Faculty Profiles - HASHIKAWA Kazunobu

Bacterial Colonization of the Condyle in Patients with Advanced Mandibular Osteoradionecrosis: Analysis of Hemimandibulectomy Specimens. Reviewed

Takeda D, Hashikawa K, Shigeoka M, Kanzawa M, Yatagai N, Arimoto S, Kusumoto J, Hasegawa T, Terashi H, Akashi M

International journal of dentistry Vol. 2021 page： 9998397 2021

Language：English Publishing type：Research paper (scientific journal)

Advanced mandibular osteoradionecrosis (ORN) sometimes requires extended resection (e.g., hemimandibulectomy). Bacterial infection contributes to ORN pathogenesis. To control infection and determine the extent of debridement required, an understanding of bacterial spread within sites of mandibular ORN is important. The current study used a histopathological approach to assess bacterial colonization in the mandibular condyle and elucidate possible paths of bacterial spread towards the mandibular condyle. Four hemimandibulectomy specimens were selected. Areas of bone destruction were macroscopically assessed and confirmed using hematoxylin and eosin staining. Bacterial presence within mandibular condyle was confirmed with Gram staining. Bone exposure was observed in the molar area in all specimens. Macroscopic bone destruction was apparent especially near the medial side of the cortical wall. Gram staining revealed bacterial colonization of the mandibular condyle in three of the four specimens. In conclusion, bacteria tended to spread posteriorly and through the medial side of the mandibular cortical wall. In patients with advanced ORN, the potential for bacterial colonization of the mandibular condyle should be considered during treatment.

DOI： 10.1155/2021/9998397

Treatment of orbital blowout fracture using a customized rigid carrier

Osaki Takeo, Tamura Ryosuke, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY Vol. 48 ( 11 ) page： 1052 - 1056 2020.11

Language：Japanese Publisher：Journal of Cranio-Maxillofacial Surgery

Purpose: This study aimed to examine the usefulness of treating orbital blowout fracture using a customized rigid carrier. Material and methods: Patients who underwent surgery for orbital blowout fractures in our department from April 2016 to March 2019 were recruited in the study. We molded a rigid thermoplastic material into the same shape as the reconstruction material according to the 3D model and transplanted it into the orbital space along with the reconstruction material. We assessed Hertel exophthalmometry, awareness of diplopia, and the Hess area ratio (HAR%). Results: We performed this procedure in 15 patients with blowout fractures. Reconstruction materials used were iliac bone, absorbable plates, and titanium mesh in 12, 2, and 1 patient, respectively. None of the patients showed a difference of more than 2 mm on Hertel exophthalmometry. Only one patient had diplopia after surgery. The average preoperative and postoperative HAR% were 83.1 and 90.6, respectively. HAR% was more than 85% in 6 of 7 postoperative cases. Conclusions: This method can be applied for surgery using various reconstructive materials and can be a useful method, especially in patients with a wide range of orbital bone defects.

DOI： 10.1016/j.jcms.2020.09.002

Analysis of Orbital Morphology and its Relationship With Eyelid Morphology

Osaki Takeo, Murakami Hidetaka, Tamura Ryosuke, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

JOURNAL OF CRANIOFACIAL SURGERY Vol. 31 ( 7 ) page： 1875 - 1878 2020.10

Language：Japanese Publisher：Journal of Craniofacial Surgery

Correct anatomical reconstruction of the orbital wall for function and cosmesis is important; however, this is difficult because of the structure’s complexity. The authors aimed to analyze and classify orbital morphology from computed tomography (CT) images and examine the relationship between orbital morphology and eyelid morphology in the Japanese population. CT images of 60 men (right side, 29; left side, 31) and 44 women (each side, 22) were included. The lengths of the orbital medial wall and floor in the coronal plane at the anterior, middle, and posterior planes of the orbit; angle between them; simotic index; and the thickness of upper eyelid were measured. Additionally, the presence or absence of double eyelids was evaluated. Non-paired Student’s t test and Pearson correlation coefficient test were used for analysis. Orbital morphology was symmetrical on both sides, and men had a larger orbit than women. Orbital morphology was classified into 2 groups according to the posterior angle, and there was a difference between the groups in the simotic index. The difference between groups may represent a genetic difference between the Jomon and Yayoi people and not only provide a new classification for the orbit of the population but also be useful in orbital reconstruction.

