Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 64, Issue 7
Displaying 1-9 of 9 articles from this issue
Preface
Invited review articles
  • Naozumi ISHIMARU
    2018 Volume 64 Issue 7 Pages 390-393
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    A variety of infectious diseases are observed in area of oral and maxillofacial surgery. Appropriate diagnosis for them plays a key role in the effective therapy of serious infection. Many infectious diseases in the area of oral and maxillofacial surgery are known, including dental caries, infection in the periodontal tissue, the oral membrane, the bone, and salivary glands.

     Oral cavity is an anatomically unique organ. Oral cavity is the entry of intestinal tract as well as respiratory tract. In addition, oral membrane is adjacent to skin through labial membrane. Moreover, oral cavity is so important in the points of life and social activities, such as eating, chewing, swallowing, and speaking. Oral tissues are often targeted by pathogenic microorganisms, and a lot of infections develop in the oral cavity. In this review article, the pathogenesis of infectious diseases in the oral region is explained in detail.

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  • Shungo FURUDOI, Takahide KOMORI
    2018 Volume 64 Issue 7 Pages 394-403
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    The infection in the oral and maxillofacial regions is frequently observed on a daily basis, and most of them are odontogenic. Odontogenic infections are commonly the result of carious teeth with pulpal exposure, periodontitis, pericoronitis, or complications of dental procedures. They respond well to current medical and surgical treatments. However, they can sometimes extend beyond the oral cavity, with serious consequences. Cellulitis in the oral and maxillofacial region can spread to deep neck spaces and possibly to the mediastinum. Computerized tomography play the important role in diagnosis of cellulitis. Fulminating infection in the head and neck may present as a rapidly progressive, potentially fatal condition characterized by extensive necrosis along the fascia of the neck. One form of such infection is necrotizing fasciitis. Early diagnosis and treatment is critical. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score was a valuable assisted diagnosis tool. The keys to successful management of these infections are protection and control of the airway, intravenous antibiotic therapy and aggressive incision and surgical drainage. It is usually preferable to drain multi-space infections involving the sublingual, submental, submandibular, masseteric, pterygomandibular, and/or lateral pharyngeal spaces, as early as possible from an extraoral approach.

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Original article
  • Shingo YONEDA, Masaharu MITSUGI, Hidetoshi TOHMORI, Hiroshi MURODUMI, ...
    2018 Volume 64 Issue 7 Pages 404-411
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    Although Le Fort I osteotomy is performed to correct vertical maxillary alveolar excess (VMAE) in patients with a gummy smile and high palate, this procedure carries the risk of nasal cavity constriction. A combined Le Fort I and horseshoe osteotomy is complicated. On the other hand, although total maxillary alveolar osteotomy (TMAO), which was reported by Wolford and Hall, can improve VMAE without causing nasal cavity constriction, correctly performing one-stage osteotomy is very difficult because of difficulty in obtaining a sufficient surgical field with maintenance of the blood supply.

     Therefore, we have devised a two-stage procedure for TMAO. In this procedure, osteotomy of the palatine bone is performed initially, followed by another osteotomy of the buccal side after wound healing. In this study, the accuracy of superior repositioning and the postoperative stability of the maxilla obtained by two-stage TMAO in patients with a gummy smile were found to be excellent. Therefore, we consider two-stage TMAO to be an effective procedure for correcting a gummy smile accompanied by VMAE.

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Case reports
  • Akiko ITO, Kazuko TAKUBO, Nobufumi OGAWA, Syunsuke TANIO, Isamu KODANI ...
    2018 Volume 64 Issue 7 Pages 412-417
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    Solitary fibrous tumors (SFTs) are mesenchymal neoplasms. Although they are most frequently located in the pleura, they have also been observed in other locations. We report two cases of SFTs in the buccal region of a 78-year-old man and 56-year-old woman, respectively. The chief complaint of both patients was a swelling of the buccal space. Each patient underwent surgical excision after receiving a clinical diagnosis of a buccal tumor. We obtained a definitive diagnosis in the female patient, but the tumor decreased in size after the biopsy. The histopathological characteristics of both tumors included proliferating spindle cells and thin-walled, branching, staghorn-like vascular patterns.

