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Volume 61, Issue 10
Displaying 1-10 of 10 articles from this issue
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Preface
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[in Japanese]2015 Volume 61 Issue 10 Pages 495
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSDownload PDF (474K)
Invited review article
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Yoshiyuki YONEHARA, Takashi NAKATSUKA2015 Volume 61 Issue 10 Pages 496-504
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSThe oral and maxillofacial area includes both static and dynamic structures as well as organs of special functions such as mastication, swallowing and speech. These functions are important for quality of life after treatment. Small tissue defects can be treated with primary suture closing, skin graft and local flaps. To reconstruct large tissue defects, pedicle flap or vascularized free flap transfer is often required. In terms of timing of reconstruction, there are two types: one is immediate reconstruction that is intended to cover and fill the defect just after tumor ablation and another is secondary reconstruction that is performed later to aim at restoration of form and function. In order to perform the free flap transplant successfully, it is necessary to have correct understanding of flap selection and design, anastomosis vessel selection, and postoperative management. Typical flaps used in oral and maxillofacial reconstruction include the forearm flap, rectus abdominis musculocutaneous flap, anterolateral thigh flap and latissimus dorsi flap.View full abstractDownload PDF (742K)
Original article
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Junya KUSUMOTO, Shungo FURUDOI, Akiko SAKAKIBARA, Midori HATA, Masaya ...2015 Volume 61 Issue 10 Pages 505-512
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSNecrotizing fasciitis is a rare, but lethal disease. This disease requires prompt surgical debridement of the necrotic tissue. However, it is often difficult to differentiate early-onset necrotizing fasciitis from cellulitis and abscess. The laboratory risk indicator for necrotizing fasciitis （LRINEC） score was introduced as a tool for the early recognition and diagnosis of necrotizing fasciitis. There have been several reports on the utility of the LRINEC score in the extremities and trunk, but only one report on the head and neck region. We therefore retrospectively investigated the utility of the LRINEC score for necrotizing fasciitis in the head and neck region. The subjects were 10 patients with necrotizing fasciitis and 86 patients with severe cellulitis. The LRINEC score was significantly higher in patients with necrotizing fasciitis （mean 7.0 points, range 0-10） than in those with severe cellulitis （mean 1.9 points, range 0-10). A LRINEC score of ≥6 had a sensitivity of 90.0%, a specificity of 88.4%, a positive predictive ratio of 47.4%, and a negative predictive ratio of 98.7%. Our results suggested that the LRINEC score is a valuable auxiliary diagnostic tool, especially for the exclusive diagnosis of necrotizing fasciitis in the head and neck region.View full abstractDownload PDF (750K)
Case reports
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Toyoko SHIBUKAWA, Tadashi MIKOYA, Yusuke MATSUZAWA, Yumi ITO, Izumi SO ...2015 Volume 61 Issue 10 Pages 513-517
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSWe describe our experience with a case of congenital epulis arising in both the maxillary and mandibular alveolar ridge, which showed spontaneous regression. Two distinct lesions were found in an 8-day-old newborn infant at the first medical examination: one was a sessile lesion on the maxillary alveolar ridge corresponding to the right upper deciduous canine, and the other was a pedunculated lesion on the mandibular alveolar ridge corresponding to the right lower deciduous lateral incisor. Because the patient did not have any problem with feeding using a nursing bottle or with breathing, we decided to perform follow-up observation. During follow-up, both lesions regressed spontaneously, with no increase in size. As of 21 months after birth, the deciduous incisors, canines, and first molars had erupted in the normal position in both the upper and lower jaws, without any complications. As shown by the present case, congenital epulis may regress spontaneously with the growth of the infant. Careful follow-up is essential before deciding to perform surgical excision, especially in patients with lesions that show no increase in size and cause no dysfunction.View full abstractDownload PDF (529K) -
Nobuyuki KAIBUCHI, Toshihiro OKAMOTO, Toshiyuki KATAOKA, Akira KUMASAK ...2015 Volume 61 Issue 10 Pages 518-523
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSWe report a case of temporomandibular joint （TMJ） ankylosis suspected to be caused by psoriatic arthritis and treated by condylectomy. The patient was a 63-year-old woman. She was referred to our department by a university oral surgery department because of trismus. Her medical history revealed the onset of psoriasis at the age of 14 years. She experienced pain on mouth opening in the right TMJ, and the interincisal distance was 12 mm. Panoramic radiography and computed tomography revealed narrowing of the right TMJ cavity. Blood tests indicated a mildly increased C-reactive protein level, negativity for rheumatoid factor, and presence of human leukocyte antigens A2 and B46. On the basis of a clinical diagnosis of TMJ ankylosis caused by psoriatic arthritis, condylectomy was performed with the patient under general anesthesia. During surgery, the mandibular condyle was found to adhere to the temporal bone in the right TMJ region. The lower portion of the mandibular condyle adhesions was resected, and the temporal and masseter muscles were detached bilaterally. This resulted in an intraoperative interincisal distance of 40 mm. After surgery, the patient performed the recommended mouth-opening exercise training. However, 1 year after surgery, the interincisal distance had decreased to 22 mm because of an exacerbation of systemic symptoms of psoriasis.View full abstractDownload PDF (758K) -
Manabu IYODA, Katsunori OGAWARA, Hiroki KASAMA, Kazuyuki KOIKE, Yasuhi ...2015 Volume 61 Issue 10 Pages 524-527
