- Email: [email protected]
P.157 A case of familial Schwannomatosis
Posters in the OSAS treatment, and to describe some interesting cases of maxillo facial surgery practice as well. Methods: A selection of the most frequent maxillo-facial operations is presented in patients with OSAS disease and different maxillo facial malformations associated to OSAS disease as well, such as: bimaxillary advancement, anchilosis correction, mandibular distractions and midface advancement. Pre- and postoperatively evaluation with telecranium x-rays in 2 projections (P-A and L-L), Panorex, CT scan and polisonnographic exams was carried out. Results and Conclusion: The approach and methodology of surgical treatment planning was site-specific: the selection of specific surgical procedures was based primarily on each individual patient’s sites of disproportionate anatomy. Besides a post operative polisomnography was performed and it showed the disappearance of apnea events and facial simmetry restoration, furthermore OSAS treatment guide lines is showed.
Oral surgery
S207
in the cranial base, the pharynx, the floor of mouth and the lung, and numerous small ones in the neck and subclavicular region on the T2-weigted images. Biopsy was taken from the lesion of the floor of mouth, and the specimen revealed dominant Antoni type B with scattering Antoni type A. She had an intractable pain in right part of the face, and the tumor in the cranial base could be causing the pain. The tumor in the cranial base was partially removed at the department of neurosurgery, and then the pain was completely disappeared. Histological examination revealed that the lesion was also schwannoma. The tumor of the right floor of mouth was removed under general anesthesia three month after the cranial surgery. Conclusions: Since her two aunts and an uncle had multiple schwannomas in several segments of the body without vestibular tumor, this case was considered as familial schwanomatosis from the diagnostic criteria proposed by the National Neurofibromatosis Foundation. P.158 A pedunculated hemangioma of the hard palate
Oral surgery
H. Kitano, H. Ogawa, H. Matsuyama, B. Saito, T. Ueki. Ooyaguchikamichou, Itabashi-ku, Japan
P.156 4-D simulation for “square mandible”: report of a case
Objectives: The hemangioma is common as a benign tumor of the oral cavity. The tongue, lips, and bussal mucous membrane are the most common sites for a hemangioma of the oral cavity. But, it is an extremely rare that a pedunculated hemangioma is appeared of the oral cavity. Methods: We present the case of a 75-year-old female diagnosed with a pedunculated hemangioma of the hard palate. On examination, the tumour was found of situated to the right of the hard palate region. After two months later, the tumour size of 15155 mm was grew up to 2520×10 mm. Magnetic resonance imaging studies of the thoracic spine showed a well-defined intradural mass at the hard palate with a diameter of 25 mm and a length of 20 mm. The signal intensity of the mass relative to the hard palate was isointense on T1 weighted images, hypertense on T2-weighted images, and showed homogeneous, strong enhancement on Gd-DTPA images. Results: The patient underwent excision of the tumour under local anaesthesia. Interestingly, the tumour has a peduncle of leading to the hard palate. On histopathological study, the tumour was found to be consisted of vascular differentiation with small or large vascular channels by thin-walled vessels. The tumour was diagnosed for capillary hemangioma. Conclusions: We reported a pedunculated hemangioma on the hard palate.
