JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY
Online ISSN : 1884-474X
Print ISSN : 1349-581X
ISSN-L : 1349-581X
Volume 19, Issue 3
Displaying 1-10 of 10 articles from this issue
  • Keisuke Mizuta, Takanori Wakaoka, Bunya Kuze, Hisakazu Kato, Mitsuhiro ...
    2009 Volume 19 Issue 3 Pages 147-151
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    A 64 years-old man with recurrent chordoma had a massive tumor in the infratemporal fossa. CT and MRI findings suggested that the tumor invaded the cavernous sinus. Because the tumor was considered likely to recur, we planned surgery using the maxillary swing procedure to preserve the postoperative function and facial form.
    A palatal fistula has been often reported after the operation using the maxillary swing. We operated on a patient using a modified palatal incision to prevent the incidence of palatal fistula associated with the maxillary swing procedure. No postoperative palatal fistula occurred.
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  • Taku Yamashita, Masayuki Tomifuji, Akihiro Shiotani
    2009 Volume 19 Issue 3 Pages 153-160
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    Transoral lateral oropharyngectomy (TLO) for T1 to T3 oropharyngeal cancer using FK pharyngoscope, a distending laryngoscope, rigid videoendoscope and electrocautery designed for laparoscopic surgery is reported here. This method was performed for eight patients. The T stages were as follows: T1, one patient; T2, two patients; and T3, five patients. Seven patients underwent neck dissection with TLO and five patients underwent postoperative irradiation without chemotherapy. A tracheostomy was needed for only one patient and no patients underwent reconstructive surgery. One case had a “close to margin” and the others were negative surgical margins. Seven of eight patients were swallowing normal food postoperatively. A high level of safety and certainty were ensured and the indication of TLO has been expanded by establishing a new surgical environment. The postoperative swallowing function was also satisfactory. TLO is one of the useful options of mild invasive surgery for selected lateral oropharyngeal cancer.
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  • Katsuyuki Doi, Takanori Asano, Takashi Kinoshita
    2009 Volume 19 Issue 3 Pages 161-165
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    This study examined the clinical findings, treatment and outcome of seven patients with mandibular bone metastatic tumors. The most common location of the metastatic lesion was the molar region of the jaws. The primary tumors in these patients included papillary carcinoma and follicular carcinoma of the thyroid gland, osteosarcoma of the tibia, neuroepithelioma of the lumbar dura, hepatocellular carcinoma of the liver, adenocarcinoma of the rectum, and small cell carcinoma of the lung. The most common symptoms were pain of the mandible and paresthesia of the mental nerve. When primary tumors and generalized metastasis were uncontrolled, the patients died within six months. When the primary tumors and generalized metastasis were controlled, we treated them aggressively. One patient survived seven year and two months after treatment, and now two patients are still alive more than three years after treatment.
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  • Seiji Hosokawa, Jun Okamura, Yoshinori Takizawa, Hiroyuki Mineta
    2009 Volume 19 Issue 3 Pages 167-171
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    A 61-year-old male was referred to our hospital because of relapsing of swelling in the left parotid gland. Ultrasonography and CT of the neck showed multiple enhanced cystic lesions. A fine-needle-aspiration biopsy and an open biopsy of the left parotid gland did not demonstrate malignant cells. A second parotid resection revealed a mucosa associated lymphoid tissue (MALT) lymphoma. He was treated by general chemotherapy of “R-CHOP” therapy, i.e. standard “CHOP therapy” with rituximab, with a resultant complete response.
    Low-grade or indolent malignant lymphoma of the B-cell type, including MALT lymphoma, is often observed for a long period. It is important to perform frequent biopsies or remove the tumor for diagnosis.
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  • Hiroshi Iwai, Kensuke Suzuki, Shoichi Hoshino, Koichi Tomoda, Muneo In ...
    2009 Volume 19 Issue 3 Pages 173-178
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    Salivary fistula and sialocele are rare diseases that occur especially after parotid surgery. They can be generally treated with local oppression and/or drainage; however, they show a delay in healing occasionally. We herein report four cases where local injection of a minocycline hydrochloric acid solution was effective for persistent diseases after parotid surgery. There no severe complications, including facial nerve paralysis, were observed in this therapy. Minocycline has been used as a sclerotherapy for chylous fistula following neck dissection, renal cyst, etc. Therefore, our minocycline procedure may be considered as the initial treatment modality for patients suffering from prolonged salivary fistula or sialocele after parotid surgery.
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  • Shinichiro Maseki, Kei Ijichi, Yoshihisa Nagashima, Nobuhiro Hanai, Ta ...
