The supraclavicular artery island flap (SCAIF) is a pedicled fasciocutaneous flap vascularized by the supraclavicular artery. Although SCAIF had been used for pharynx reconstruction and its usefulness has been reported in some articles, there are few reports for oral reconstruction in Japanese. We report two cases of oral reconstruction using an SCAIF after oral cancer resection.
　【Case 1】The patient was a 37-year-old female with no medical comorbidities. She underwent reconstruction with an SCAIF alone after a left oral hemiglossectomy and ipsilateral neck dissection. Partial necrosis of the distal flap occurred; however, the wound was healed with secondary intention three weeks postoperatively.
　【Case 2】The patient was a 65-year-old female with no medical comorbidities. She underwent reconstruction with an SCAIF and fibular flap after an anterior segmental mandibulectomy with a facial skin resection and bilateral neck dissection. Partial necrosis of the distal flap occurred; however, the wound was healed with secondary intention six weeks postoperatively.
　The SCAIF has some limitations such as extension of the rotational arc and volume. However, it is very useful in some cases of oral reconstruction.

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　Psoriatic arthritis (PsA) is a systemic inflammatory arthritis caused by psoriasis. We report the case of 32-year-old male was suffering from severe trismus due to PsA-related temporomandibular joint (TMJ) ankylosis. CT images showed that the bilateral condyle was completely fused to the glenoid fossa by bony ankylosis. Therefore, we performed an interpositional gap arthroplasty using a temporalis muscle fascia flap together with a coronoidotomy. The patient began jaw exercises one week after surgery, and by performing intermaxillary fixation using a bite plate with extra thickness in the molar area, the mandibular ramus height (gap) was maintained. The patient’s maximum mouth opening increased significantly from 5 mm to 38 mm within two weeks of the surgery. Four years after the surgery, his maximum mouth opening was 32 mm and stable occlusion was maintained. According to a review of the literature, 66.8％ of PsA patients experienced a relapse of trismus and bony ankylosis after surgery. Based on our experience with this case and our review of the literature, we conclude that primary disease control via pharmacotherapy, gap arthroplasty and postoperative management may prevent a relapse for patients with PsA-related TMJ ankylosis.

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　Kabuki syndrome is a rare congenital disease characterized by typical facial dysmorphic features, skeletal abnormalities, mental retardation, dermatoglyphic changes, and postnatal growth retardation. Oral symptoms include progenia, open bite, narrowed maxillary dentition, congenitally missing teeth and cleft palate. Calcifying epithelioma is reported as an extremely rare complication of Kabuki syndrome. We report our experience in treating a patient with Kabuki syndrome who had multiple calcified epitheliomas on the facial skin.
　The patient was a 12-year-old girl referred to our hospital by a local dentist for a detailed examination of swelling of the buccal gingiva of the right upper first premolar. Panoramic X-ray and CT scans revealed an X-ray luminal area at the root apex of the right maxillary first premolar, and a total of four calcifications, two each on the left and right facial skin. An ultrasound examination was performed to check for calcifications on the facial skin, but no blood flow signals were observed in the check calcifications, and phleboliths were ruled out. Based on a clinical diagnosis of a radicular cyst in the right upper first premolar and multiple facial skin tumors, we performed the removal of the cyst and excisional biopsies of the tumors under general anesthesia. Histopathological examination revealed a diagnosis of radicular cyst and calcified epitheliomas. A genetic test was performed to help determine the treatment plan, and a mutation in the KMT2D gene was found. It has now been two years since the surgery, and no enlargement of the residual lesions or recurrence has been observed.

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　Traumatic carotid-cavernous sinus fistula (CCF) is a rare disorder in which the internal carotid artery is injured by trauma, forming an arteriovenous fistula in the cavernous sinus. We report a case of traumatic CCF associated with jaw fractures. A 37-year-old male patient was referred to our emergency room in November 2022 due to injuries sustained in a traffic accident. He was conscious with JCS 10, and left-sided eye protrusion and mandibular dislocation were observed. CT revealed a left-sided maxillary fracture, mandibular fractures, and dilatation of the left-sided superior ophthalmic vein. A cerebral angiography was performed on the 6th day of admission, and a definitive diagnosis of traumatic CCF was made. On the 8th day of admission, the patient underwent open reduction and fixation of the mandibular fracture, and on the 12th day of admission, a coil embolization and parent artery occlusion (internal trapping) were performed in the neurosurgery department. No postoperative recurrence has been observed at 18 months after the surgery. Even in cases comprising jaw fracture only, strict follow-up is necessary while keeping in mind the possibility of traumatic CCF developing.

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　A diverticulum is a pouch structure projecting outward from the canal of the gastrointestinal tract. This lesion can occur at any site in the gastrointestinal tract and is known to be found more frequently in the colon. However, it rarely occurs in the oral cavity. We report a case of a diverticulum-like lesion of the bilateral buccal mucosa. A-84-year-old man was referred to the Department of Dentistry and Oral Surgery at Okitama Public General Hospital by his family dentist due to the identification of small pouches containing stagnant food residue. We found two pouches bilaterally located below the parotid papilla. The right lesion was 5mm in diameter and 6mm in depth; the left lesion was 9mm in diameter and 8mm in depth. The luminal surfaces of the pouches were smooth mucosa, and normal in color. MRI showed small pouches in the bilateral buccal mucosa. No communication with the parotid duct was noted. Based on a clinical diagnosis of a diverticulumlike lesion of the buccal mucosa, the lesion was surgically resected under general anesthesia. After the surgery, the bilateral small pouches disappeared and the food residue improved. Three years after the surgery no abnormalities or signs of recurrence have been detected.

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