatomic landmarks, such as the internal jugular vein and the omohyoid muscle, are used to guide dissection of the upper neck. In the present report, we describe the case of an abnormal relationship between the internal jugular vein and the omohyoid muscle.
A 70-year-old woman was referred to our hospital because of pain in the left mandibular molar region. Physical examination revealed no abnormal finding. There were also no abnormalities in the skeletal structure. She was given a diagnosis of a primary intra-osseous carcinoma of the left mandible with cervical lymph-node metastases on the left side.
The patient underwent segmental resection of the left mandible and left lateral functional neck dissection, followed by reconstructive surgery with a rectus abdominis muscle flap.
During dissection of the upper and middle neck, we observed that the internal jugular vein contained a foramen through which the accessory nerve passed at the level of the hyoid bone. In addition to this anatomical variation, the internal jugular vein was located above the omohyoid muscle and separated into anterior and posterior branches. The inferior belly of the omohyoid muscle passed between these venous branches. Both branches of the internal jugular vein and the omohyoid muscle were preserved.View full abstractDownload PDF (2781K) -
Hiroshi YAMAMOTO, Junji KOBAYASHI, Takehiro ICHIJIMA, Chikako HAYASHI, ...2014 Volume 60 Issue 5 Pages 286-290
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSStreptococcal toxic shock syndrome （STSS） can develop suddenly and cause septic shock, which rapidly progresses to multiple organ failure. The focus of the infection is often observed in the extremities and rarely occurs in the head or neck region. The patient was a 63-year-old woman who was referred to our department by a nearby dental clinic because of swelling beneath the jaw and pain radiating to the submental region. We administered ampicillin and clindamycin phosphate after diagnosing neck phlegmon and performed an abscess incision under general anesthesia. The patient went into shock while under postoperative supervision in the intensive care unit, and liver failure, renal failure, and disseminated intravascular coagulation developed. STSS was diagnosed after group A streptococcus was detected on bacterial culture of exudate taken from regions near the incision that was made during surgery. Antibiotics were administered, and the region of the incision was cleaned. The patient recovered well and was discharged from the hospital on day 39. One year after discharge, the patient is currently under follow-up observation at an outpatient clinic, has had no relapse to date, and is in good condition.View full abstractDownload PDF (1337K) -
Takaaki KAMATANI, Tomohiko KUTSUNA, Arisa YASUDA, Sayaka YOSHIBA, Yosh ...2014 Volume 60 Issue 5 Pages 291-294
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSIntramuscular lipoma is an uncommon tumor in the oral cavity. We report a rare case of intramuscular lipoma in the inferior surface of the tongue. A 60-year-old woman was referred to our department because of a painless swelling of the inferior surface of the tongue. Clinical examination revealed an elastic soft mass arising in the inferior surface of the tongue. The overlying mucosa was normal in color. T1- and T2- weighted images clearly showed high signal intensity, with a maximal diameter of 25 mm. The lesion was excised under general anesthesia. Histopathological examination showed proliferation of mature adipose cells, including bundles of skeletal muscle fibers. There were no atypical cells. On the basis of the results of histopathological examination, we diagnosed an intramuscular lipoma arising in the inferior surface of the tongue. No signs of recurrence have occurred as of 1 year 10 months after surgery.View full abstractDownload PDF (1506K) -
Toyonori SUZUKI, Atsushi FUJITA, Kohei MATSUDA, Wataru KAKUGUCHI, Ichi ...2014 Volume 60 Issue 5 Pages 295-299
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSA case of pyostomatitis vegetans as an initial symptom of ulcerative colitis is reported. A 16-year-old girl with no history of systemic disease was referred to our department because of oral pain. Miliary pustules with a cobblestone appearance and a partial ulcer were found in the bilateral maxillary gingiva and the left mandibular gingiva. Treatment with topical corticosteroids had no effect on the oral lesions. We recommended that the patient sought medical consultation because of fever, diarrhea, and hematochezia. She was given a diagnosis of ulcerative colitis and was prescribed mesalazine by a physician. After treatment, the fever, diarrhea, and hematochezia resolved. On the other hand, the oral lesion expanded and involved the entire mucosa of the mouth. Histopathological examination revealed that the lesion was suppurative inflammation with ulcer formation, diagnosed as pyostomatitis vegetans. Immediately after the systemic administration of corticosteroids began, the oral mucosal lesion resolved.View full abstractDownload PDF (1836K) -
Hideharu OKAMOTO, Isamu KODANI, Rieko DOI, Atsuhiro OKAMOTO, Kazuko TA ...2014 Volume 60 Issue 5 Pages 300-304
Published: May 20, 2014
Released on J-STAGE: June 03, 2015
JOURNAL FREE ACCESSHemangioma and vascular malformations often occur in the oral and facial regions. We report the case of a 33-year-old man who had a venous malformation in buccal region and received direct injection sclerotherapy with dehydrated ethanol.
Pretreatment MRA demonstrated blood flow from the facial and maxillary arteries through the lesion. Direct injection sclerotherapy with dehydrated ethanol was performed under general anesthesia. After the injection of dehydrated ethanol, the lesion shrank, and a good aesthetic outcome was obtained. There were no problematic side effects.
The authors suggest that direct injection sclerotherapy with dehydrated ethanol is an easy, effective, and safe therapy for venous malformation.View full abstractDownload PDF (1219K)
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