[Show abstract][Hide abstract] ABSTRACT: The number of patients attacked by bears has been rising recently because the opportunity to encounter wild bears has increased. Bear attacks usually focus on the head and neck areas, and the attack sometimes causes fatal injuries.We report two cases of multiple facial lacerations and mandibular bone comminuted fractures caused by a bear attack.A 70-year-old man and a 60-year-old man were attacked by a black bear while mushroom picking. They sustained mandibular bone comminuted fractures with deep lacerations of the face. They were brought to our emergency room. Their lives were saved by immediate surgery. In addition, it was necessary to provide preventative measures against infection.
Preview · Article · Jan 2014 · Nippon Koku Geka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: Gastrointestinal stromal tumours are characteristically positive for KIT (reflective of the c-KIT gene). A case is reported of an apparent rapidly growing gastrointestinal stromal tumour, which arose in the floor of the mouth and metastasized to the left neck without evidence of disease elsewhere.
No preview · Article · Aug 2007 · International Journal of Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: A benign tumour of osseous and cartilaginous origins, osteochondroma generally develops in osseous tissue and is frequently found near the end of long bones. It is relatively rare in the oral and maxillofacial region but is common in the mandibular condyle and coronoid process in the pediculate form. This is a report on a rare case of osteochondroma in soft tissue near the mandibular angle without pedicle to the bone.
Preview · Article · Apr 2007 · International Journal of Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: We report a case of squamous cell carcinoma of the lower lip occurring on a hemangioma. A 79-year-old woman was referred to our hospital because an ulcer had developed on her swollen lower lip. She had a birthmark extending from both sides of the lower lip to the mental region and neck. The birthmark of the lower lip started to swell 15 years ago and grew gradually. She noticed an ulcer on the surface of her enlarged lower lip 6 months ago. A biopsy of the ulcer was performed, and the diagnosis was squamous cell carcinoma occurring on a heman-gioma. We carried out lower lip excision and reconstruction with a free forearm-palmaris longus flap under general anesthesia on May 15, 2000. Histopathological examination showed squamous cell carcinoma occurring on a cavernous hemangioma. There has been no evidence of recurrence or metastasis as of 2 years 11 months postoperatively.
[Show abstract][Hide abstract] ABSTRACT: Postoperative sore throat and hoarseness are common complications of tracheal intubation that affect postoperative satisfaction of the patient. The purpose of the present study was to compare the effect of lidocaine-containing jelly or non-lidocaine containing jelly as a tracheal tube lubricant on sore throat and hoarseness after total intravenous anesthesia. We initially enrolled 100 patients ages over 15, ASA physical status I -III, who were scheduled for elective surgery in the supine position, Patients were premedicated with 10 mg of raftidine or 20 mg of famotidine, a H 2 blocker, 120 min before induction. Total intravenous anesthesia was induced and maintained with propofol, ketamine, fentanyl, and vecuronium with or without epidural block. Tracheal intubation was performed with a tracheal tube with standard cuff (Trachelon® , Telmo, Japan), and the tube was lubricated with either lidocaine-containing jelly (Lidocaine group, n = 50) or non-lidocaine containing jelly (Glycerine group, n = 50). The cuff was inflated until no air leak could be heard with peak airway pressure at 20 cmH 2O. The anesthesiologist in charge asked the patients about sore throat and hoarseness before they left the operating room and on the morning following surgery. The severity of sore throat and hoarseness were graded as follows: for sore throat, 0) no complaints, 1) minimal sore throat, 2) moderate sore throat, 3) severe sore throat ; and for hoarseness, 0) no complaints, 1) slight hoarseness, 2) severe hoarseness, 3) can not speak because of hoarseness. Seven patients in each group were excluded because of multiple attempts at laryngoscopy, or because postoperative sedation status was inappropriate for assessment of symptoms during the study. Therefore, 86 patients were enrolled in the present study. On the day of surgery, the incidences of sore throat and hoarseness in the Lidocaine group were 25.6% and 32.6%, respectively, and those in the Glycerine group were 30.2% and 25.6%, respectively. There were no statistical differences between the two groups in the incidences of postoperative sore throat and hoarseness on the day of surgery. The incidences of sore throat and hoarseness in the Lidocaine group decreased on the day after surgery to 11.6% and 4.7%, respectively, and those in the Glycerine group also decreased to 11.6% and 14.0%, respectively. However, there were no statistical differences in the incidences of these complications between the two groups (Table 2). The severity of sore throat and hoarseness did not differ statistically at all between the Lidocaine group and the Glycerine group throughout the study period (Table 3). In conclusion, lidocaine-containing jelly for tracheal tube lubrication did not affect the incidences of postoperative sore throat and hoarseness in comparison with lidocaine non-containing jelly. We recommend non-lidocaine containing jelly as a tube lubricant to avoid unnecessary risk of anaphylactic reaction to lidocaine.
