巻号一覧
60 巻 (2011)
- 4 号 p. 317-
- 3 号 p. 219-
- 2 号 p. 189-
- 1 号 p. 1-
60 巻, 4 号
選択された号の論文の6件中1～6を表示しています
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原著
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野添 悦郎, 中村 康典, 大河内 孝子, 石畑 清秀, 新中須 真奈, 中村 典史2011 年 60 巻 4 号 p. 317-324
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありClinical courses following two-stage mandibular wisdom tooth extraction (TMWTE) carried out for preventing postoperative mental nerve paresthesia (MNP) were analyzed. When panoramic X-ray showed 1) overlapping of wisdom tooth root on the superior 1/2 or more of the mandibular canal, 2) interruption of the white line of the superior wall of the canal, or 3) diversion of the canal, CT examination was facilitated. In cases where contact between the tooth root and canal was demonstrated in CT examination, TMWTE was then selected after gaining the patient's consent. TMWTE consisted of removing more than a half of the tooth crown and tooth root extraction at the second step after 2-3 months. The clinical features of wisdom teeth extracted and postoperative courses including tooth movement and occurrence of MNP during two-stage MWTE were evaluated.
TMWTE was carried out for 40 teeth among 811 wisdom teeth (4.9%) that were extracted from 2007 to 2009. Among them, complete procedures were accomplished in 39 teeth, and crown removal was performed insufficiently at the first-stage operation in one tooth. Tooth movement was detected in 37 of 40 cases (92.5%). No postoperative MNP was observed in cases in which complete two-stage MWTE was carried out, but one case with insufficient crown removal was complicated by postoperative MNP. Seven mild complications (dehiscence, cold sensitivity, etc.) were noted after the first-stage operation.
Therefore, we conclude that TMWTE for high-risk cases assessed by X-ray findings is useful to avoid MNP after MWTE.抄録全体を表示PDF形式でダウンロード (925K)
症例
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今井 智章, 道澤 雅裕, 藤田 源太郎, 太田 嘉幸2011 年 60 巻 4 号 p. 325-329
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありDisplaced zygomatic arch fractures are usually indicated for surgical intervention. Since isolated zygomatic arch fractures are generally treated using blind methods, it is difficult to clinically assess the precise repositioning of the fracture fragments.
We present a C-arm technique for visualizing isolated zygomatic arch fracture reduction intraoperatively in 7 cases from July 2006 to June 2009. The patients without cervical cord injuries were positioned supine with their neck extended slightly on the operating room table. The C-arm was placed such that the patient's head lay between the X-ray tube and the image intensifier along the cephalocaudal axis. The fractures were percutaneously reduced using a hook; the hook was manipulated under imaging to position fractured fragments for an ideal shape of the zygomatic arch. The outcome of reduction was satisfactory due to excellent reduction in 4 cases and good reduction in 3 cases without fair or poor reduction. Although confirmation of these outcomes requires a clinical comparative study, intraoperative use of the C-arm imaging system for displaying dynamic bone reduction contributes to prevent the small percentage of unsatisfactory outcomes in isolated zygomatic arch fractures.抄録全体を表示PDF形式でダウンロード (667K) -
大迫 利光, 小村 健, 原田 浩之, 栢森 高2011 年 60 巻 4 号 p. 330-336
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありMyoepithelial carcinoma (MC) is an extremely rare tumor accounting for approximately 0.2% of all salivary gland tumors. It is often difficult to diagnose MC because the tumor cells of MC show a wide variety of morphologies. We report a case of MC arising in the lower lip.
A 54-year-old male patient was referred to our department for evaluation of a mass in the right lower lip. Physical examination revealed a submucosal mass lesion measuring 2.5 × 2.0 cm with a well-defined border. It was elastic soft and ovate in shape. There was no palpable cervical lymphadenopathy. Biopsy of the mass suggested epithelial malignant tumor. He underwent local excision of the tumor and the resulting surgical defect was covered by a split-thickness skin graft. Postoperative histopathologic examination confirmed the diagnosis of MC with neuroendocrine differentiation.
