Patients with jaw deformities frequently have psychological and social problems. There have been many reports on psychological status and satisfaction following orthognathic surgery as determined by quantitative methods. However, only limited information can be obtained by using a quantitative method because the patient’s psychological problems are complex. On the other hand, qualitative studies are suitable for clarifying the hypothetical construction of the phenomenon and patients’ experiences and processes. The purpose of this study was to examine the process by which patient’s psychological and social problems change from pre-treatment to post-treatment. The subjects were 6 female patients who had undergone orthognathic surgery 18 months ago. We conducted semi-structured interviews and performed analysis by a grounded theory approach. The patient’s anxiety started from the period of adolescence and was affected by the patient’s friends. Information on orthognathic surgery gave the patients hope and reduced their anxiety. The processes of psychological and social changes during and after treatment were affected by friends, family, and patients with the same disease. Patients had feelings of accomplishment, happiness, and confidence because they overcame various hardships, and they acquired active attitudes in social life.

Nerve repair refers to the surgical suturing of a divided nerve or using autologous nerve grafting to repair a nerve tissue defect. In April 2016, the nerve conduit Nerbridge^® increased treatment options available to persons covered under Japanese dental health insurance as an artificial nerve graft. However, reports of its use for sensory nerve injury in the oral region are scarce. Here we report a case of significant sensory recovery obtained by nerve repair using Nerbridge^® in a patient with lingual nerve injury caused by tooth extraction. A 61-year-old woman underwent extraction of an impacted mandibular third molar in February 2016 at a dental clinic. Starting the next day, she complained of hypoesthesia on the right side of the tongue and persistent dysesthesia. That May, she visited our department for in-depth assessment and treatment. We evaluated the patient’s subjective symptoms and imaging findings, and conducted a sensory nerve action potential test to arrive at a diagnosis of partial transection of the right lingual nerve. In October, the patient underwent nerve repair followed by neurorrhaphy, stump excision on both sides, and grafting with Nerbridge^® after traumatic neuroma resection under general anesthesia．After the operation using Nerbridge^®, the lingual nerve showed marked improvement and recovery as compared with the preoperative sensory function.

The infrahyoid myocutaneous flap (IMF) is a local pedicled flap that receives its primary blood supply from the superior thyroid artery and vein. The IMF is formed by the sternohyoid, sternothyroid, and omohyoid muscles. Many reports regarding IMF have been published in the English-language literature, but none from departments of oral and maxillofacial surgery in Japan. The IMF is useful for reconstruction of medium-sized oral soft tissue defects, because it is quick and easy to harvest. We describe a patient in whom the oral floor was reconstructed using an IMF after resection of cancer of the oral floor. A 61-year-old man presented to our hospital with discomfort of the floor of the mouth. After several examinations, he was given a diagnosis of cancer of the oral floor and stomach. Resection of cancer of the oral floor with supraomohyoid neck dissection was performed, and the oral soft tissue defect was reconstructed using an IMF. One month later, laparoscopic distal gastrectomy was performed for the gastric cancer. The postoperative course was uneventful without any recurrence during our 5-year follow-up.

Metastatic carcinoma from other organs to the oral cavity is rare. We report a case of metastatic thyroid carcinoma to the condylar process. The patient was a 49-year-old woman during follow-up for a thyroid tumor. She was aware of a mass in the preauricular region. Because thyroid carcinoma was suspected, the condylar process and lung metastasis were detected on imaging examinations, and she was referred to our department for treatment of the condylar process. She underwent total thyroidectomy. The pathological diagnosis was follicular carcinoma and papillary carcinoma of thyroid. We performed hemimandibulectomy, and the pathological diagnosis was condylar process metastasis of follicular thyroid carcinoma. After radioactive iodine was given as postoperative therapy, lesions of the lungs shrank.