No preview · Article · Jan 2004 · Journal of Japanese Dental Society of Anesthesiology
[Show abstract][Hide abstract] ABSTRACT: There are no detailed long-term histological studies of hydroxyapatite implanted in human bone tissue. This report is of histological and radiographic examination of a patient with mandibular bone implanted with hydroxyapatite ceramics after cyst ennucleation and a good clinical course for 10 years. The mandibular bone was resected 11 years after the initial operation because of infection. Histology of the retrieved mandibular bone revealed that bone tissue proliferated into interparticular spaces and attached to the hydroxyapatite ceramics surfaces in the non-infected portion and that hydroxyapatite ceramics disappeared with bone destruction in the infected portion. From the histological results, clinical findings, and chronological radiographic findings for 10 years, it was concluded that hydroxyapatite ceramics could maintain their favourable properties as a bone substitute in human bone for a long time.
No preview · Article · Jun 2003 · Asian Journal of Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: The prognosis of patients who have oral cancer with contralateral neck lymph node metastasis (CLNM) is poor. In this study, we retrospectively evaluated the incidence of CLNM and conditions associated with the occurrence of CLNM.We reviewed the clinical records of 180 patients who had untreated squamous cell carcinoma that occurred unilaterally (except between the canines) in the oral and maxillofacial region. The patients were treated at our hospital between 1985 and 1999. A total of 29 patients had CLNM (16.1%). All of these patients had ipsilateral neck lymph node metastasis, and there was a trend toward a high prevalence of multiple node involvement. CLNM occurred in the patients with T 2-T 4 tongue cancer and with advanced (T 4) cancer in other regions. Four of the 29 patients with CLNM had simultaneous recurrence at primary sites and three of them had undergone ipsilateral radical neck dissection at initial treatment.Our results suggest that patients with T 4 tumors or T 2-T 4 tongue tumors have a high risk of CLNM. Furthermore, patients with primary tumor recurrence should be closely observed for CLNM if ipsilateral neck dissection had previously been performed.
[Show abstract][Hide abstract] ABSTRACT: A case of squamouse cell carcinoma arising in a pectoralis major myocutaneous flap used in the oral cavity is reported.A 64-year-old woman was treated for lower gingival squamouse cell carcinoma. After radiation therapy, radical neck dissection, mandibulectomy, total resection of oral floor, and resection of buccal mucosa and skin were performed. A PM-MC flap was used to reconstruct the defect. Six years later, recurrence in the gingiva of the maxilla was diagnosed, and the maxilla was resected partially. Eight years after the first operation, a new tumor showing papillary proliferation was noted in the center of the transplanted PM-MC flap. The tumor was simply resected and pathological examination showed that it was a well differenciated squamouse cell carcinoma in situ. In six months, a tumor was noted on the flap again. After complete resection of the tumor, there has been no recurrence for 3 years.
[Show abstract][Hide abstract] ABSTRACT: Between 1985 and 1992, 13 patients were treated for delayed lymph-node metastases that developed after obtaining control of primary lesions of the tongue. These lesions were treated primarily by radiotherapy or surgical resection; cervical metastases were treated mainly by delayed radical neck dissection (RND). Seven of the 13 patients survived with no evidence of recurrence. The other six patients developed tumors in the neck, and five of these patients died due to uncontrollable disease. In all but one patient, recurrence appeared between the site of the primary lesion and the region of RND, the oral floor and/or the parapharyngeal space. None of the patients with recurrence received radiotherapy in the area between the primary lesion and the site of RND. In contrast, there was no recurrence in patients who received external irradiation to the primary lesion and upper cervical lymph nodes. This review emphasizes the need to direct more attention to the area between the site of the primary lesion and the regional lymph nodes in patients receiving treatment for delayed metastases associated with small carcinomas of the tongue.
No preview · Article · Nov 1995 · International Journal of Oral and Maxillofacial Surgery
[Show abstract][Hide abstract] ABSTRACT: Reconstruction of the lower and upper lips, commissure, and full-thickness cheek defects using a composite radial forearm palmaris longus free flap with secondary commissuroplasty is described. This flap is useful for reconstruction of the total lower lip as well as larger defects that include full-thickness cheek and the commissure.
No preview · Article · Dec 1994 · Annals of Plastic Surgery
[Show abstract][Hide abstract] ABSTRACT: Fourteen cases of malignant lymphoma (ML), diagnosed in our depratment over 26 years from 1965 to 1991, were examined clinically, focusing mainly on the intial symptoms. The results were as follows:1) ML Accounted for 4. 5% of all oral malignant tumors.2) The patients consisted of 10 males and 4 females. The majority of them were advanced in age.3) There were 5 nodal cases (35. 7%) and 9 extranodal cases (64.3%).4) In all 5 nodal cases, the initial lesion involved the neck and/or submandibular lymphnodes. In the externodal cases, 3 cases appeared in the gingiva, 2 in the maxillary sinus, 2 in mandibular bone, 1 in the cheek, and 1 in mandibular bone and the front of the ear.5) Swelling was the initial local symptom in all cases.6) The initial clinical diagnoses in the 14 cases were malignant lymphoma in 1 case, malignant tumor in 8 cases, benign tumor in 3 cases, inflammation in 1 case, and inflammation and tumor in 1 case.7) In X-ray examinations, the nodal cases showed no abnormal images. In the extranodal cases, 2 cases with maxillary sinus lesions showed radiopaque areas, and 2 cases with gingiva lesions and 3 with mandibular lesions presented bone destructive changes.8) ML was suspected in 1 of 5 cases by CT examiation and in 4 of 6 cases by ultrasound examination.9) Laboratory examinations indicated cases with high LDH values tended to have a poorer prognosis.