Yujiro Handa

Kabuki make-up syndrome (Niikawa-Kuroki syndrome) with cleft lip and palate

Kabuki make-up syndrome (Niikawa-Kuroki syndrome), recognized in Japan in 1981, is characterized by mental and growth retardation with specific craniofacial malformation such as lower palpebral eversion and depressed nasal tip. In this paper we describe a case associated with cleft lip and palate. Attention should be paid by maxillofacial surgeons to this syndrome, since 41% of the cases have been associated with cleft lip and palate (Niikawa et al., 1988; Tonoki and Niikawa, 1988).

The short-term effect of discectomy on the osteoarthrotic temporomandibular joint in sheep

The short-term effect of discectomy on osteoarthrotic joints was tested experimentally in sheep. Bilateral temporomandibular joint (TMJ) osteoarthrosis was induced, and at 3 months discectomy was performed on one joint, with the other being left as a control. Neither masticatory nor mouth-opening disturbances had been found after discectomy. The animals were killed at 6 months, and the TMJs were removed, fixed, and assessed radiologically, macroscopically, and histologically. The control joints showed ongoing degenerative changes consistent with previous reports. The discectomy joints showed marked fibrous repair with joint surface remodelling rather than ongoing degeneration. This result is consistent with the clinical findings after discectomy for osteoarthrotic joints.

The effect of occlusal loss on normal and pathological temporomandibular joints: an animal study

The effect of unilateral posterior malocclusion on temporomandibular joint intra-articular pathology was studied in sheep. In Group I, osteoarthritic changes were induced in the left temporomandibular joint by gentle scraping of the articular surface (Ishimaru and Goss, 1992). Group II had the same procedures as Group I, with concurrent extraction of all the left maxillary posterior teeth. Group III had a different osteoarthritic precondition in the left temporomandibular joint, allowing synovial fluid to contact the condylar marrow (Ishimaru et al., 1992). Group IV had the same procedure as Group III, with concurrent extraction of all the left maxillary posterior teeth. Group V had unilateral maxillary molar teeth extraction in the left side. At 3 months, the animals were sacrificed and the joints examined histologically. There were no significant differences between normal control joints and those with unilateral tooth extraction (Group V). Similarly the degree of osteoarthritic change was the same between Groups I and II. Significant differences (p < 0.05) were seen between Groups III and IV with tooth extraction increasing the osteoarthritic effects. Hence it was concluded that in sheep, malocclusion had no effect on the normal temporomandibular joint and on one type of experimental osteoarthritis, but accelerated osteoarthritic change in another model.

Effect of marrow perforation on the sheep temporomandibular joint

The effect of surgically perforating the mandibular condyle to allow synovial fluid to contact the marrow was examined in 5 sheep temporomandibular joints. The surgical defect showed replacement of the marrow with fibro-osseous tissue and subcortical cysts. A vertical, central osteophyte emerged from the perforation, causing attenuation or perforation of the disc and temporal surface proliferation. These changes were radiographically and histologically similar to advanced osteoarthritis. This supports the concept that intraarticular micro or macrofracture may result in osteoarthritis.

Chondroma of the tongue. Report of a case.

A case of chondroma which occurred in the midline of the dorsum of the tongue in a 40-year-old Japanese male is reported together with a review of the literature. Histological investigation revealed that this lingual chondroma had the characteristics of hyaline cartilage. We regard the metaplastic transformation theory as the best explanation of histogenesis of lingual chondroma at the lateral margin, while cartilaginous rests are the origin of lingual chondroma on the dorsum of the tongue.

Diagnostic accuracy of the ultrathin arthroscope for temporomandibular joint osteoarthrosis: Comparison of arthroscopic and histologic findings in a sheep model

The diagnostic accuracy of the ultrathin arthroscope was evaluated by examination of the superior joint space of the left temporomandibular joint in 20 sheep. At the time of induction of osteoarthrosis all joints were found to be normal. Six months later the arthroscopic examination was repeated and the results compared with the histologic examination. Similar findings were seen in 11 joints (55%), with arthroscopic overdiagnosis in two (10%) and underdiagnosis in seven (35%). Eight of 16 (50%) disc perforations were found. It was concluded that underdiagnosis occurred because the whole joint space cannot be examined arthroscopically and fibrillated tissue masks bone exposure.

The short-term effect of autogenous auricular cartilage graft following discectomy on the osteoarthrotic temporomandibular joint in sheep

The aim of this experimental study was to determine the effect of auricular cartilage graft replacement on the progression of experimentally induced osteoarthrosis in sheep. Bilateral osteoarthrosis was induced in the sheep temporomandibular joint (TMJ). Three months later, discectomy and autogenous auricular cartilage grafting were performed unilaterally. At sacrifice, three months postrepair and six months postinduction of osteoarthrosis, it was found that the untreated side had extensive condylar osteoarthrosis and the grafted side showed evidence of fibrous repair. The graft prevented intra-articular adhesions and reduced degenerative changes, but there was a tendency towards graft perforation. Auricular cartilage grafting was effective in minimizing osteoarthrotic effects on the TMJ in the early stages after grafting.

Short-term effect of fresh disk allograft on the osteoarthrotic sheep temporomandibular joint.

UNLABELLED The aim of this experimental study is to evaluate the effect of fresh disk allograft on the osteoarthrotic temporomandibular joints in four sheep. STUDY DESIGN Bilateral osteoarthrosis was induced in the sheeps temporomandibular joint. Three months later, unilateral diskectomy and fresh disk allograft repair were performed, with the contralateral joint being left as a control. At 6 months after the initial procedure, 3 months after the repair, the four sheep were sacrificed. RESULTS It was found that the operated joint was fibrously repaired without ankylosis, whereas the control joint showed progressive disease. One grafted disk survived, but the other three were perforated and displaced. CONCLUSION Fresh disk allograft does temper progression of the disease in the early stages.

A modification of the sagittal splitting technique: Ensuring that the osteotomy split lies immediately medial to the lateral cortex

A modification of Obwegesers sagittal splitting method for the correction of mandibular prognathism has been developed. The anterior border of the proximal segment is partially removed at the beginning of osteotomy, which is carried out on the immediate inner surface of the lateral cortex. This osteotomy plane just under the lateral cortex, obtained by the use of a thin, disposable reciprocating sawblade, contributed to a lower incidence of postoperative lower lip hypaesthesia in the 14 cases presented.

The platysma myocutaneous flap for oral reconstruction: Experience with MacFee's cervical incision

The present study was performed to demonstrate and evaluate the effectiveness of the Platysma Myocutaneous Flap in conjunction with MacFees cervical incision (MacFee, 1960) for reconstruction after oral cancer excision. Ten squamous cell carcinoma cases were provided for postoperative evaluation of tongue movement and aesthetic problems of the cervical skin. It was found that the thickness of the skin island was adequate for covering the oral defects and was not a hindrance to proper postoperative function. MacFees incision improved the condition of the scar caused by flap elevation. The procedure for preparing the muscle pedicle beneath the cervical skin tunnel was carried out without much difficulty by carefully preparing the surgical field.