K. Nakaoka, Y. Hamada, T. Saito, Y. Shigeta, S. Hirai, T. Ikawa, A. Mishima, T. Ogawa, K. Seto. Tsurumi University, First Department of Oral & Maxillofacial Surgery, Yokohama, Japan Objectives: The aim of this presentation is to introduce the ‘4-dimensional (4-D) muscle model” using for surgical planning in a patient with so-called square mandible (SQM). Methods: The present patient was a 23-year old man with SQM. He had suffered from a sever mouth opening restriction without pain for 10 years. Unsuccessful non-surgical treatments, such as mouth-opening exercise, physiotherapy and so on were applied. Based on the CT and MRI findings, TMJ disease and hyperplasia of the coronoid process (bony interference) were denied. Although his symptom was suspected to be attributable of the masseter or temporal muscle disorders, we could not determine which muscles were main causal factors by using conventional examinations. Thus, we tried to detect the contracted muscles with ‘4-D muscle model’ which was constructed from the digital data of 3D-CT and 4-D mandibular movements of the patient. Results: The cause of mouth-opening restriction was suggested to be a contraction of the temporal muscle. Consequently, we performed bilateral coronoidectomy with no surgical intervention for masseter muscle. The limited mouth opening of the range of mandibular motion was remarkably improved up to 48 mm, postoperatively. Conclusion: The present ‘4-D muscle model’ would be valuable tool to decide the target muscle of surgical treatment for SQM. P.157 A case of familial Schwannomatosis H. Konishi1 , M. Dohi1 , K. Suzuki1 , N. Kubota2 , M. Kobayashi1 , Y. Sasakura1 , E. Kubota1 . 1 Department of Oral Maxillofacial Surgery, Kangawa Dental College, 2 Department of Diagnostic Pathology, Kanagawa Dental College, Japan Objective: Schwannomatosis is extremely rare disease, which was recently recognized as the new form of neurofibromatosis (NF). It was distinct from NF1 and NF2 in genetic. We report a case of familial Schwannomatosis. Patient: A 37-year-old female was referred to the department of Oral and Maxillofacial Surgery of Kanagawa Dental College (Yokosuka, Japan), with an asymptomatic swelling of the right floor of mouth in 13th, November, 2006. There was the soft tumor with clear boundary at the right floor of mouth, without an ulcer nor inflammatory findings in the covering mucosa. The MRI examination showed four large lesions with high signal intensity
P.159 A study of odontogenic tumors by the new WHO classification S. Morita, K. Tsuji, S. Matsuda, K. Fukuchi, A. Fukuda, K. Yamada, S. Kinoshita, K. Matsumoto, M. Tabushi, H. Yoshida, T. Iseki. Osaka Dental University, Osaka, Japan We classified and analyzed statistically 192 odontogenic tumors from the files of the First Department of Oral and Maxillofacial Surgery in Osaka Dental University Hospital from April 1994 to March 2006 according to the new WHO histological classification revised in 2005. None of the tumors were malignant. There was no statistical sex predilection; the male-female ratio of the tumors was 1.04:1. The average age of the patients was 40 years, with a range from 7 to 87 years. One hundred twenty-five cases (65.1%) were found between the second and fifth decade of life, with a peak in the third decade (22%). The keratocystic odontogenic tumor (54 cases, 28%) was the most frequent type, followed by ameloblastomas (44 cases, 23%), odontomas (31 cases, 16%), osseous dysplasias (25 cases, 13%) and ossifying fibromas (10 cases, 5%). The maxilla-mandible ratio was 1:3.9. The most frequent area of odontogenic tumors was the posterior mandible (40%) followed by the anterior to posterior mandible (17%).
Oral surgery
S207
in the cranial base, the pharynx, the floor of mouth and the lung, and numerous small ones in the neck and subclavicular region on the T2-weigted images. Biopsy was taken from the lesion of the floor of mouth, and the specimen revealed dominant Antoni type B with scattering Antoni type A. She had an intractable pain in right part of the face, and the tumor in the cranial base could be causing the pain. The tumor in the cranial base was partially removed at the department of neurosurgery, and then the pain was completely disappeared. Histological examination revealed that the lesion was also schwannoma. The tumor of the right floor of mouth was removed under general anesthesia three month after the cranial surgery. Conclusions: Since her two aunts and an uncle had multiple schwannomas in several segments of the body without vestibular tumor, this case was considered as familial schwanomatosis from the diagnostic criteria proposed by the National Neurofibromatosis Foundation. P.158 A pedunculated hemangioma of the hard palate
Oral surgery
H. Kitano, H. Ogawa, H. Matsuyama, B. Saito, T. Ueki. Ooyaguchikamichou, Itabashi-ku, Japan
P.156 4-D simulation for “square mandible”: report of a case
Objectives: The hemangioma is common as a benign tumor of the oral cavity. The tongue, lips, and bussal mucous membrane are the most common sites for a hemangioma of the oral cavity. But, it is an extremely rare that a pedunculated hemangioma is appeared of the oral cavity. Methods: We present the case of a 75-year-old female diagnosed with a pedunculated hemangioma of the hard palate. On examination, the tumour was found of situated to the right of the hard palate region. After two months later, the tumour size of 15155 mm was grew up to 2520×10 mm. Magnetic resonance imaging studies of the thoracic spine showed a well-defined intradural mass at the hard palate with a diameter of 25 mm and a length of 20 mm. The signal intensity of the mass relative to the hard palate was isointense on T1 weighted images, hypertense on T2-weighted images, and showed homogeneous, strong enhancement on Gd-DTPA images. Results: The patient underwent excision of the tumour under local anaesthesia. Interestingly, the tumour has a peduncle of leading to the hard palate. On histopathological study, the tumour was found to be consisted of vascular differentiation with small or large vascular channels by thin-walled vessels. The tumour was diagnosed for capillary hemangioma. Conclusions: We reported a pedunculated hemangioma on the hard palate.
