Asian Journal of Oral and Maxillofacial Surgery最新文献

Invasive fungal sinusitis is still a life-threatening infection in immunocompromised patients. Its onset is rapid and leads to severe complications. We describe a neutropenic patient with acute myeloid leukemia who developed invasive sinus aspergillosis despite receiving prophylactic itraconazole and empirical micafungin. The patient demonstrated apparent clinical findings such as nasal discharge, nasal congestion, and skin and mucosal necrosis. Computer tomography scans strongly demonstrated invasive maxillary sinusitis. Serological examinations for (1-3)-β-d-glucan and Aspergillus galactomannan antigen were positive, suggesting Aspergillus infection. The diagnosis of invasive sinus aspergillosis was confirmed by in situ hybridization using Aspergillus-specific probe in formalin-fixed, paraffin-embedded tissue samples. The causative organism was identified as Aspergillus fumigatus by fungal culture. Despite surgical treatment with drainage and intensive antifungal administration of voriconazole and liposomal amphotericin B, the infection rapidly disseminated to the lungs, resulting in a fatal progression of the condition.

The case of an angiolipoma of the cheek in a 76-year-old man is reported. Angiolipoma is a benign tumor which is very rare in the soft tissue of the oral region, with only 21 reported cases, including our case. In our case, microscopically, the mass consisted of mature adipose cells intermixed with scattered vascular components. The tumor had a low proliferative capacity and the capsule was present, indicating a noninfiltrating type. After surgical treatment, the patient has done well with no sign of recurrence for 3 months.

Denture fragment inhalation is uncommon. Denture fragment impaction at the glottis is rare. A glottis impaction without incurring airway symptoms is even rare. The populations of elderly wearing denture are significant and abundant. It is important as not to miss the possibility of denture inhalation as the illustrated in this case report. In the event of broken or swallowed denture, all patients warrant a proper upper airway assessment for foreign body until proven otherwise.

We report herein a case of extensive osteomyelitis of the mandibular region in a 32-year-old woman on hemodialysis. This patient, who showed extensive malnutrition and formation of an abscess in the pterygo-mandibular and lateral pharyngeal space, was referred to our hospital on suspicion of infection. Use of antibiotics allowed reduction of the abscess. However, over the next 12 months, all the teeth of the mandibular region were lost and severe osteomyelitis developed. This patient is being followed up on a regular basis without further treatment. Osteomyelitis of the mandible is still present.

The authors report a case of right mandibular metastasis from thyroid follicular carcinoma of a 71-year-old woman who suffered from painless swelling in the right retromolar region for 10 months. As pulse was detected through a mass, we suspected that the mass was hemangiosarcoma or A–V malformation. However, by an incisional biopsy, a diagnosis of a metastasis from thyroid follicular carcinoma, was suggested. Under general anesthesia, right lobe thyroid gland resection, mandible segmental resection, neck dissection, and plate reconstruction were performed. Final diagnosis of thyroid follicular carcinoma and metastasis to the right mandible was made. The postoperative period was uneventful and the patient was asymptomatic without signs of recurrence 4 years postoperatively. The present case is the uncommon case of mandibular metastasis from thyroid follicular carcinoma.

Three-dimensional (3D) models are commonly employed in surgeries for tumor ablation and reconstruction, and jaw deformities. The advantages of the 3D anatomic model techniques include better understanding of the bone morphology, and an accurate and easier planning of pre-operative bending of the plate. Although many studies have reported the usefulness and benefits, there is a paucity of data on the objective evaluation of subjective opinion surveillance for the surgeons. The aim of this retrospective study was to objectively verify the contribution of 3D models by comparing the operating time of the 3D model-aided surgeries and conventional free-hand plate bending surgeries in patients undergoing mandibular reconstruction.

We reviewed the operation time, the volume of blood loss, and the duration for mandibular reconstruction from the clinical records. The duration for mandibular reconstruction was defined as the period from the end of mandibular resection to the time of intraoperative radiological examination for the condylar position.

