日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
62 巻, 10 号
選択された号の論文の9件中1~9を表示しています
巻頭言
総説
  • 梅田 正博, 船原 まどか, 林田 咲, 五月女 さき子
    2016 年 62 巻 10 号 p. 506-512
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    We described postoperative infection after oral cancer surgery and its general prophylaxis, and showed our study about preventive effects of perioperative oral management on postoperative infection. The frequency of surgical site infection (SSI) after oral cancer surgery is high, especially in clean-contaminated surgery or major surgery. To prevent SSI, general prophylaxis recommended by CDC Guideline should be performed.

     The number of oral bacteria increases remarkably in patients during intubation by trachectomy. We reported that topical administration of tetracycline ointment in the oral cavity reduced bacteria in the oropharyngeal fluid to the fewer level than that before intubation during 6 hours. A multicenter randomized clinical trial on the preventive effect of topical tetracycline administration on SSI is being performed now.

     Postoperative pneumonia sometimes occurred in oral cancer surgery. The risk factors for development of postoperative pneumonia are old age, diabetes, lower pulmonary function, smoking, large surgical stress, postoperative dysphagia, etc. However, few investigators reported the relationship between oral hygiene and pneumonia. We reported that perioperative oral management reduced the risk of postoperative pneumonia in patients undergoing esophageal cancer surgery in a multicenter retrospective study. These results suggest that proper oral managements may prevent the development of postoperative pneumonia also in oral cancer surgery.

症例報告
  • 榎木 祐一郎, 福島 洋介, 大久保 正彦, 野島 淳也, 佐藤 毅, 依田 哲也
    2016 年 62 巻 10 号 p. 513-517
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Epithelioid hemangioma (EH) is classified as a benign vascular tumor and rarely occurs in the oral or maxillofacial region. We report a case of EH in the left mental region. A 50-year-old woman was referred to our hospital because of swelling of the left mental region. An indolent elastic-soft tumor with a diameter of approximately 15 mm was present. The tumor was surgically excised and histopathologically diagnosed as EH on the basis of the presence of several microvessels surrounded by endothelial cells with an epithelium-like appearance. Histopathological examination is essential for the definitive diagnosis of EH. Intensive observation is also necessary owing to the risk of recurrence in patients with EH.

  • 大泉 丈史, 高橋 正任, 熊本 裕行, 高橋 哲
    2016 年 62 巻 10 号 p. 518-520
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Black hairy tongue (BHT) is a rare disease, especially in a newborn infant. To the best of our knowledge, only a few cases in infants have been reported in the literature. These cases were reported to be associated with long-term administration of antibacterial agents, fungal infections, developed spontaneously, or were related to bacteremia. In addition, this disease cannot be treated with the same medications as those used in adults, because the safety of those agents in newborns has not been established. Therefore, treatment should be designed to maintain proper oral hygiene by cleaning with a tongue brush and eliminating causal factors by withdrawing antimicrobial agents or taking other appropriate actions. We present a case of BHT in a 4-week-old newborn infant. In this patient, microorganisms and filamentous foreign bodies adhered to the filiform papillae, without fungal infection. The patient had not received antibiotics. We recommended brushing the tongue with a toothbrush several times a day, and the lesion consequently disappeared. Our case is probably the youngest case of BHT to be ever reported.

  • 銘苅 泰明, 上田 剛生, 仲間 錠嗣, 比嘉 努, 澤田 茂樹, 幸地 真人
    2016 年 62 巻 10 号 p. 521-524
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Congenital maxillomandibular fusion is a very rare congenital anomaly in which the maxilla (medial orbital wall or maxillary process) and mandible (mandibular process or lateral lingual swelling) adhere via bony or soft tissue. It is also called congenital maxillomandibular fusion or congenital syngnathia or congenital oral synechia, but is referred to as congenital maxillomandibular fusion in this paper. We describe a case that developed in a 2-day-old male infant with cleft lip and palate. He was born at 40 weeks, 4 days’ gestation and weighed 3046 g. The Apgar score was 8/9. His condition was diagnosed as lactation disorder, cleft lip and palate, and a funicular structure from the lower lip to palate at birth, and he was admitted to our department in Okinawa Chubu Hospital. We resected the funicular structure extending anteriorly from the left lower lip to the left incisive bone. To date, five kinds of desmoplastic attachment areas have been reported, which are the residual ridge interval, floor of mouth and hard palate, tongue and hard palate, tongue and soft palate, and lower lip and the hard palate. Cleft palate is the most commonly reported complication of congenital maxillomandibular fusion, and syndromes such as Van der Woude syndrome (cleft lip and palate, lower lip fistula), popliteal pterygium syndrome (cleft lip and palate, lower lip fistula, genital malformation, limb malformation, popliteal pterygium) have also been reported. Only two cases of congenital maxillomandibular fusion in which the palate adhered to the lower lip in association with popliteal pterygium syndrome have been reported. We recently encountered a patient with bilateral cleft lip and palate who had adhesion between the lower lip and hard palate, and report this case along with a review of the literature.