K. Nakaoka, Y. Hamada, T. Saito, Y. Shigeta, S. Hirai, T. Ikawa, A. Mishima, T. Ogawa, K. Seto. Tsurumi University, First Department of Oral & Maxillofacial Surgery, Yokohama, Japan Objectives: The aim of this presentation is to introduce the ‘4-dimensional (4-D) muscle model” using for surgical planning in a patient with so-called square mandible (SQM). Methods: The present patient was a 23-year old man with SQM. He had suffered from a sever mouth opening restriction without pain for 10 years. Unsuccessful non-surgical treatments, such as mouth-opening exercise, physiotherapy and so on were applied. Based on the CT and MRI findings, TMJ disease and hyperplasia of the coronoid process (bony interference) were denied. Although his symptom was suspected to be attributable of the masseter or temporal muscle disorders, we could not determine which muscles were main causal factors by using conventional examinations. Thus, we tried to detect the contracted muscles with ‘4-D muscle model’ which was constructed from the digital data of 3D-CT and 4-D mandibular movements of the patient. Results: The cause of mouth-opening restriction was suggested to be a contraction of the temporal muscle. Consequently, we performed bilateral coronoidectomy with no surgical intervention for masseter muscle. The limited mouth opening of the range of mandibular motion was remarkably improved up to 48 mm, postoperatively. Conclusion: The present ‘4-D muscle model’ would be valuable tool to decide the target muscle of surgical treatment for SQM. P.157 A case of familial Schwannomatosis H. Konishi1 , M. Dohi1 , K. Suzuki1 , N. Kubota2 , M. Kobayashi1 , Y. Sasakura1 , E. Kubota1 . 1 Department of Oral Maxillofacial Surgery, Kangawa Dental College, 2 Department of Diagnostic Pathology, Kanagawa Dental College, Japan Objective: Schwannomatosis is extremely rare disease, which was recently recognized as the new form of neurofibromatosis (NF). It was distinct from NF1 and NF2 in genetic. We report a case of familial Schwannomatosis. Patient: A 37-year-old female was referred to the department of Oral and Maxillofacial Surgery of Kanagawa Dental College (Yokosuka, Japan), with an asymptomatic swelling of the right floor of mouth in 13th, November, 2006. There was the soft tumor with clear boundary at the right floor of mouth, without an ulcer nor inflammatory findings in the covering mucosa. The MRI examination showed four large lesions with high signal intensity
P.159 A study of odontogenic tumors by the new WHO classification S. Morita, K. Tsuji, S. Matsuda, K. Fukuchi, A. Fukuda, K. Yamada, S. Kinoshita, K. Matsumoto, M. Tabushi, H. Yoshida, T. Iseki. Osaka Dental University, Osaka, Japan We classified and analyzed statistically 192 odontogenic tumors from the files of the First Department of Oral and Maxillofacial Surgery in Osaka Dental University Hospital from April 1994 to March 2006 according to the new WHO histological classification revised in 2005. None of the tumors were malignant. There was no statistical sex predilection; the male-female ratio of the tumors was 1.04:1. The average age of the patients was 40 years, with a range from 7 to 87 years. One hundred twenty-five cases (65.1%) were found between the second and fifth decade of life, with a peak in the third decade (22%). The keratocystic odontogenic tumor (54 cases, 28%) was the most frequent type, followed by ameloblastomas (44 cases, 23%), odontomas (31 cases, 16%), osseous dysplasias (25 cases, 13%) and ossifying fibromas (10 cases, 5%). The maxilla-mandible ratio was 1:3.9. The most frequent area of odontogenic tumors was the posterior mandible (40%) followed by the anterior to posterior mandible (17%).