BACKGROUND: Diffuse axonal injury (DAI) is a major complication of traumatic brain injury that leads to severe functional disorder. To our knowledge, no studies have been previously reported on the correlation between DAI and maxillofacial injury. The aim of this analysis is to review the outcome of DAI with maxillofacial injury. METHODS: We reported 6 DAI patients with oral and maxillofacial injury out of 28 DAI patients treated in Iizuka Hospital between 2001 and 2008. Age, etiology, GCS (Glasgow Coma Scale) about consciousness, and GOS (Glasgow Outcome Scale) for prognosis implication were retrospectively analyzed. Result: GCS score of 6 patients ranged from 3 to 8 on arrival, and they did not change 48 hours later. Two patients were moderate DAI and four were severe DAI. Two patients of severe DAI resulted in poor outcome (severe disability) but others showed relatively good GOS (good recovery and moderate disability). CONCLUSIONS: Outcomes of DAI patients with oral and maxillofacial injury were better than those of DAI patients without oral and maxillofacial injury.
We report a case of metastatic hepatocellular carcinoma with numb chin syndrome as a initial manifestation. A 55-year-old man was referred to our hospital due to numbness of the left lower lip. Radiographic examination revealed neither osteosclerotic nor radiolucent lesion inside the left mandible. However, the invasive destsruction of the buccal cortex at this region was discovered by the computed tomography. A biopsy inside the mandible suggested metastatic hepatocellular carcinoma. Although the patient was scheduled to receive chemotherapy, his general condition deteriorated rapidly and died four months after the first visit.
We report a case of contact stomatitis due to a periodontal dressing material (surgical pack N®). In July 2007, a 42-year-old woman presented at our hospital complaining of pain in the mouth. The patient had severe pain due to stomatitis around the upper right gingiva and buccal mucosal membrane in contact with a periodontal dressing material which had been placed for wound protection after a flap operation for peri-inplantitis at a dental clinic. An allergic reaction was suspected in the region surrounding the periodontal dressing material. The patient underwent a patch test for some dental metals, periodontal dressing materials and liquid inside periodontal dressing materials. As a result, the liquid of a periodontal dressing material was indicated as the source of the stomatitis. After removing the periodontal dressing material, the stomatitis and symptoms disappeared.
Bevacizumab, a recombinant humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF), intercepts the supply of blood which is indispensable for cancer to proliferate and metastasize to the whole body. We report a case of osteonecrosis of the jaw during chemotherapy using Bevacizumab in a 64-year-old woman with unresectable colorectal cancer. After surgical treatment for sigmoid colorectal cancer had been performed in the surgery department of another hospital, multiple lung and bone metastases were discovered. Therefore, she received Bevacizumab therapy combined with another chemotherapy. At the initial examination, there was exposed bone in the right mandibular lingual gingiva of the third molar region. This bone was isolated as a sequestrum and was easily removed. The surgical wound became completely covered with mucosal epithelia. There was no evidence of recurrence for 10 months after treatment. We suspect that this osteonecrosis of the jaw was caused by the antiangiogenic property of Bevacizumab.