Asian Journal of Oral and Maxillofacial Surgery最新文献

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease of the temporomandibular joint (TMJ) is rare. This article presents a 72-year-old man with CPPD deposition disease of TMJ. The patient's initial clinical presentation, diagnosis and treatment are discussed.

It was reported that nizatidine, a histamine H₂-receptor antagonist, promoted salivation by inhibiting acetylcholinesterase and increasing acetylcholine in cholinergic nerves. However, little is known concerning the appropriate usage of the drug for dry mouth. Therefore, the relationship between the causes of dry mouth and the effects of nizatidine was investigated in order to examine the indication of the drug in dry mouth.

In the study, 45 patients who came to the Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hachioji Medical Center, with a chief complaint of dry mouth during the 1-year period from August 2006 to August 2007, were given nizatidine at 300 mg/day continually for 4 weeks. At 2 weeks and 4 weeks of administration, gum tests were conducted on the patients, and the effect of nizatidine was evaluated on a visual analog scale. The cases were divided into groups according to the causes of hyposalivation, and the effect of nizatidine was examined for each group. As a result, the group with aging as the cause, and the group with drug side effects as the cause, was observed to have increased salivary secretion and improvement in subjective symptoms.

Oral myiasis is a rare pathology in humans with higher incidence in developing countries having hot climatic conditions. Most of the infestations are associated with various predisposing factors like poor oral hygiene, suppurative lesions, senility, alcoholism and debilitating conditions. The diagnosis is made basically by presence of larvae. This article deals with traumatic oral myiasis in healthy male and myiasis in mentally challenged female patient. The treatment consisted of manual removal of the larvae by topical application of turpentine oil and surgical debridement of the wound.

Atrophic edentulous mandibular fractures occur primarily in elderly population. Elderly patients who are more than 80 years old have risks for general anesthesia because of degradation of biological function. Recently, drugs and medical instruments have been developed and appliance for general anesthesia has also improved. We had the experience of a case where we had to carry out open reduction with internal fixation (ORIF) under general anesthesia for a 98-year-old female with severe atrophic mandible to improve her functional disability and acquire a faster recovery. Osteosynthesis was carried out using 2.8 mm Mandibular Recon Plate (Stryker Osteosynthesis, Friburg, Germany). She made a good recovery and there were no complications. There was no relapse or complications during 17 months of follow-up so that she could reach the age of 100 years.

Sentinel node navigation surgery (SNNS) have received widespread application in the staging and treatment of many tumors including oral cancer. In general, radioactive colloid and dye, or both is used as the tracer for SNNS. While these methods are useful, there is some disadvantage such as radiation exposure and necessity of special equipment. Therefore, we conducted to examine the utility of fluorescence navigation using indocyanine green (ICG) for the detection of sentinel lymph node (SNL) in patients with oral cancer. Twelve patients with oral cancer were enrolled. The ICG was injected submucosal around the oral tumor. Fluorescence imaging immediately showed subcutaneous lymph nodes. After incising the cervical skin over the point of appearance of the fluorescence, the SLN was dissected under fluorescence guidance. In all patients, the SLN were successfully visualized and dissected. One patient was found to have lymph node metastases pathologically. In this report, we suggest that the method is feasible and safe, and allowing real-time observation for intraoperative detection of SLN without any radioisotope applications.

Our study aimed to develop an intelligent wound dressing containing elements that promote wound healing. Unlike conventional dressings, this is a gel-type dressing that contains basic factors required by cells in a complex of alkaline-treated collagen and atelocollagen. Full-thickness 8-mm skin defects were made with a DermaPunch^® in the left and right sides of the back of 8-week-old genetically diabetic mice (db/db). Collagen gel was applied to the fascia on the right side, while the left (control) side was left untreated. Both wounds was coated and fixed with Tegaderm^®. On days 3, 7 and 14, macroscopic appearance and percent decrease in wound area were assessed histopathologically. On the collagen-gel side, granulation tissue had formed, with wound contraction caused by migration of epidermal cells from the surrounding tissue. By day 14, wound area had decreased to 37% for the untreated side as compared to 22% on the collagen-gel side, indicating that collagen gel was associated with significantly greater wound contraction. Moreover, there were a lot of blood vessels on the collagen-gel side. Collagen-gel dressing is most effective for dry, open wounds, i.e., those with minimal effusion, and it may also be effective for depressed open wounds. Collagen-gel dressing is expected to be very useful in treating wounds such as skin defects and skin ulcers.

Objective

This study was performed to evaluate the usefulness of continuous-selective intra-arterial injection of antibiotics via the superior thyroid artery for osteoradionecrosis of the mandible.

Patients and methods

Three osteoradionecrosis cases were treated with this innovative drug delivery system. Totals of 7200 mg, 7810 mg and 6960 mg of clindamycin (CLDM) were administered in cases 1, 2 and 3, respectively. Patients also received conventional intravenous cefozopran hydrochloride (CZOP) or ceftazidime (CAZ) or moxifloxacin (MFLX) and hyperbaric oxygen therapy (HBO).

Results

Both clinical findings and laboratory data improved immediately after these treatments in these cases.

Conclusion

The present study indicates that continuous-selective antibiotic injection via the superior thyroid artery might be an additional treatment option if performed in combination with conventional approaches in the refractory cases.

Lipoma is a common tumor found anywhere on the body. However, reports of large lipoma of the submandibular region, particularly extending into the parapharyngeal space, are rare. To remove tumor of the parapharyngeal space, many authors recommend a transcervical or transparotid-cervical approach. We report a case of lipoma of the submandibular region that extended into the parapharyngeal space which was removed with small invasion using a transmandibular approach.

Background

Fractures of fronto-ethmoidal bones (FEFs) are treated by a surgical team. A staging system for classifying FEFs is of paramount importance in order to plan surgery, to define prognosis and to exchange information among trauma centers. Some classifications are available but they are quite complex. Here a simple stage is proposed.

Methods

Five types of FEFs are possible: in situ FEF (without fragment dislocation, dura laceration or cerebrospinal fluid leak), type I (dislocated fracture involving the outer cortical bone, i.e. anterior frontal sinus wall), type II (dislocated fracture involving the inner cortical bone – i.e. posterior frontal sinus wall – and/or structures comprised in the diploe – i.e. the sinunasal tract), type III (dislocated FEF with dura laceration and cerebrospinal fluid leak), and type IV (i.e. comminuted fronto-ethmoid-orbital fractures). To evaluate the suitability of the proposed classification a retrospective study on a series of 42 patients was performed. Age, gender, stage, clinical diagnosis at admission, type of surgery and outcome were considered.

Results

A good correlation between the proposed classification and the studied variables was detected.

Conclusions

The proposed classification (that is a simplification of the Ioannides’ system) is a simple and precise method for staging FEFs. It can be used in daily practice. It is our understanding, however, that a multi-center study should be performed before the effectiveness of the proposed classification can be clearly stated.

Bilateral tongue flaps were employed for the reconstruction of large defects in the lip vermilion. A bilateral tongue flap is a useful procedure because, not only can it reconstruct large defects in the lip vermilion with good color and contour, but it can also preserve enough tongue papilla to ensure adequate post-operative taste function. The operation procedure is simple, reliable and of short duration. It provides good aesthetic and functional results with no major complications such as flap necrosis. We employed this technique on 11 patients over a 10-year period and it has proven to be very effective. This article describes two such cases.