The patient is being followed up and shows no evidence of local recurrence or lymph node or distant metastasis of the tumor 24 months after surgery.抄録全体を表示PDF形式でダウンロード (1555K) -
―1例の超音波診断装置による観察―武井 良子, 山下 夕香里, 森 紀美江, 綾野 理加, 高橋 浩二2011 年 60 巻 4 号 p. 337-340
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありTo investigate the tongue movements of a 19-year-old male with lateral articulation, ultrasonography was used before and after speech therapy, and the improvement in tongue movements was evaluated. The tongue movements were observed in coronal and sagittal sections. The results were as follows:
1. In coronal section, before speech therapy, the middle part of the tongue moved upward, and only one side of the tongue edge moved downward during lateral articulation. After the therapy, when normal speech was acquired, the middle part of the tongue formed a groove, and the movements of the tongue edge were symmetrical.
2. In sagittal section, before the therapy, the tongue blade moved rapidly upward toward the palate. After the therapy, the body of the tongue formed a flat shape.
3. Observation by static palatography showed that the tongue contacted the center of the palate during lateral articulation. After the therapy, there was a space at the center of the oral cavity.
The study showed that the ultrasonic observation from coronal and sagittal sections was useful for identifying the tongue movements specific to lateral articulation, and objectively evaluating the improvement in tongue movements. Also, multidimensional observation of tongue movements was feasible by combining ultrasonography with static palatography.抄録全体を表示PDF形式でダウンロード (654K) -
―顎関節強直症の続発リスクに基づいた治療例―今井 智章, 道澤 雅裕2011 年 60 巻 4 号 p. 341-348
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありIn the treatment of pediatric mandibular fractures, less invasive methods are preferred than in adult cases. However, open reduction and fixation should be considered in cases that have large deviation or incomplete fixation with non-open reduction. In condylar fracture cases, it is important to prevent post-traumatic sequelae such as TMJ ankylosis.
We report a pediatric case of multiple fractures of the mandible. A 6-year-old boy fell from a height of 6 meters onto a road surface after scaling a fence, and was transferred to the emergency room in our hospital. CT scan showed bilateral lateral dislocation of the mandibular condyle with sagittal splitting fracture and a gap on the lingual aspect of the parasymphysial fracture resulting in widening of the inter-ramus width. To obtain anatomical reduction and adequate stability of the anterior for postoperative mouth-opening and closed management of condylar fractures, open reduction and internal fixation were performed in the parasymphysial fracture using titanium mini-plates. Intermaxillary fixation was not applied intraoperatively or postoperatively.
Near-daily jaw exercises commenced on postoperative day 3, and the degree of mouth-opening gradually increased to 40 mm. The plates were removed at 3 months post-operation. No abnormal mandibular function has been observed for 3.5 years post-operation. Careful observation should be continued for a long time in view of the growth of the mandible and permanent dentition.抄録全体を表示PDF形式でダウンロード (924K) -
―言語所見および超音波画像所見について―山下 夕香里, 高橋 浩二, 宇山 理紗, 森 紀美江, 武井 良子, 綾野 理加2011 年 60 巻 4 号 p. 349-355
発行日: 2010/08/10
公開日: 2011/10/18
ジャーナル 認証ありThe purpose of this study was to use speech intelligibility test and ultrasonography to examine the efficacy of a palatal augmentation prosthesis (PAP) in relation to speech function in a patient after glossectomy. A 38-year-old male with severe articulation disorders was referred to our clinic for treatment. Prosthetic treatment using PAP and speech therapy was performed. Speech function with and without PAP was evaluated using the Japanese Conversational Speech Test, a one hundred syllable Japanese Speech Intelligibility Test and ultrasound observation at two months and six months after surgery.
The results were as follows.
1. Japanese Conversational Speech Test: When wearing PAP, speech intelligibility was improved from Stage 4 to Stage 2 at two months after surgery and from Stage 3 to Stage 1 at six months after surgery.
2. Japanese Speech Intelligibility Test: By wearing PAP, the mean speech intelligibility improved from 14% to 43% at two months after surgery, and from 22% to 57% at six months after surgery.
3. Observation of movements of the tongue with ultrasonography during production of the vowel /i/: Both residual and reconstructed tongue exhibited restricted movement at two months after surgery. Despite the decrease in tongue volume, the movement of tongue increased at six months after surgery.
The study concluded that PAP was useful in the patient with severe restriction in tongue movement resulting from glossectomy. The ultrasonography was useful in evaluating the volume and movement of the tongue after wearing PAP.抄録全体を表示PDF形式でダウンロード (1124K)
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