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSThe present study was performed to investigate risk factors for postoperative pulmonary complications in oral cancer surgery. Between 2007 and 2011, a total of 288 patients underwent oral cancer surgery under general anesthesia in the Department of Oral-Maxillofacial Surgery, Chiba University Hospital. Postoperative pulmonary complications occurred in 44 patients （15.3%）. The results of statistical analysis showed that 14 risk factors were related to pulmonary complications: age, gender, history of chronic obstructive pulmonary disease （COPD）, history of brain disease, history of smoking, preoperative abnormal chest radiograph, preoperative volume of sputum, activities of daily living （ADL）, American Society of Anesthesiologists （ASA） classification, duration of operation, duration of anesthesia, volume of blood loss during surgery, blood transfusion during surgery, and tracheotomy. In addition, we found that activities of daily living, blood transfusion during surgery, and tracheotomy were more strongly related to postoperative pulmonary complications on multivariate logistic regression analysis.View full abstractDownload PDF (388K) -
Kenji YOSHIDA, Satoru MORI, Tomo YOKOI, Yuichiro KUROIWA, Kenichi KURI ...2015 Volume 61 Issue 10 Pages 528-533
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSUnilateral hypoplasia of the coronoid process is very rare. We present such a case in a 10-year-old girl who was referred to our department for examination of the left coronoid process. A panoramic radiograph revealed hypoplasia of the left coronoid process. Atrophy of the left coronoid process and developmental disorder of the left condyloid process from the ramus were also found. Ultrasonography indicated lower blood flow to the left temporal muscle than to the right temporal muscle. An electromyogram showed weaker activity in the left temporal muscle than in the right temporal muscle. However, the true etiology of the hypoplasia was unclear. The patient started orthodontic treatment from the age of about 16 years. Genioplasty was conducted when the patient was 21 years old. As of 17 years after the first medical examination, the patient has good occlusion without relapse.View full abstractDownload PDF (661K) -
A patient with massive salivary retention in the parapharyngeal space occurring after sialolithotomyYu OHASHI, Akiko KUMAGAI, Ayako MITA, Mitsuru IZUMISAWA, Hideki HOSHI, ...2015 Volume 61 Issue 10 Pages 534-538
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSWe encountered a patient in whom it was difficult to discriminate between a ranula and salivary retention in the parapharyngeal space after sialolithotomy. The patient was a 19-year-old woman who visited our hospital because of swelling of the left submandibular region. The patient had noticed swelling and pain of the left submandibular region 7 months earlier, visited an otorhinolaryngology clinic, and was given a diagnosis of a salivary stone in the left Wharton’s duct. Excision of the sialolith through an intraoral approach was attempted, but it could not be removed. Swelling of the region increased after several days, and the patient was instructed to press the submandibular region by a otorhinolaryngologist. Swelling and pain of the region repeatedly occurred for 6 months thereafter. The patient consulted a dental office about the swelling of the left submandibular region, and she was referred to our department. She was given a diagnosis of massive salivary retention and a salivary stone in the submandibular region, and imaging was performed. The massive salivary retention extended from the submandibular to parapharyngeal space. When the sublingual gland was removed, and fenestration was performed with the patient under general anesthesia, a large volume of fluid flowed out of the salivary retention space, with which swelling of the submandibular region markedly regressed. As of 1 year 6 months after exteriorization and compression, fluid retention extending to the parapharyngeal space has disappeared, and no recurrence has occurred. The current condition is favorable without any clinical signs or symptoms of sialolithiasis.View full abstractDownload PDF (601K) -
Keiko NAITO, Shoko SUZUKI, Akihiko NOMACHI, Keiko HAISHIMA, Shigeta TA ...2015 Volume 61 Issue 10 Pages 539-542
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSAs perioperative oral functional management has been covered by national health insurance since fiscal 2012 in Japan, these services have been provided in the Department of Oral and Maxillofacial Surgery, Hamamatsu Medical Center. We report a case of mucormycosis developing in the oral cavity during the perioperative oral functional management of a patient with acute myeloid leukemia who underwent bone marrow transplantation. Rhinocerebral mycosis usually arises in the nasal cavity, paranasal sinuses, or oculus. In our patient, discoloration of the maxillary gingiva was the first symptom, and only oral findings were useful for diagnosis. Patients receiving perioperative oral functional management are compromised and at risk for rare infectious diseases. In conclusion, we recognize that it is very important to manage oral function in perioperative patients not only for the maintenance of oral function, but also for the early detection of oral abnormalities.View full abstractDownload PDF (558K) -
Taku KANDA, Naohiro KIMURA, Toshinori ANDO, Shigeaki TORATANI, Jun-ich ...2015 Volume 61 Issue 10 Pages 543-547
Published: October 20, 2015
Released on J-STAGE: December 19, 2015
JOURNAL FREE ACCESSCherubism is a rare inherited disease characterized by a cherubic facial appearance. Generally, symmetric jaw swellings and indolent clinical course are early symptoms in early childhood. A few sporadic cases have been decribed1,2）. We report the case of a central giant cell lesion diagnosed to be cherubism. The patient was 7-year-old girl who consulted our clinic because of bilateral painless swelling of the jaws. Computed tomographic examination showed well-delineated multilocular radiolucent lesions associated with bilateral enlargement of the jaws. Her father had a clinical history of bilateral giant cell reparative granuloma arising in the mandible. Because histopathological examination of a biopsy specimen revealed central giant cell granuloma, enucleation of the lesions was performed with the patient under general anesthesia. Histopathological examination of the enucleated specimen revealed an accumulation of giant cells resembling osteocyte and hemosiderin deposits in granulation tissue with spindle cells. There has been no evidence of recurrence as of 3 years after surgery.View full abstractDownload PDF (719K)
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