{"title":"口腔底癌切除後のInfrahyoid myocutaneous flapによる再建","authors":"一平 遠藤, 真也 吉田, 智一 吉崎","doi":"10.5106/JJSHNS.21.163","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.163","url":null,"abstract":"頭頸部腫瘍手術の再建において遊離皮弁術はその有用性にすぐれ多くの施設で標準治療として汎用されている。一方で，有茎皮弁術も血行の安定性，挙上法の信頼性の点で利用価値が高い。Infrahyoid myocutaneous flap（IHMCF）は上甲状腺動静脈を血管茎とする前頸筋群を主体とした有茎の筋皮弁である。症例は81歳男性で左口腔底の腺様嚢胞癌（T3N1M1）である。肺転移を認めていたが，口内痛が強く経口摂取も困難であったため局所制御目的に口腔底癌手術を施行した。頸部から口腔底癌切除後にIHMCFにて欠損部に逢着した。術後，皮弁上皮の一部に壊死を認めたが局所処置にて改善した。皮弁のdonor部位も一期的に閉創した。術後，口内痛も消失し経口摂取も良好となった。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132993063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Hirakawa, N. Hanai, Taijiro Ozawa, I. Hyodo, Keishi Kouyama, Atsushi Suzuki, Takuya Miyazaki, Ikuma Harata, T. Mizukami, Hiroki Okamoto, Y. Hasegawa
{"title":"Skull base surgery for malignant nasal and paranasal tumors","authors":"H. Hirakawa, N. Hanai, Taijiro Ozawa, I. Hyodo, Keishi Kouyama, Atsushi Suzuki, Takuya Miyazaki, Ikuma Harata, T. Mizukami, Hiroki Okamoto, Y. Hasegawa","doi":"10.5106/JJSHNS.21.151","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.151","url":null,"abstract":"［目的］鼻副鼻腔悪性腫瘍の頭蓋底進展例に対する頭蓋底手術の成績および安全性，予後因子を検討する。［対象］当院にて2000年から2009年の間に頭蓋底手術を施行した鼻副鼻腔悪性腫瘍症例47例が対象である。［結果］原発部位は上顎洞35例，篩骨洞7例，鼻腔5例であった。5年全粗生存率は59.8%であり，扁平上皮癌症例では74.7%であった。多変量解析の結果，予後不良因子は切除断端陽性であった。術後合併症は35.4%に認められた。［結論］術後成績および合併症は諸家の報告と同様であった。切除断端陽性例は予後不良であり術前評価，手術計画における安全域確保の重要性が改めて示された。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123143296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bilateral congenital cholesteatoma -a case report-","authors":"Y. Katagiri, N. Fukushima, Tomohisa Hirai, Masaaki Hajima, Kazunori Kubota","doi":"10.5106/JJSHNS.21.41","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.41","url":null,"abstract":"先天性真珠腫の報告例は近年，増加傾向にあるが，両側性先天性真珠腫の報告例はまれであり，渉猟しえた限り内外あわせても15症例にすぎない。今回われわれは両側先天性真珠腫の1例を経験したのでその概要を報告する。症例は6歳男児，近医にて左先天性真珠腫を疑われ当科を紹介受診した。初診時の左鼓膜所見において鼓膜のほぼ全面に白色病変が透見された。右鼓膜所見は正常と思われたが，CTでは右耳のツチ骨前方に異常陰影を認めた。左耳は段階的鼓室形成術を，右耳は一期的鼓室形成術を施行し，術後経過は良好である。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130953483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Formalin application therapy under the concept of \"natural-end cancer\" for the treatment of a very old patient with parotid gland cancer","authors":"S. Iwae, Yuji Hirayama, H. Komatsu, H. Shinomiya","doi":"10.5106/JJSHNS.21.85","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.85","url":null,"abstract":"","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123044457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of functions after reconstruction for wide resection of oropharyngeal cancer : Gehanno's method","authors":"R. Sugimoto, K. Okami, A. Sakai, K. Ebisumoto, D. Maki, Taku Atsumi, K. Nishiyama, M. Iida","doi":"10.5106/JJSHNS.21.47","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.47","url":null,"abstract":"中咽頭は解剖学的・生理的に複雑なので，上壁型や側壁型中咽頭癌の広範囲切除の再建術後には，構音・嚥下機能障害が生じる。今回，上壁型と側壁型中咽頭癌に対するGehanno法を用いた再建術後機能について，評価および検討した。東海大学付属病院において2000年から2009年までの間に，17例の中咽頭癌患者に対して広範囲切除および再建術を施行した。このうち13例でGehanno法を用いた再建術を施行した。この13例で，術後の構音・嚥下機能について嚥下内視鏡検査を中心に評価した。13例全例において，比較的良好な機能が温存されており，中咽頭癌に対するGehanno法による再建法の有用性が確認できた。