Fumihiko Matsushita

Mesenchymal Chondrosarcoma of the Mandible

Abstract This report describes a 33-year-old man diagnosed with mesenchymal chondrosarcoma. The patient was referred with a painless, elastic hard mass in the retromolar region. Radiologically, the tumour presented as an expansion of the right mandibular ramus partly extending to the inferior masseter A segmental mandibulectomy was performed during the initial surgery. Histopathologically, the tumour showed well-differentiated hyaline cartilage tissue in the lobules with cartilaginous islands and small cells. Immunohistochemically, the tumour cells reacted positively to clusters of differentiation99 and S-100 protein. The tumour recurred in the right inferior temporal fossa 3 years after the initial surgery. Although radical right maxillectomy and dissection of the inferior temporal fossa were carried out immediately, the patient developed multiple pulmonary metastases after 10 months.

A case study of temporomandibular joint rheumatoid arthritis with perforation into the external auditory meatus

We report a case of temporomandibular joint rheumatoid arthritis with perforation into the external auditory meatus.The patient was 64-year-old man with progressive rheumatoid arthritis, associated with otopyorrhea and difficulty in mouth opening with pain. He had difficulty with the occlusion and was nearly edentulous jaw for a long time. He was also infected with MRSA in inflammatory granulation tissue in the meatus. He was treated with difficulty by an otorhinolaryngologist, who introduced him to our clinic.We first made and applied dentures. Intermaxillary traction was applied by rigidly fixing the denture with an occlusal pivot to the jaw by means of an osseous screw and circumferential wiring. Antibiotics active against MRSA in the granulation tissue were given. After intermaxillary fixation for 2 weeks and intermaxillary elastic traction for the next 2 weeks, the TMJ space was enlarged and the granulation tissue in the meatus disappeard. Epithelialization successfully occurred. We finally attempted occlusal adjustment by raising the bite of the upper and lower dentures.We fortunately treated the case successfully, but long-term observation is necessary.

A Case of Marfan's Syndrome with Mandibular Prognathism

A case of mandibular prognathism with Marfans syndrome treated with sagittal splitting ramus osteotomy was presented.A 37 year-old man, complaining of difficulty of mouth opening was referred to our clinic. The patient was diagnosed as bilateral temporomandibular joints arthrosis with mandibular prognathism.Although occlusal treatment with bite splint was effective to some extent, intermittent trismus did not disappear, so bilateral sagittal splitting ramus osteotomy was performed to correct his dental malocclusion.Postoperative course was not eventful and his range of mouth opening increased to 35mm between incisal edges of maxillary and mandibular central incisor.