DOI： 10.1097/SCS.0000000000006634

En Bloc Subtotal Temporal Bone Resection in a Case of Advanced Ear Cancer: 2-Dimensional Operative Video

Kimura Hidehito, Taniguchi Masaaki, Shinomiya Hirotaka, Teshima Masanori, Fujita Yuichi, Hashikawa Kazunobu, Nibu Ken-ichi, Kohmura Eiji

OPERATIVE NEUROSURGERY Vol. 19 ( 4 ) page： E402 - E403 2020.10

Use of dermal fat grafts for treating anetoderma with lipoatrophy following involution of hemangiomas

Nomura Tadashi, Nakasone Mika, Okamoto Takako, Ejiri Hirotaka, Osawa Sayuri, Hashikawa Kazunobu, Terashi Hiroto

PEDIATRIC DERMATOLOGY Vol. 37 ( 4 ) page： 776 - 779 2020.7

Language：Japanese Publisher：Pediatric Dermatology

Infantile hemangioma (IH) is a benign vascular tumor that gradually involutes over several years. Rapidly involuting congenital hemangioma (RICH) is the relatively rare congenital vascular tumor that is fully grown at birth and does not undergo postnatal growth and involutes during the first year. However, after involution of both IH and RICH, some have severe sequelae, such as redundant skin or conspicuous scarring, requiring additional treatment. We present the case of a 6-year-old girl with a concave deformity due to subcutaneous atrophy, skin darkening, and altered skin texture of her left zygomatic region following involution of a hemangioma. We successfully treated this patient by transferring a dermal fat graft. This technique can be beneficial for atrophic sequelae after regression of a hemangioma and is easy to perform and cosmetically effective.

DOI： 10.1111/pde.14207

OPN4 belongs to the photosensitive system of the human skin

Kusumoto Junya, Takeo Makoto, Hashikawa Kazunobu, Komori Takahide, Tsuji Takashi, Terashi Hiroto, Sakakibara Shunsuke

GENES TO CELLS Vol. 25 ( 3 ) page： 215 - 225 2020.3

Language：Japanese Publisher：Genes to Cells

The human skin has previously been described to be affected by light; however, the underlying mechanism remains unknown. OPN4 (melanopsin) expression was first identified in the skin of amphibians; however, whether it is also expressed and functioned in the human skin has not yet been identified. Here, we show that OPN4 was expressed in the human skin tissue and cultures of isolated keratinocytes, melanocytes and fibroblasts. Additionally, Ca2+ influx in vitro and ex vivo and phosphorylation of extracellular signal-regulated kinases 1/2 in human fibroblasts were observed by stimulation of blue light irradiation. Notably, our findings showed that this Ca2+ influx and phosphorylation of extracellular signal-regulated kinases 1/2 are promoted in an intensity-dependent manner, indicating that the light signal is converted to an intracellular signal via OPN4 in the human skin. Overall, in this study we showed that the human skin functions as a photoreceptor by demonstrating that in human skin, the photoreceptive protein was expressed, and photoreception was conducted via photoreceptive protein.

DOI： 10.1111/gtc.12751

Effect of size difference between hemiglossectomy and reconstruction flap on oral functions: A retrospective cohort study

Sakakibara Akiko, Kusumoto Junya, Sakakibara Shunsuke, Hasegawa Takumi, Akashi Masaya, Minannikawa Tsutomu, Furudoi Shungo, Hashikawa Kazunobu, Komori Takahide

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY Vol. 72 ( 7 ) page： 1135 - 1141 2019.7

Language：Japanese Publisher：Journal of Plastic, Reconstructive and Aesthetic Surgery

