Hajime Hanaoka

Surgical Treatment for Superior Advanced Maxillary Carcinoma and Reconstruction of the Zygomaticoorbital Floor

In cases of superior advanced maxillary carcinoma, the zygomaticoorbital floor is reconstructed using a rectus abdominis muscle flap or a osteocutaneous scapular flap after a radical maxillectomy including the zygomaticoorbital floor bone. In cases with residual disease in the zygomaticoorbital floor without an invading palatine process after radiotherapy and chemotherapy, we made an effort to keep the palatine process intact and reconstruct the zygomaticoorbital floor using a collagen plate. On the other hand, in cases with residual disease in both the zygomaticoorbital floor and palatine process, we performed a radical maxillectomy and carried out the reconstruction using an osteocutaneous scapular flap combined with a collagen plate. We performed a partial or radical maxillectomy for 8 patients with superior advanced maxillary carcinoma and reconstructed the zygomaticoorbital floor defects using a collagen plate. One was reconstructed by combining a collagen plate with an osteocutaneous scapular flap. By this method we succeeded in preventing eye ball sinking.

A Case of Olfactory Neuroblastoma

A case of olfactory neuroblastoma is reported. A 74-year-old man visited our hospital exhibiting left nasal obstruction and bleeding in May 1997. An examination revealed a large tumor in his left nasal cavity; its surface was smooth and it bled easily. The patient did not have any visual acuity difficulties and the cervical lymph nodes were not swollen. A CT scan revealed a large tumor in his left nasal cavity and maxillary sinus which did not extend into the cranial space or eye socket. There were no bone defects. The patient underwent surgery for an olfactory neuroblastoma in June 1997. Based on the pathological findings, we made a diagnosis of olfactory neuroblastoma. The patient was treated with radiation therapy after surgical therapy. 45 Gy radiation therapy was added. The patient was followed up for 1 year and 6 months. In January 1999, there was local tumor reccurence and the tumor invaded his brain. Unfortunately, he died soon after from this local recurrence of his brain tumor in June 1999.

A Case of Leukoencephalopathy after Drip Infusion of 5-Fluorouracil (5-FU)

A 42-year-old man was admitted due to advanced nasopharynx cancer and administered a total dose of 19250 mg 5-fluorouracil (5-FU). On the fifth day, he exhibited acute consciousness disturbance, and the 5-FU administration was immediately stopped. An MRI revealed a high intensity lesion on the T2weighed image. The brain disease improved gradually. We do not have an effective cure for this disease but it must be detected early.