The duration for mandibular reconstruction was 17–64 min (median 30 min, n = 7) and 37–90 min (median 55 min, n = 21) in the prebending with 3D model and intraoperative free-hand bending groups, respectively. Although the 3D model did not help shorten the total operation time, the mandibular reconstruction time was remarkably reduced (p = 0.0192, Mann–Whitney's U-test). In patients with systemic problems, reconstruction plates are often indicated instead of free bone or vascularized bone grafts. The 3D model technology might play an important role in such patients.

Objective

The aim of this study was to identify differentially expressed gene(s) among lymph node-positive (pN+) cases and lymph node-negative (pN−) cases of tongue squamous cell carcinoma (TSCC).

Patients and methods

We examined genetic aberrations and gene expression profiles in 20 cases of primary TSCCs, paired normal oral tissues, six TSCC-derived cell lines, and normal oral keratinocytes (NOKs). Whole genome profiling using the Affymetrix 10K SNP Mapping Array was performed on three pN+ cases and two pN− cases of TSCCs and the results were compared to normal tissues. We also examined the mRNA expression level of the candidate gene product identified.

Results

We found that the DNA copy number abnormality of the chromosome 6q region is associated with TSCC metastasis. ZDHHC14 is on 6q25.3, a region gained in pN+ cases of TSCCs compared with pN− cases. Quantitative real-time reverse-transcription polymerase chain reaction showed that ZDHHC14 was overexpressed in all TSCC-derived cell lines compared with primary cultured NOKs at the mRNA level. Similar to the TSCC-derived cell lines, high frequencies of ZDHHC14 up-regulation were evident in mRNA levels of primary tumors (n = 8/20, 40%). This up-regulation also is closely associated with lymph node status (P = 0.0008).

Conclusions

These results suggested that ZDHHC14 expression may be correlated with lymph node metastasis and offers clues to the planning of new treatments such as early detection, prevention, and therapy for TSCC metastasis.

Teratoma is a neoplasm composed of tissue from all three germinal layers. Benign cystic teratoma is extensively researched and documented in literature. It displays a wide spectrum of presentations. Only 6.9% of teratomas occur in the head and neck region. Teratoma of tongue is a rare tumor of the oral cavity with only 21 cases reported in the literature. We report a rare case of benign cystic teratoma of tongue in a 10-year-old female, who presented as macroglossia and was successfully treated with surgery.

We examined co-localization of the vanilloid receptor subtype 1 (VR1) with sweet (T1R2, T1R3) or bitter (T2R6) receptors in human circumvallate taste cells using double-fluorescence immunohistochemistry. All the T1R2-, T1R3-, or T2R6-immunoreactive cells observed in the circumvallate co-exhibited VR1-immunoreactivity. Many of VR1-immunoreactive cells exhibited α-gustducin immunoreactivity as well. Results support the idea that capsaicin may interact with the transduction pathways of sweet and bitter taste stimuli in human, possibly, in mediation of its receptor VR1 located in taste cells. Additionally, it is suggested that α-gustducin may play a role in the tentative modulatory function of capsaicin in sweet and bitter transductions.

Background

Fractures of the facial skeleton in children are relatively uncommon in comparison with adults. Within the orbital region fractures are recognised to be rare due the timing of development of the maxillary and frontal sinuses which are not fully developed until 12 years of age. We have recently seen several cases of medial wall fractures in children, which according to the existing literature should be exceptional. This prompted a review of the unit database to clarify the incidence and identify common aetiological factors for these injuries.

Method

Retrospective case note review using the ACFU database.

Results

Six cases were identified with a most cases occurring in males. The aetiology was found to be variable in each case with no identifiable pattern and the subsequent management reviewed.

Conclusion

These six cases highlight that this pattern of fracture can occur more commonly than the existing literature suggests and this should be remembered by those who treat facial trauma in children.