Background and objective: Forearm free flaps are used after hemiglossectomy. However, no investigation has been performed on whether oral functions are better preserved when sizes of the resection and reconstruction flap are exact matches, or whether the size of the resection should be changed. We aimed to retrospectively examine whether size differences between the resection and reconstruction flap affect speech and swallowing functions postoperatively, and to determine whether there are more favorable flap size ratios. Methods: This is a retrospective cohort study of patients undergoing hemiglossectomy using a forearm free flap between 2006 and 2016 at Kobe University Hospital, Japan. The effect of size difference between the resection and reconstruction flap on maintained oral function was assessed. Speech and swallowing functions were assessed, and their correlation with the ratio of the flap size to that of the resected area was determined. With these data, distribution maps of the relationship between the functional level and reconstructed dimension ratio were prepared. The more suitable reconstructed dimension ratio was examined and evaluated. The Fisher exact test, Kruskal–Wallis test, and Scheffe test were used in statistical analyses. Results: Eighty-eight patients underwent hemiglossectomy using a forearm free flap during a 10-year period. Of these cases, 66 patients were included in this study, while 22 were excluded. The ratio of the area of the reconstruction flap to that of the resection site was 0.59–2.79 (median: 1.61). Sixty patients had flaps greater than the resection area, whereas 6 had smaller flaps. Significant differences were found in speech intelligibility and swallowing function when the reconstructed dimension ratio was categorized as follows: ≤1.3, 1.3–1.8, and ≥1.8. Conclusion: Our findings suggest that postoperative deterioration of oral functions after hemiglossectomy could be reduced if reconstruction is performed using a forearm free flap with a surface area 1.3 to 1.8 times greater than that of the resection area.

DOI： 10.1016/j.bjps.2019.03.015

Factors preventing prolonged closed-suction drain placement after immediate breast reconstruction with tissue expanders

Tokiyoshi T., Tsunashima C., Nomura T., Hashikawa K., Terashi H., Kawamura S.

Kobe Journal of Medical Sciences Vol. 65 ( 4 ) page： 132 - 137 2019

Language：Japanese Publisher：Kobe Journal of Medical Sciences

Background: Prolonged drain placement occasionally causes complications such as infection in patients who have undergone implant-based breast reconstruction; therefore, the drainage period must be shortened to avoid complications. Purpose: To identify the factors that prevent prolonged drain placement in patients who have undergone immediate breast reconstruction with tissue expanders. Methods: This was a retrospective medical chart review of all patients who underwent immediate breast reconstruction with tissue expanders at a single center from April 2013 to March 2016. Closed-suction drains were placed in and on the implant pocket. An extra drain was positioned in the axilla in patients undergoing axillary lymph node dissection. The drains were removed at a drainage volume of ≤50 ml per 24 hours. Prolonged drain placement was defined as a period greater than the 75th percentile among all patients. Nine potential risk factors associated with prolonged drain placement were analyzed with multivariate logistic regression analysis. Results: In total, 89 tissue expanders in 89 patients were placed in this study. Prolonged drain placement, determined as ≥9 days (range, 5–14 days), was significantly associated with body mass index ≥25 kg/m2, tissue expander size ≥500 ml, and intraoperative bleeding ≥100 ml, in the multivariate analysis. Axillary lymph node dissection with extra-axillary drainage did not prolong the drainage period. Conclusions: Our findings suggested that placing an extra-axillary closed-suction drain following axillary dissection, and reducing intraoperative bleeding and surgical trauma, could prevent prolonged drain placement in immediate breast reconstruction with tissue expanders.

Mature teratoma treated as lymphatic malformation for 5 years: a case report and literature review

Maruguchi Hayato, Nomura Tadashi, Sasaki Satoru, Hashikawa Kazunobu, Terashi Hiroto

CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY Vol. 6 ( 1 ) page： 63 - 68 2019

Language：English Publisher：Case Reports in Plastic Surgery and Hand Surgery

Teratomas and lymphatic malformations are included in the differential diagnosis of congenital neck masses. They can exhibit similar clinical findings. The authors present a case of mature teratoma that had been managed as a lymphatic malformation for years. Clinicians should be careful not to dismiss clues for the correct diagnosis.

DOI： 10.1080/23320885.2019.1619458

Reverse vascular pedicle digital island flap with preservation of the dorsal branch of the digital nerve

Osaki Takeo, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY Vol. 6 ( 1 ) page： 74 - 78 2019

Language：English Publisher：Case Reports in Plastic Surgery and Hand Surgery

A reverse vascular pedicle digital island flap is a useful treatment option for reconstruction in fingertip amputation. We describe a surgical procedure to preserve the dorsal branch of the digital nerve in the middle phalanx during elevation of this flap with favourable outcomes.

