[A Case of Cavernous Sinus Metastasis following of the Postoperative Maxillary Gingival Carcinoma].

We report a case of cavernous sinus metastasis following postoperative maxillary gingival squamous cell carcinoma. An 83-year-old man was referred to our hospital due to pain in the left maxillary gingiva. Contrast-enhanced computed tomography imaging showed a mass lesion with bone destruction in the left maxillary gingiva. Biopsy indicated the presence of squamous cell carcinoma(T4bN1M0, Stage ⅣB), and the tumor was resected under general anesthesia. Four months after surgery, the patient experienced headache, and orbital pain, failing vision, and movement disorder of the left eye appeared. Magnetic resonance imaging revealed a tumor invading the cavernous sinus and orbit. The lesion was clinically diagnosed as metastatic cavernous sinus following postoperative left maxillary gingival carcinoma. Although the patient underwent chemotherapy, he died from multiple organ failure about 5 months after surgery.

[Mass Screening of Oral Cancer in Eastern Shimane Prefecture during 2015-2019].

The Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, has been conducting mass screening of oral cancer using oral abrasion cytology by oral surgeons in eastern Shimane prefecture for public awareness and its early detection. As a result, 3(0.09%)cases of oral cancer were identified. Case 1: The patient was diagnosed with well-differentiated squamous cell carcinoma in the floor of the mouth(pT1N0M0, Stage Ⅰ)after undergoing Matsue city oral cancer screening in 2016. Case 2: The patient underwent oral cancer screening in Izumo city in 2018 and was diagnosed with verrucous carcinoma in the back of the tongue(pT1N0M0, Stage Ⅰ). Case 3: The patient was diagnosed with highly differentiated squamous cell carcinoma of the palate(pT1N0M0, Stage Ⅰ)after undergoing the Izumo city oral cancer screening in 2019. Awareness of oral cancer is important, and cancer screening by oral surgeons using cytology is highly useful and should be continued in the future.

[A Case of Treatment Applicable to Squamous Cell Carcinoma of the Tongue by Mass Screening Examination of Oral Cancer in Western Part of the Shimane Prefecture].

Radical excision, a common oral cancer treatment, produces variable postoperative results depending on the specialized tissues involved and the extent of the cancer. Furthermore, the material selected for reconstruction also influences functional outcomes. Oral dysfunction due to postoperative tissue loss is more common with advanced cancer; therefore, early detection and treatment are important. To improve oral cancer awareness and early detection, mass oral cancer screenings led by maxillofacial surgeons in cooperation with the Shimane prefecture and local dental associations were conducted. We describe the mass screening methods and describe a case of tongue cancer that was detected and treated as a result of our screening efforts.

Expression of aquaporin 3 and 5 as a potential marker for distinguishing dry mouth from Sjögren's syndrome.

A study was performed to investigate whether expression of aquaporin (AQP) 3 and 5 has potential as a marker for distinguishing dry mouth from Sjögren's syndrome. Twenty-five patients underwent labial minor salivary gland biopsy (dry mouth, n = 9; Sjögren's syndrome, n = 16; control, n = 8). All patients were interviewed about their medical history and subjective oral symptoms, and intraoral examinations were conducted. Quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry were used to examine the expression and localization of AQP3 and 5. Significant differences in oral dryness, dry eye, medical history, and Saxon test results were revealed among the groups. However, there were no significant inter-group differences in expression of mRNA for AQP3 and 5. Immunohistochemical staining for AQP3 was localized mainly in the basolateral and part of the ductal cell membrane, and was barely evident in the apical membrane of acinar cells. AQP5 was localized to the basolateral and apical membrane and cytoplasm, but not the ductal cell membrane. Staining intensity for AQP3 in the apical membrane was significantly stronger in Sjögren's syndrome, and that for AQP5 was significantly weaker in dry mouth. Taken together, the present data suggest that expression of AQP3 and 5 may be a marker for distinguishing between patients with dry mouth and those with Sjögren's syndrome.

Fracture of the Clavicle following Radical Neck Dissection and Reconstruction Using Pectoralis Major Myocutaneous Flap Accompanied by Postoperative Radiotherapy.

Fracture of the clavicle following radical neck dissection (RND) and/or radiotherapy is a rare complication. Several causes of fracture of the clavicle after treatment of head and neck cancer were postulated in previous reports. We present a case of fracture of the clavicle after treatment of squamous cell carcinoma of the tongue. An 81-year-old Japanese woman underwent RND, subtotal glossectomy, reconstruction using a pectoralis major myocutaneous flap (PMMCF), and postoperative radiotherapy (50.4 Gy). One month after the primary treatment, fracture of the clavicle occurred. It was thought that muscular dynamic factor and reduction of blood supply in the clavicle associated with RND and PMMCF were the causes of the fracture. We have to recognize the occurrence of this complication and try to reduce the factors related to the complication.

Rapid Deterioration of Basic Life Support Skills in Dentists With Basic Life Support Healthcare Provider.

The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.