Language：Japanese   Publisher：(NPO)日本口腔科学会  

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

To compare three-dimensional (3D) nasal forms after definitive correction of unilateral cleft lip (UCL)-nose using an extended spreader cartilage graft with/without a cross-lap joint cartilage graft technique. Twenty-four patients with UCL who underwent definitive nose correction using an extended spreader cartilage graft with a cross-lap joint technique (CLJ group) and fifteen patients with UCL who underwent nose correction without a cross-lap joint technique (non-CLJ group) were enrolled in this study. Pre- and postoperative 3D nasal forms were compared between the two groups. The CLJ group demonstrated more successful recovery of the nasal tip and anterior nasal ridge in the center of the face (P < 0.01), and the higher nasal tip was maintained for more than 1 year (P = 0.008). The differences in the cephalo-caudal heights of the nasal alar groove and curvatures of the alar groove arch were successfully improved in both CLJ and non-CLJ groups. The nasal angles on lateral profiles did not change in either group. An extended spreader cartilage graft with a cross-lap joint technique facilitates satisfactory recovery of the nasal tip in the center of the face and a higher nasal tip, avoiding over-projection in the definitive correction of UCL-nose.

DOI： 10.1016/j.jcms.2020.08.008

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ajoms.2020.01.003

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Publisher：日本医用画像工学会  

口唇裂とは,胎児の顔面が癒合する過程において唇が完全に形成されない場合に生じる先天異常で,日本においては約500人に1人の割合で発生する.左右対称な口唇と外鼻を形成することを目的として治療が行われているが,医師の主観に依存した判断基準に基づいているため,手術部位の対称度合を定量的に判断する必要がある.本論文では,手術部位の対称性を解析するための顔の対称基準となる面を検出する手法を提案する.提案法では被験者の顔を撮影した3次元点群データに対し,顔器官を点として検出したのち,口唇裂による形状変化の影響が顕著とされる上唇から鼻尖点までの領域を除外した鏡像反転点群との位置合わせを行う.次に,元の点群内の1点と鏡像反転像内の対応点の間を垂直2等分する平面を求めることにより対称基準面を設定する.提案法を実3次元点群データに適用した結果,良好な精度で対象基準面を検出することができた.(著者抄録)

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE:: To visualize and quantitatively analyze facial surface asymmetry following primary cleft lip repair in patients with unilateral cleft lip and palate (UCLP) and to compare this with noncleft controls. DESIGN:: Retrospective comparative study. PATIENTS:: Twenty-two patients with complete UCLP who underwent primary lip repair from 2009 to 2013 were enrolled in this study. The preserved 3-dimensional (3D) data of 23 healthy Japanese participants with the same age were used as controls. INTERVENTIONS:: All patients had received primary labioplasty in accordance with Cronin triangular flap method with orbicular oris muscle reconstruction. MAIN OUTCOME MEASURES:: Shadow and zebra images established from moire images, which were reconstructed from 3D facial data using stereophotogrammetry, were bisected and reversed by the symmetry axes (the middle line of the face). The discrepancies of the gravity and density between cleft and noncleft sides in 2 regions of interest, facial and lip areas, were then calculated and compared with those of healthy participants. RESULTS:: In the UCLP group, the mean discrepancies of gravity on shadow and zebra images were 1.76 +/- 0.70 and 2.63 +/- 1.72 pixels, respectively, in the facial area and 1.31 +/- 0.36 and 3.83 +/- 2.08 pixels, respectively, in the lip area. There was a significant difference in the mean discrepancies of gravity and density on zebra images in the lip area between the UCLP and control groups. CONCLUSIONS:: Our image analysis of digital facial surface asymmetry in patients with UCLP provides visual and quantitative information, and it may contribute to improvements in muscle reconstruction on cleft lip repair.

DOI： 10.1177/1055665618819645

PubMed

Publisher：(一社)日本小児口腔外科学会  

症例は16歳女性で、口底部の腫脹で受診した。MRIでラヌーラと診断したが当時幼児であったため、経過観察を選択した。その後、腫脹は徐々に増大し、オトガイ下部まで腫脹を認めるようになった。単純MR所見では、舌下、口底からオトガイ下部にかけて、境界明瞭、辺縁平滑、楕円形、大きさ約48.0×37.2×66.7mmの嚢胞性病変を認めた。舌は挙上し、舌骨上筋群は圧排され、咽頭腔の狭窄を認めた。病変内部は不均一で、T2強調画像では球形様病変が集簇し、おはじき様所見を呈した。CT、MRIから口底部類皮嚢胞と診断し、全身麻酔下にて嚢胞摘出術を施行した。摘出後はドレーンを舌下小丘後方の口底正中に留置し、閉創した。術後は通常の喉頭鏡で喉頭展開が可能となり、咽頭・喉頭のスペースは十分であったため、抜管を行い一般病棟管理となった。術後6ヵ月を経過後も再発を認めず、いびき音は改善され経過良好である。病理組織学的診断は類皮嚢胞であった。

