Journal of the Japan Society of Cranio-Maxillo-Facial Surgery
Online ISSN : 2433-7838
Print ISSN : 0914-594X
Current issue
Displaying 1-5 of 5 articles from this issue
Review
  • Rei OGAWA
    2022 Volume 38 Issue 3 Pages 80-84
    Published: 2022
    Released on J-STAGE: September 25, 2022
    JOURNAL RESTRICTED ACCESS

      The world's first facial allotransplantation was performed in France in November 2005. Between 2005 and March 2022, 47 cases of surgery were performed. Currently, whole face transplantation is performed, in which soft tissue and facial bone are transplanted simultaneously. Facial allotransplantation surgery has emerged as a new technique for reconstruction of severe facial injuries that are limited by conventional free flaps, local flaps, and skin grafts. However, recipients need to take lifelong immunosuppressive drugs, and cases that die younger than the average life expectancy are increasing. In addition, the number of patients who receive a second face transplant is increasing because the face that was transplanted was rejected by an immune response. In this paper, we discuss the present situation based on the literature and reports from overseas media. Currently, the surgical procedure of allogeneic face transplantation has become established; however, it is essential to improve financial problems, patient’s mental care, and long-term maintenance of transplanted tissue for the future development of facial allotransplantation

    Download PDF (1211K)
Original Article
  • Takanobu MASHIKO, Yoshitsugu HATTORI, Tomoaki EGUCHI
    2022 Volume 38 Issue 3 Pages 85-91
    Published: 2022
    Released on J-STAGE: September 25, 2022
    JOURNAL RESTRICTED ACCESS

      Primary closure of scalp defects is sometimes difficult because of low extensibility, especially with a history of repeated operations, infections, and the use of artificial materia. We prefer to use intraoperative tissue expansion using a Foley catheter for closing scalp wound. We evaluated its usefulness through retrospective analysis of 36 consecutive patients who were treated with this procedure. The patients(average: 43.8 years old)included 19 tumor, 13 post-neurosurgical, and four scarring alopecia patients. We routinely placed a 20-Fr Foley catheter into the sub-or supra-periosteal pockets, and expand the scalp with 10 to 30 ml of saline in a cyclic loading manner(5 minutes inflation and 3 minutes deflation). After expansion, the surgical wounds were closed. The average diameters of the defects was 30.8 mm(range: 12 to 52 mm). All wounds were successfully closed; however, one patient(2.8%)presented wound dehiscence and five patients(13.9%)presented postoperative scarring alopecia. Intraoperative expansion is considered a safe and effective method for treatment of scalp defects; however, well-vascularized tissue transfer or chronic expansion are recommended for complex cases who present a history of repeated operations, infections, and radiation therapy

    Download PDF (6568K)
Case Report
  • Takuya SEIKE, Keisuke KASHIWAGI
    2022 Volume 38 Issue 3 Pages 92-98
    Published: 2022
    Released on J-STAGE: September 25, 2022
    JOURNAL RESTRICTED ACCESS

      Dermoid cyst is a benign tumor with a membrane composed of the dermis, which contains sweat glands, sebaceous glands, hair follicles, and stratified keratinized epidermis, and a lumen containing keratin and hair.
      The patient was a 27-year-old man. He had noticed a subcutaneous mass outside his left eyebrow for 6 to 7 years. A 35 × 20 mm subcutaneous mass was palpated on the lateral side of the left eyebrow. CT and MRI revealed a subcutaneous mass in the left buccal region and a continuous mass outside the muscular cone in the left orbit and a depressed deformity of the lateral margin of the left orbital bone. In operation, the zygomatic-frontal suture at the left orbital margin was depressed, and a cystic mass extending into the orbit and under the temporal muscle was dissected, identified, and removed. Six months after surgery, there was no recurrence of the tumor.
      Eyelids and orbits are the most common sites of dermoid cysts, which arise from ectodermal tissue during the third to fifth week of fetal life. When the tumor is large, it may penetrate or depress the outer orbital wall and become bifocal, extending into and out of the orbit.

    Download PDF (4970K)
  • Akinori IWAKAMI, Takeshi KAN, Norio FUKUDA
    2022 Volume 38 Issue 3 Pages 99-105
    Published: 2022
    Released on J-STAGE: September 25, 2022
    JOURNAL RESTRICTED ACCESS

      Aplasia cutis congenita(ACC)is a rare congenital disorder, which most commonly involves the scalp, but can also affect the skull and the dura mater. There is no consensus on the initial treatment for ACC. Although tissue expansion can be performed to cover a residual alopecia defect, the appropriate time of surgery has not been specified yet.
      A male child was born with ACC involving the right frontal scalp and the skull. The wound epithelialized within one month by conservative treatment using silver-containing hydrofiber and basic fibroblast growth factor (bFGF). At 4 years of age, the patient underwent two-stage scalp reconstruction for residual baldness. Two rectangular tissue expanders were placed on the periosteum. After the maximal expansion, they were removed, and the scar was replaced with expanded flaps. The skull had a temporary depression, but no other complications were found. An acceptable cosmetic result was obtained.
      Conservative treatment with silver-containing hydrofiber and bFGF was useful for ACC involving skull defects. It was possible to safely perform tissue expansion at 4 years of age to cover the alopecia defect. Completion of scalp reconstruction during the pre-school period may reduce psychological and social distress.

    Download PDF (4655K)
  • Kei KOIZUMI, Kaoru SASAKI, Masahiro SASAKI, Junya OSHIMA, Yukiko AIHAR ...
    2022 Volume 38 Issue 3 Pages 106-112
    Published: 2022
    Released on J-STAGE: September 25, 2022
    JOURNAL RESTRICTED ACCESS

      Orbital linear fracture with muscle entrapment is known to often result in prolonged postoperative diplopia and limited ocular motility, when early surgery is not possible; however, there are few reports of extraocular muscle paralysis after orbital fracture. We experienced a case of extraocular muscle paralysis following orbital linear fracture surgery, which was performed the day after injury. An 11-year-old girl visited the hospital due to left-side facial trauma. Following the event, she exhibited nausea and adduction disorder of her left eye. Simple computed tomography revealed orbital medial wall fracture with missing rectus sign. She was referred to our department the following day, and surgery was performed on the same day. Thirteen days after the operation, her left eye showed limitation of adduction, and excyclotropia, suggestive of medial rectus muscle paralysis. By her 8-month follow-up examination, ocular motility had recovered. In trapdoor fractures with entrapped extraocular muscle, it is important to perform surgery as soon as possible, and postoperative muscle paralysis is a complication of which physicians should be aware.

    Download PDF (3759K)
feedback
Top