     Immunohistochemically, both cases were positive for CD34 and STAT6. The male patient showed no recurrence or metastasis 2 years 4 months after surgery, but the female patient had recurrence 2 months postoperatively. Long-term follow-up is necessary because of the unpredictable recurrence or metastasis associated with SFTs.

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  • Yukinobu TAKAHASHI, Hideki IMAI, Kaori MOCHIDA, Kanako SUMIKURA, Hiroy ...
    2018 Volume 64 Issue 7 Pages 418-422
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    Cystic lymphangioma usually occurs in infants and children, but rarely develops in adults. We report a case of cystic lymphangioma arising in the left submandibular region of 44-year-old woman. The patient presented with a soft, painless mass in the left submandibular region in December 2012. Magnetic resonance imaging revealed a multilocular lesion surrounding the submandibular gland. The patient underwent resection of the tumor with the submandibular gland under general anesthesia in March 2013. Histopathological examination revealed cystic lymphangioma. There has been no evidence of recurrence as of 4 years 3 months after surgery.

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  • Shohei KANEMARU, Susumu SHINGAKI, Michiko YOSHIZAWA, Hideyoshi NISHIYA ...
    2018 Volume 64 Issue 7 Pages 423-428
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    Sarcomatous transformation of fibrous dysplasia (FD) is an extremely rare event. We report a case of low-grade central osteosarcoma (LGCO), which arose secondarily from FD of the mandible. A 35-year-old woman, who had regularly been followed up for a 19-year period for a diagnosis of FD, presented with a painful swelling in right mandibular body. On computed tomographic images, the right mental area was prominently expanded with the eroded cortex, and its inner part was entirely filled with an inhomogeneously enhanced lesion. Since a biopsy specimen taken from the anterior lesion was diagnosed to be LGCO, a segmental mandibulectomy and reconstruction with a fibula free flap was performed. There has been no sign of recurrence or metastasis as of 7 years after surgery. It is important to make a diagnosis and a treatment plan in patients with FD because malignant transformation of FD occurs rather infrequently.

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  • Shunsuke TANIO, Kazuko TAKUBO, Nobuyuki FUJII, Takayuki TAMURA, Rieko ...
    2018 Volume 64 Issue 7 Pages 429-433
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    Myoepithelioma is a rare benign tumor that represents less than 1 % of all salivary gland tumors. We report a case of myoepithelioma developing in the submandibular gland of a 70-year-old woman. On clinical examination, a 15×10 mm hard, slightly tender mass was located in the left submandibular region. The lesion was clinically suspected to be a submandibular gland tumor. Resection was performed with the patient under general anesthesia. Histologically, the tumor consisted of the epithelial-like cells. Immunohistologically, S-100 protein, cytokeratin, α-SMA, calponin, and vimentin were positive. The tumor was diagnosed as myoepithelioma pathologically. As of 53 months after the operation, the postoperative course is good, with no recurrence of the tumor.

     α -SMA, calponin, and vimentin were positive. The tumor was diagnosed as myoepithelioma pathologically. As of 53 months after the operation, the postoperative course is good, with no recurrence of the tumor.

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  • Hironobu KOBASHI, Koichi OTSUKI, Emiko ISOMURA, Takeshi HARADA, Katsuh ...
    2018 Volume 64 Issue 7 Pages 434-438
    Published: July 20, 2018
    Released on J-STAGE: September 20, 2018
    JOURNAL FREE ACCESS

    While cleft lip and palate are common phenotypes associated with orofacial congenital anomaly, there are only a few cases in which uncommon types of clefts occur. One such cleft is an oblique facial cleft with clefts extending from the upper lip or corner of the mouth to the internal or external canthus. Medical information on the treatment of this disease is underreported because it is a rare phenotype of orofacial cleft. We describe our clinical experience in performing facial plastic surgery and palatoplasty in a patient with bilateral oblique facial clefts, a left Tessier No. 5 cleft and a right Tessier No. 4 cleft, and an atypical right palatal cleft. At 3 months of age, bilateral plastic surgery was performed using the modified Z-plasty method. Our ophthalmologist treated the hypoplastic right eye by removing and suturing ocular-like tissue and inserting an artificial eye material. In addition, modified Furlow palatoplasty was done by double-opposing Z-plasty to close an atypical cleft palate at 1 year of age. Our experience will provide valuable clinical information on how to treat uncommon phenotypes of orofacial clefts.

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