DOI： 10.1080/23320885.2019.1632202

Facial artery musculomucosal flap to close an oroantral fistula

Ohtsuki Yumi, Akashi Masaya, Hashikawa Kazunobu, Komori Takahide

JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY Vol. 30 ( 6 ) page： 492 - 495 2018.11

Language：Japanese Publisher：Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Oroantral fistulas (OAF), which develop as a result of maxillary sinus infection caused by oroantral communication, are sometimes intractable. We present a case of closure with a facial artery musculomucosal flap (FAMM flap) for intractable OAF. A 73-year-old man presenting with an OAF and rhinorrhea was referred to our department. Twenty-eight years earlier, he had undergone bilateral radical surgery for maxillary sinusitis, and six years earlier, he underwent extraction of his right maxillary first and second molars. Six months after the dental extractions, he developed maxillary sinusitis secondary to oroantral communication. Four years after the dental extractions, he underwent endoscopic sinus surgery with closure of the OAF with a rotational pedicled palatal flap, but the OAF recurred. To treat the OAF recurrence, we used a FAMM flap. His postoperative course was good, with no OAF recurrence 6 years after surgery. FAMM flaps are useful to close intractable OAFs.

DOI： 10.1016/j.ajoms.2018.05.001

A comparative study of ethanolamine oleate and polidocanol for sclerotherapy in venous malformations

Kuramoto Y., Nomura T., Ejiri H., Kawakila I., Sakurai A., Hashikawa K., Terashi H.

Japanese Journal of Plastic Surgery Vol. 61 ( 4 ) page： 450 - 456 2018.4

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

For sclerotherapy in venous malformations, three agents, i.e., ethanol, ethanolamine oleate, and polidocanol have been used in Japan. Among these, superiority with regard to outcome and complications has rarely been discussed. Between June 2000 and July 2015, we had 187 patients with venous malformations who were treated by percutaneous sclerotherapy with surfactant sclerosants; we evaluated the efficacy and safety of the therapy retrospectively. Patients were divided into three subgroups depending on the surfactant sclerosants used for treatment: liquid ethanolamine oleate (1-EO group; n=68, 128 sessions), foamy ethanolamine oleate (f-EO group; n=56, 101 sessions), and foamy polidocanol (f-Po group; n=63, 81 sessions). High success rate with excellent and good outcomes were as follows: 71% in the 1-EO group, 65% in the f-EO group, and 78% in the f-Po group. There was no significant difference among the 3 subgroups. Hemoglobinuria occurred in 49 sessions (38%), in 26 sessions (26%), and none, in the 1-EO, f-EO, and f-Po groups, respectively. Thus, less hemoglobinuria was observed with the use of f-Po in comparison with the other two agents. Soft tissue necrosis occurred in 18 sessions (14%), 9 sessions (8%), and 2 sessions (2%) in the 1-EO, f-EO, and f-Po groups, respectively. Therefore, f-Po showed lower incidence of tissue necrosis compared with 1-EO. Since polidocanol demonstrated lower complication rates than ethanolamine oleate, while its efficacy was equivalent to that of the other agents, polidocanol is strongly recommended as a useful surfactant sclerosant for the treatment of venous malformations in Japan.

Usefulness of iliac cancellous bone grafts in orbital fracture surgery

Hashikawa K., Nomura T., Terashi H.

Japanese Journal of Plastic Surgery Vol. 61 ( 1 ) page： 53 - 58 2018.1

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Although various grafts using autogenous bone, autogenous cartilage, and alloplastic substitutes have been used for orbital wall reconstruction in facial fracture surgery, none have proven to be the gold-standard graft material. We have used iliac cancellous bone sheets as graft material in cases of orbital fracture. The iliac cancellous bone graft is considered the most appropriate material for orbital wall reconstruction because it is pliable enough to fit the delicate curve of the orbital wall and soft enough to be cut easily with surgical scissors. Here, we describe the details of our surgical technique for orbital floor reconstruction with iliac cancellous bone. A summary of our procedure for orbital floor fracture repair is as follows : 1. to approach the orbital floor, a subciliary incision is usually used ; 2. the fracture and defect site are exposed subperios-Teally, and the orbital content herniating into the maxillary sinus is carefully repositioned ; 3. a milli-meter-Thick bone block is harvested from the ileum; 4. the harvested block is thinned to a 1-2 mm-Thick cancellous bone sheet with a surgical burr ; 5. the sheet is adequately trimmed with surgical scissors; and 6. the sheet is placed onto the orbital floor to cover the bone defect without fixation.

