Tomoyuki Aomura

Three Case Reports of Synovial Chondromatosis of Temporomandibular Joint: Histopathologic Analyses of Minute Cartilaginous Loose Bodies From Joint Lavage Fluid and Comparison With Phase II and III Cases

0 Synovial chondromatosis (SC) is a benign monoarticular lesion characterized by chondrometaplasia of the synovial membrane with cartilaginous loose bodies often found released into the joint spaces. It is a condition that mainly affects the large joint areas, such as the knee, hip, and elbow, and SC of the temporomandibular joint (TMJ) is rarely seen. The common characteristics of SC of the TMJ include swelling, unilateral pain, occlusal changes, clicking, crepitation, deviation, and limited mandibular function. In he early stages of SC of the TMJ, the cartilaginous odules or loose bodies are often undetectable on lain radiographs. The symptoms are similar to that of emporomandibular disorder (TMD); consequently, any months or years often pass before the correct iagnosis is made. Milgram divided the conditions of SC into 3 separate phases, and each developmental stage was fur-

Cytopathologic diagnosis on joint lavage fluid for patients with temporomandibular joint disorders

Temporomandibular joint (TMJ) disorders (TMD) are usually diagnosed based on the patients clinical findings and the results of image investigations; however, understanding of the inflammatory process in TMJ is difficult. In addition, many of the TMJ disease types share common principal symptoms. Therefore, TMJ diseases in the early stage can be misdiagnosed with TMD. It is hypothesized that cytopathologic examination of the joint lavage fluids is useful in interpreting the TMD‐associated inflammatory process from a cellular aspect. The aim of this study was to assess the TMJ lavage fluid cytopathologically in TMD patients. Thirty‐nine patients, clinically diagnosed as TMD, were included in the present study. Clinical symptoms of the patients were recorded. Forty‐four samples of TMJ lavage fluid were collected and paraffin‐embedded cell sections were made by cell block tissue array method. Cytologic conditions in upper articular cavity of TMJ were cytopathologically diagnosed and were compared with the clinical symptoms of each patient. Cell components were detected in 22 of the 44 analyzed joint lavage fluids. There was a correlation between cytopathologic findings and clinical symptoms. Variety of cytopathology and inflammatory conditions in patients with similar clinical symptoms were also found. The results suggested that cytopathologic examination of the joint lavage fluids from TMD patients is helpful for gaining an understanding of the inner local conditions of TMJ at the cellular level. Diagn. Cytopathol. 2014;42:30–36.

Long-term restoration of masticatory function with fixed mandibular implants in cases of oral cancer.

The results of the present study show that the fixed mandibular implant system enables patients who have operations to treat oral cancer to use a stabilized denture continuously over an extended period of time.

Combined treatment for two advanced carcinomas of the buccal mucosa with local hyperthermia.

頬粘膜進展癌の2例に対し温熱療法を組み入れた集学治療を施行し, 良好な経過を辿っているので報告する。症例1: 61歳, 男性。高分化型扁平上皮癌 (T3N2bM0) で, 治療はPM療法5クール (PEP1回2.5mg計72.5mg, MMC1回10mg計50mg) , 60Co36Gy, 温熱療法を頬部に5回, 頸部に6回, OK-432を総量44.5KE投与し, 左側全頸部郭清, 腫瘍切除, D―P皮弁による頬部全層欠損の即時再建術を施行した。症例2: 69歳男性, 高分化型扁平上皮癌 (T4N2bM0) 。右側浅側頭動脈を用いてCDDP150mg, PEP70mg, 5-FU1回125mg計2000mgを動静注し, 60Co照射を頬部, 頸部にそれぞれ40.5Gy, 60.5Gy併用した。さらに温熱療法を頸部に9回併用し, OK-432を術前に総計40.4KE投与した。1988年6月7日, 右側全頸部郭清, 腫瘍切除, 植皮術を施行した。初診より4年と2年7か月経過した現在、再発・転移なく経過良好である。2例とも重大な合併症も無く, 予定の化学療法, 放射線療法が施行でき, 根治的手術が可能であったことが良好に経過している要因と考えられた。