Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Current issue
Displaying 1-6 of 6 articles from this issue
Preface
Invited review article
  • Ryoji YOSHIDA, Junki INOUE, Hideki NAKAYAMA
    2024 Volume 70 Issue 11 Pages 458-465
    Published: November 20, 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
     The lingual lymph node (LLN) metastasis is not included in the cervical lymph node level system in oral cancer. Although the frequency of LLN metastasis is relatively low, we should always take into consideration that it is often difficult to treat once it occurs. In this review, we investigated LLN metastasis in patients with oral squamous cell carcinoma (OSCC), including the para-hyoid region. The subjects were 311 patients with OSCC at the tongue and oral floor who were treated between January 2012 and December 2019. LLNs were classified based on the reports of Suzuki et al. (Head and Neck Surgery, 2016). The analysis showed that LLN metastases were found in 10 patients (3.2%). Lateral LLNs and para-hyoid LLNs were found in 5 cases and 5 cases, respectively. The primary site of metastatic lesions were the tongue in 8 cases and on the floor of the mouth in 2 cases. One case of metastasis in the lateral LLN was identified at the time of initial treatment, four cases were identified as delayed neck metastasis after partialglossectomy, and one case was identified as neck recurrence after neck dissection. All cases of para-hyoid LLNs were identified as neck recurrences after initial radical surgery. The cases of LLN metastasis were extremely poor regardless of multimodality treatment. LLN metastases are often difficult to control if the opportunity for treatment is missed, and their presence needs to be recognized during treatment.
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  • On HASEGAWA, Michihide KONO, Daichi CHIKAZU
    2024 Volume 70 Issue 11 Pages 466-469
    Published: November 20, 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
     To improve the treatment outcomes of oral cancer, it is crucial to minimize the risk of recurrence after primary treatment. Therefore, it is necessary to clearly define the points to be aware of in preoperative diagnosis, surgical resection, and postoperative follow-up before proceeding with treatment. In this study, we retrospectively reviewed cases of tongue cancer treated at our facility and reconfirmed the points to be conscious of in order to reduce recurrence. Here, we report the overview of our findings.
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  • Takeshi KUROSHIMA, Hiroyuki HARADA
    2024 Volume 70 Issue 11 Pages 470-475
    Published: November 20, 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
     Intervening lymph nodes appear inconstantly and interrupt the lymphatic collecting vessels. Intervening lymph nodes in the course of lymphatic vessels from the oral cavity to the cervical lymph nodes are the lingual and facial lymph nodes. In patients with oral cancer, metastases can occur in these nodes. In this article, we review the anatomical location, characteristics of metastasis, surgical consideration, and issues of these nodes in patients with tongue carcinoma. Lingual lymph nodes are classified into median and lateral lingual lymph nodes according to their anatomical location. The median lingual lymph nodes are situated in the lingual septum, and the lateral lingual lymph nodes are situated in four anatomical areas (sublingual space, submandibular space, medial surface of the hyoglossus muscle, and lower end of the parapharyngeal space) along the lingual artery, vein, and hypoglossal nerve. Previous studies have reported the incidence of median and lateral lingual lymph node metastasis to be 0.5–3.0% and 1.4–14.3%, respectively. Although lingual lymph node metastases are uncommon, clinicians should be aware of them in all patients with tongue carcinoma, as the prognosis is poor when they do occur. Given the unfavorable prognosis associated with delayed metastases in lingual lymph nodes, it is recommended that these nodes be resected prior to the clinical appearance of metastases. However, the surgical procedure employed may vary depending on the location of these nodes. Resection of the lingual lymph nodes in the sublingual space (or part of it), the submandibular space, and the lower end of the parapharyngeal space can be performed during neck dissection. Further accumulation and analysis of cases are required to elucidate predictive factors for lingual lymph node metastasis and to develop diagnostic modalities and adjuvant therapies for lingual lymph node metastasis.
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Case reports
  • Koki UMEMORI, Kyoichi OBATA, Kisho ONO, Kunihiro YOSHIDA, Hirokazu YUT ...
    2024 Volume 70 Issue 11 Pages 476-481
    Published: November 20, 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
     Chronic sclerosing sialadenitis is characterized by painless and sclerosing swelling of the salivary glands. It usually occurs in the submandibular gland and rarely in the sublingual gland.
     A 69-year-old woman was referred to our department due to mouth swelling. At her first visit, a painless and hard mass was palpated under the submucosa of the oral cavity near the right sublingual gland. MRI showed that the mass involved the mylohyoid muscle and extended into the submandibular region. Based on various examinations, we suspected a sublingual tumor and performed a tumor resection. Intraoperatively, we observed a hiatus in the right mylohyoid muscle, and a part of the mass had ruptured into the hiatus. Histopathological examination resulted in a diagnosis of chronic sclerosing sublingual sialadenitis.
     In this case, we concluded that the chronic inflammation occurred as a result of stimulation to the sublingual gland, which had herniated into the hiatus of the mylohyoid muscle during functional movements of the muscle. Although there are very few reports on sublingual gland CSS, given the prevalence of mylohyoid muscle hiatus (42%-77%) and sublingual gland herniation through hiatuses (10%-32%), it is thought that there are more cases than currently reported.
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  • Yohei TSUBAHARA, Yoshinari MYOKEN, Yoshinori FUJITA, Shigeru SAKURAI, ...
    2024 Volume 70 Issue 11 Pages 482-487
    Published: November 20, 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
     In stage 3 medication-related osteonecrosis of the jaw (MRONJ) of the posterior maxilla, removal of the necrotic bone and infected soft tissue leads to large defects with oroantral communications. It is essential to cover the exposed bone and close the communications by using well vascularized local flaps for good long-term results. Here, we describe a case of stage 3 MRONJ of the posterior maxilla in a 76-year-old male patient who had been taking bisphosphonate and denosumab for skeletal metastasis of prostate cancer. The patient eventually underwent extensive surgery consisting of removal of the necrotic bone and infected soft tissue and developed a large oroantral communication. A superiorly-based facial artery musculomucosal (FAMM) flap was used for reconstruction of the large maxillary defect. He obtained complete resolution of MRONJ without leaving facial deformity or hypoesthesia at more than 10 months postoperatively and resumed denosumab therapy. Thus, the superiorly-based FAMM flap should be considered a reliable option for defect reconstruction in stage 3 maxillary MRONJ with functionally and esthetically promising results.
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