    2009 Volume 19 Issue 3 Pages 179-183
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    We reported 16 patients with parotid gland carcinoma treated at Nagoya City University Hospital for five years between 2003 and 2008. Of those, 10 patients (71.4%) were diagnosed as having malignant carcinoma by fine needle aspiration (FNA) before operation. Nine patients underwent the frozen section (FS) technique and eight were diagnosed as having malignant carcinoma during operation. Of the six patients whose carcinomas were not diagnosed as malignant by FNA, three patients underwent the FS technique and two patients were confirmed as having malignant carcinoma. Of the 16 patients, 14 underwent surgery, which was selected based on the results of the FNA and/or FS technique. Postoperative courses were eventual and no recurrence was found except for one patient with salivary duct carcinoma. Our data suggested that the FS technique following FNA is useful not only for confirming malignancy of the parotid tumor but also for selecting an appropriate operation for the patient.
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  • Toshiharu Hirota, Taku Yamashita, Takeshi Matsunobu, Akihiro Kurita, M ...
    2009 Volume 19 Issue 3 Pages 185-190
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    We report on an 80-year-old male who had been administered an enlarged total parotidectomy and then whose subaural lesion had been reconstructed by submental island flap (SIF). The pathological diagnosis was epithelial-myoepithelial carcinoma. The next day after the operation he could get up, walk around, and orally take meals. Due to satisfactory recovery, he left our hospital on the 13th postoperative day.
    Microvascular free flap has been used for reconstruction of moderate facial defects after parotidectomy. Disadvantages are the physical burden for the elderly or seriously ill cases. Furthermore, the color of skin may not match the facial construction. On the contrary, SIF, which means a pedicle musculocutaneous flap in the neck, can be safe, rapid, and simple to use. Furthermore, it can realize an excellent color match and leave a well-hidden donor site.
    We recommend that SIF is an alternate means for microvasucular free flap for physically disadvantageous patients as well as cosmetically demanded patients.
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  • Hiroshi Tsubota, Tomoko Shintani, Mitsuru Go, Etsuko Saikawa, Nobuhiko ...
    2009 Volume 19 Issue 3 Pages 191-197
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    Although most cases of thyroidectomy are completed with only a collar incision, sometimes a sternotomy is required for good visualization of the mediastinal extension of the thyroid tumors or lymph node metastases.
    We describe here six cases of thyroid tumor that was resected by sternotomy. We analyzed the pre-operative diagnosis, indications of sternotomy, type of sternotomy, airway conservation and complications. Five of six cases were carcinoma, four of which were papillary carcinoma and one of which was poorly differentiated carcinoma. One of the six cases was a benign adenomatous goitor extending into the posterior mediastinum.
    All of carcinoma cases showed possible extra-capsular extension adhered to the trachea or esophagus by computed tomography examination. The case of benign adenomatous goiter showed remarkable extension to the posterior mediastinum.
    We performed an L-shaped or reversed L-shaped sternotomoy except for one case of median sternotomy. A tracheostomy was performed on the former three cases for airway conservation after surgery, but tracheal intubation was performed on the recent two cases. Mediastinitis, regarded as a very severe complication after sternotomy, did not occur in any cases.
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  • Kazuya Arakawa, Kiyoto Shiga, Takenori Ogawa, Atsuko Maki, Masanori Am ...
    2009 Volume 19 Issue 3 Pages 199-204
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    As a carotid body tumor (paraganglioma) is a very hypervascular tumor, preoperative embolization of the feeding arteries is indicated when surgical removal is attempted. We performed percutaneous direct injection of liquid material NBCA into the carotid body tumor preoperatively and blood loss was markedly decreased.
    We think this procedure will be popular to embolize hypervascular tumors of the head and neck.
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  • Nobuo Saeki, Tomonori Terada, Kousuke Sagawa, Nobuhiro Uwa, Kiyoko Fuj ...
    2009 Volume 19 Issue 3 Pages 205-211
    Published: February 28, 2010
    Released on J-STAGE: March 15, 2010
    JOURNAL FREE ACCESS
    Cervical lymphangioma (hygroma) is a congenital malformation of the lymphatic channels. It usually occurs in infants under two years old, but it is rarely found in adults. We report two rare cases of lymphangioma arising from the neck of adults. Case one was a 57-year-old female with the soft tumor in the left upper lateral neck. The lesion size was 4.0 cm. The tumor was completely resected under general anesthesia. The histopathological diagnosis was cystic lymphangioma. No recurrence has been noted to date. Case two was a 26-year-old female with a tumor in the bilateral submandibular region. The lesion size was 6 cm each. Fine needle aspiration contained bloody discharge. The CT and MRI showed multiloculated cystic masses. The tumor caused a slow airway restriction that warranted an urgent tracheotomy. The tumor was cured OK-432. The tumor has a tendency to reduce in size.
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