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129381152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A clinical analysis of 42 cases of major salivary gland carcinomas","authors":"K. Kainuma, Kenji Sano, Hiroaki Suzuki, Ryosuke Kitoh, U. Shin-ichi","doi":"10.5106/JJSHNS.21.97","DOIUrl":"https://doi.org/10.5106/JJSHNS.21.97","url":null,"abstract":"1999年から2008年までに当科で手術療法にて加療した大唾液腺癌の42例を対象に生存率に係る臨床的および組織病理学的因子について，統計学的に検討した。原発部位は耳下腺が31例，顎下腺が11例だった。42例全体の5年疾患特異的生存率は74.5%，耳下腺，顎下腺の5年疾患特異的生存率はそれぞれ76.3%，70.1%だった。組織型については，11例は低悪性度，7例は中悪性度，24例は高悪性度だった。単変量解析でT分類，頸部リンパ節転移の有無，組織学的悪性度，切除断端の状態，顔面神経麻痺の有無，リンパ管浸潤の有無，病期の7項目，多変量解析ではリンパ管浸潤の有無の1項目に統計学的に有意差を認め，大唾液腺癌において重要な予後規定因子であることが示唆された。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"155 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131898406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"アミノレブリン酸(5-ALA)を用いた正常副甲状腺の術中光線力学的同定","authors":"猛 鈴木, 亮介 内田, 惠也 清水, 守 由美子, 飯田 由美子, 渋谷 真理子, 勉 沼田","doi":"10.5106/JJSHNS.20.291","DOIUrl":"https://doi.org/10.5106/JJSHNS.20.291","url":null,"abstract":"甲状腺腫瘍などの手術において正常副甲状腺を同定し確実に温存することは，術後の血中カルシウム維持のために重要である。これまで，病的副甲状腺の染色方法の報告はあるものの，正常副甲状腺の術中同定法の報告は少ない。今回，アミノレブリン酸（5-ALA）を用い，正常副甲状腺の術中光線力学的同定を行った。甲状腺良性腫瘍患者9例において，副甲状腺を露出する約5時間前に5-ALA 20mg/kgを経口投与した。甲状腺裏面露出後，周囲組織を波長405nmの青紫色光で励起させ，赤色発光し副甲状腺と考えられる組織を一部生検し病理組織検査を行った。全例が赤色蛍光発光し容易に確認でき，病理組織学的にも正常副甲状腺と確認された。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133229389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"上顎骨（前頭骨を含む）・頬骨骨折","authors":"大堀 純一郎, 祐一 黒野","doi":"10.5106/JJSHNS.20.81","DOIUrl":"https://doi.org/10.5106/JJSHNS.20.81","url":null,"abstract":"","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127530618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"頸部外側に発生したCarcinoma showing thymus-like differentiation（CASTLE）の1例","authors":"照章 滝下, 伸也 門田, 安彦 山下, 愛 山崎","doi":"10.5106/JJSHNS.20.167","DOIUrl":"https://doi.org/10.5106/JJSHNS.20.167","url":null,"abstract":"Carcinoma showing thymus-like differentiation（CASTLE）は，異所性の胸腺類似腫瘍で，頸部に発生する稀な悪性腫瘍である。病理所見は，扁平上皮癌やリンパ上皮腫様癌の形態を呈することが多い。今回，診断に難渋したCASTLE症例を経験したので報告する。症例は23歳女性。左上内深頸リンパ節領域に，4cmの腫瘤を認めた。他部位に病変なく，悪性リンパ腫を疑い生検したが，低分化癌リンパ節転移との病理報告であった。原発不明癌頸部リンパ節転移として手術を施行し，術後化学放射線療法を行った。術後の免染所見でCD5とCD117の陽性が確認され，最終診断に至った。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125564143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"頸部に発生したextra-abdominal desmoid tumorの1例","authors":"昇 羽生, 裕 徳丸, 彰人 進藤, 達雄 松永, 正人 藤井","doi":"10.5106/JJSHNS.20.173","DOIUrl":"https://doi.org/10.5106/JJSHNS.20.173","url":null,"abstract":"頸部に発生したextra-abdominal desmoid tumor症例を経験したので報告する。Desmoid tumorは骨格筋の結合織，筋膜から発生する良性の線維性増殖を特徴とし，局所浸潤性が強い病変である。好発部位は腹壁で，頭頸部には少ない。組織学的には悪性所見を認めないが，局所再発が多く治療に難渋することが多い。症例は60歳男性，右頸部の弾性硬の腫瘤を主訴に紹介受診した。MRIでは，右中頸部に大きさ20×30mmで，造影効果のある辺縁不整の腫瘤を認め胸鎖乳突筋内への浸潤が疑われた。確定診断目的に局所麻酔下に生検術を施行し，desmoid tumorが疑われたため，改めて頸部郭清に準じて手術を施行した。術後経過は良好で，現在のところ再発は認められていない。","PeriodicalId":276583,"journal":{"name":"Journal of Japan Society for Head and Neck Surgery","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122125522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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