  • 藤尾 正人, 西川 雅也, 若山 博隆, 原 憲史, 土屋 周平, 日比 英晴
    2016 年 62 巻 10 号 p. 525-528
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Enterobacter cloacae infection of the maxillary sinus is very rare. The patient was a 66-year-old woman with a chief complaint of a painful swelling in the left cheek. She was referred to our hospital by a dental clinic. Bacteriological examination of pus obtained during root canal treatment revealed multidrug-resistant Enterobacter cloacae. We administered antibiotics, performed root canal treatment, and extracted the infected tooth to allow pus drainage and irrigation. After appropriate medical and surgical treatment, the patient’s clinical symptoms resolved.

  • 三次 翔, 宮本 郁也, 吉賀 大午, 松尾 拡, 高橋 哲, 冨永 和宏
    2016 年 62 巻 10 号 p. 529-533
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    We treated a patient with chronic graft-versus-host disease (GVHD) in whom multiple tongue nodules developed following an allogeneic peripheral blood stem-cell transplantation (allo-PBSCT) procedure. A 30-year-old man was given a diagnosis of Hodgkin’s lymphoma and underwent autologous peripheral blood stem-cell transplantation at another hospital in 2007. Relapse occurred in 2011, at which time he underwent allo-PBSCT from his brother, a matched HLA donor. Extensive stomatitis, a characteristic disorder related to chronic GVHD, developed 30 days after transplantation. The resultant ulcers on the dorsal surface of his tongue gradually resolved. However, multiple nodules appeared on the entire tongue, causing difficulty in food intake. All polypoid nodules were surgically excised with the patient under general anesthesia in our hospital, and the pathological diagnosis was fibrous polyp with mild epithelial dysplasia. At a follow-up examination 3 years later, there was no recurrence, though persistent mild oral chronic GVHD was noted. It is important to perform follow-up examinations of patients with oral GVHD soon after transplantation. If lesions suspected to be malignant are found, they should be excised as thoroughly as possible.

  • 村瀬 友里香, 岸本 晃治, 吉田 祥子, 銅前 昇平, 志茂 剛, 佐々木 朗
    2016 年 62 巻 10 号 p. 534-538
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Congenital lower lip pits often appear as one of the main features of Van der Woude syndrome (VWS), which is an autosomal dominant disorder syndrome. Although most cases are associated with cleft lip, cleft palate, or both, some cases are rarely accompanied by anomalies other than cleft lip and palate. Lower lip pits are usually excised for cosmesis, but some of them have mucocele as a complication. In this paper, we report a case of lower lip pits associated with commissural pits, which was complicated by a mucocele after excision.

     A 5-year-old boy was referred to our hospital because of an abnormal form of his lower lip. He had two lower lip pits and bilateral commissural pits, but no other anomalies. He was suspected to have VWS because his father also had lower lip pits. We excised the lip pits for cosmesis. However, a mucocele occurred in his right lower lip 1 month after the operation. After cystectomy, the shape of the lower lip became satisfactory, and the clinical course has been good.

  • 木田 久美子, 小倉 孝文
    2016 年 62 巻 10 号 p. 539-543
    発行日: 2016/10/20
    公開日: 2016/12/20
    ジャーナル フリー

    Solitary fibrous tumor (SFT), first reported by Klemperer and Rabin in 19311), is a mesenchymal tumor rarely found in the oral cavity. We report a case of SFT in the lower gingiva.

     The patient was a 37-year-old woman with a 15 mm elastic soft mass in the left lower lingual gingiva. We performed tumor resection. Microscopic examination revealed haphazard proliferation of spindle cells and abundant capillary vessels. Immunohistochemically, the tumor cells showed positive staining for CD34 and bcl-2, but negative staining for S-100, desmin, and α-SMA. The tumor was diagnosed as an SFT. The patient had no signs of recurrence or metastasis 17 months later.

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