Isao Kamiyama

Detecting early oral cancer: narrowband imaging system observation of the oral mucosa microvasculature

The aim of this study was to analyze and describe the intrapapillary capillary loops (IPCL), which are a feature of early oral neoplastic lesions, using a narrowband imaging (NBI) system. Forty-one patients (26 men, 15 women; mean age, 52.34 years; range, 23-83 years) presenting with non-neoplastic or neoplastic lesions, and normal cases, were examined using the prototype Evis Lucera Spectrum (Olympus Co.). The images were analyzed and an IPCL classification was devised. All normal cases (n=10) had regularly distributed capillary loops of the same shape (type I). Non-neoplastic lesions (n=8) had mild changes of the capillary loops (types II and III) and neoplastic lesions (n=23) were irregularly distributed and had several loop shapes (types III and IV). The microvascular organization of non-neoplastic lesions was notably different from that of neoplastic lesions. A brownish area was found in five cases of early carcinoma. The narrowband imaging system is a potential approach for clinically analyzing microvascular organization and IPCL. It could be useful for diagnosing oral squamous cell carcinoma at an earlier stage and for determining the margin of resection.

Experiences in Lingual Nerve Repair Surgery

Objective: To evaluate the clinical usefulness of lingual nerve repair surgery in patients diagnosed with sensory impairment of the lingual nerve after impacted lower molar surgery treated at the Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Japan. Patients and Methods: This prospective study reviewed the cases of 6 patients who were treated between 1998 and 2002. Of 6 patients, 3 underwent lingual nerve repair surgery. These patients were interviewed about their subjective symptoms with regard to their sensory perception, and were subjected to examinations of their sensory threshold values using a Semmes-Weinstein pressure anesthesiometer and taste perception using filter paper disk and whole-mouth methods. Results: Although patients whose lingual nerve had been divided showed almost no postsurgical taste recovery in the filter paper test, sensory perception was found to be on the way to recovery. Further, none of the patients showed deterioration in their condition as compared with their presurgical condition. Conclusion: In case of suspicion of lingual nerve severing or serious nerve injury, immediate nerve repair surgery is recommended.