Publisher：(公社)日本口腔外科学会  

22歳男。半年前から左側下顎骨の膨隆を自覚していたが、疼痛がないため放置してした。口腔内所見として左下歯3〜7相当部歯肉に40×40×30mm大で境界明瞭、骨様硬、表面平滑な膨隆を認めた。パノラマX線では左下歯3〜7にかけて、内部に石灰化物を伴う不定形で境界明瞭なX線透過像を認めた。生検で「骨芽細胞腫の疑い」と臨床診断し、全身麻酔下に下顎区域切除術を行い、切除標本の病理組織所見から骨芽細胞腫と確定診断した。7年前に近医歯科医院で撮影されたパノラマX線写真が入手できたためその観察を行ったところ、左下歯6近心根周囲に境界不明瞭な透過像が認められ、骨芽細胞腫の初期像である可能性が考えられた。

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Publisher：Japanese Society of Oral and Maxillofacial Surgeons  

<p>Osteoblastoma is a rare tumor that accounts for less than 1% of all bone tumors and is characterized by the development of osteoblasts and osteoid tissue. It is classified as an intermediate type tumor with local aggressiveness. The tumor mass is usually larger than 2 cm, and there have been no reports of large osteoblastomas in Japan in recent years. We report the case of a large osteoblastoma, including a description of the previously obtained X-ray films.</p><p>　The patient was a 22-year-old man who visited our hospital with a chief complaint of swelling of the left side of the mandible. The tumor measured 40×40×30 mm, and X-ray films showed a radiolucent image including a calcified body with a clear margin. Osteoblastoma was diagnosed on the basis of two biopsies. Segmental mandibulectomy was performed with the patient under general anesthesia. There has been no recurrence after the operation, and the patient is making good progress. A panoramic X-ray film taken 7 years ago (at 15 years of age) revealed slight bone resorption resembling periodontitis in the region where the tumor had developed. Consequently, there was a high probability that this X-ray film indicated an early stage of this tumor.</p>

DOI： 10.5794/jjoms.63.388

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To develop criteria for the analysis of upper lip configuration of patients with cleft lip while they produce various facial expressions by comparing the 3-dimensional (3D) facial morphology of healthy Japanese adults and patients with cleft lip. PATIENTS AND METHODS: Twenty healthy adult Japanese volunteers (10 men, 10 women, controls) without any observed facial abnormalities and 8 patients (4 men, 4 women) with unilateral cleft lip and palate who had undergone secondary lip and nose repair were recruited for this study. Facial expressions (resting, smiling, and blowing out a candle) were recorded with 2 Artec MHT 3D scanners, and images were superimposed by aligning the T-zone of the faces. The positions of 14 specific points were set on each face, and the positional changes of specific points and symmetry of the upper lip cross-section were analyzed. Furthermore, the configuration observed in healthy controls was compared with that in patients with cleft lip before and after surgery. RESULTS: The mean absolute values for T-zone overlap ranged from 0.04 to 0.15 mm. Positional changes of specific points in the controls showed that the nose and lip moved backward and laterally upward when smiling and the lips moved forward and downward medially when blowing out a candle; these movements were bilaterally symmetrical in men and women. In patients with cleft lip, the positional changes of the specific points were minor compared with those of the controls while smiling and blowing out a candle. The left-versus-right symmetry of the upper lip cross-section exceeded 1.0 mm in patients with cleft lip, which was markedly higher than that in the controls (0.17 to 0.91 mm). These left-versus-right differences during facial expressions were decreased after surgery. CONCLUSION: By comparing healthy individuals with patients with cleft lip, this study has laid the basis for determining control values for facial expressions.

DOI： 10.1016/j.joms.2016.03.030

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: A surgical strategy for definitive cleft lip-nasal correction that stably provides symmetric and natural nasal forms has not been established to date. The purpose of this study was to describe our surgical techniques and 3-dimensional (3D) assessment results after the definitive correction of cleft lip-nose deformity using an extended spreader cartilage graft with a cross-lap joint technique to achieve a rigid strut for lower lateral cartilage repositioning to obtain a desirable nasal tip projection. PATIENTS AND METHODS: This study enrolled 14 patients with unilateral cleft lip (UCL) with or without cleft palate and 8 patients with bilateral cleft lip (BCL) with or without cleft palate who underwent definitive nose correction and were followed for 1 to 3 years. All patients were treated by open rhinoplasty, repositioning of the lower lateral cartilage, use of an extended spreader cartilage graft with a cross-lap joint technique for nasal tip support, and medial-upward advancement of nasolabial components with vestibular expansion by a free mucosal graft. For the BCL nose, pedicle flaps from rim skin were used for columella lengthening. Preoperative and postoperative nasal forms were 3-dimensionally analyzed by use of 3D images serially obtained in 12 patients. RESULTS: The postoperative nasal forms were satisfactorily improved in all patients, without any serious postoperative complications. Preoperative and postoperative 3D analyses showed a significantly projected nasal tip in the postoperative noses of patients in both the UCL group and the BCL group (P < .01 and P < .05, respectively) and a sharper nasal tip angle in the BCL group (P < .05). Lateral deviation of the nasal tip was significantly improved in the center of the face in patients in the UCL group (P < .01). CONCLUSIONS: The results of this study suggest that the extended spreader cartilage graft using the cross-lap joint graft technique is useful to provide a desirable projection of the nasal tip in the center of the face on definitive correction of both UCL and BCL nose deformities.

DOI： 10.1016/j.joms.2016.03.027

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

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Venue：福岡  

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国内学会

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