A case of malignant melanoma in the hallux with popliteal lymph node metastasis

退縮後に摘出術を行った耳下腺乳児血管腫の治療経験 Reviewed

野村正, 橋川和信, 寺師浩人

日本形成外科学会会誌 Vol. 38 page： 652 - 658 2018

KITAGAWA Hiroshi, NOMURA Tadashi, HASHIKAWA Kazunobu, FUJIWARA Susumu, TAJIMA Shoko, NISHIGORI Chikako, TERASHI Hiroto

Skin Cancer Vol. 31 ( 3 ) page： 233 - 237 2017

Language：Japanese Publisher：The Japanese Skin Cancer Society

<p>The present case was of a 67-year-old male patient, who detected a black spot under his left hallux nail plate approximately one year prior to his initial medical examination. Subsequently, the lesion expanded, causing destruction of the nail ; this led the patient to undergo an examination at the department of dermatology at our hospital. Clinical analysis revealed primary malignant melanoma in the left hallux. Based on positron emission tomography-computed tomography results, the patient was suspected to have popliteal and inguinal lymph node metastasis ; he was therefore referred to our department. We performed a primary tumor resection, a sentinel lymph node biopsy, and a popliteal lymph node dissection. The primary tumor had a thickness of 11 mm and had infiltrated the periosteum. The inguinal lymph node biopsy was 1/3 positive (denoting metastasis to superficial inguinal lymph node) and the popliteal lymph node dissection was 1/2 positive (denoting metastasis to deep popliteal lymph node). At a later date, we performed an inguinal lymph node dissection and lymph node metastasis was no longer observed. Invasion of the primary tumor up to the hallux periosteum suggested that the tumor may have metastasized to the deep popliteal lymph node from the periosteum via deep lymphatic vessels. In conclusion, in cases where a primary tumor extends to deep tissues, it is important to consider the possibility of flow to deep lymphatic vessels.[<i>Skin Cancer (Japan)</i> 2016 ; 31 : 233-237]</p>

DOI： 10.5227/skincancer.31.233

CiNii Research

特集 All about頭頸部再建-多彩な皮弁を使いこなす! 扉

橋川和信

耳鼻咽喉科・頭頸部外科 Vol. 87 ( 7 ) page： 455 - 455 2015.6

Fibular osteocutaneous flap

Vol. 87 ( 7 ) page： 508 - 515 2015.6

Neural circuit analysis of axons regenerated by facial-hypoglossal nerve cross-link surgery

Sakakibara Shunsuke, Ishida Yasuhisa, Hashikawa Kazunobu, Terashi Hiroto

REGENERATIVE THERAPY Vol. 1 page： 86 - 90 2015.6

Language：Japanese Publisher：Regenerative Therapy

Introduction: Several methods of nerve reconstruction for facial nerve palsy are known. Although the recently introduced method of "cross-linking" of the facial and hypoglossal nerves with a grafted nerve has proved efficacious, the underlying mechanism is unclear. Methods: In this study, we created an animal model with Wistar rats and analyzed the newly reconstructed neural circuit by anterograde and retrograde neural tracer methods. The saphenous nerve was harvested as a graft, and its double end-to-side neurorrhaphy with the facial and hypoglossal nerves with epineural windows was carried out under the microscope. After an appropriate interval, small amounts of fluoro-ruby or fluoro-emerald were injected into the animals and analyzed 5 days later by fluorescent microscopy (Anterograde experiment: fluoro-ruby into the hypoglossal nucleus at 5 weeks; retrograde experiment: fluoro-ruby into the distal facial nerve sheath and fluoro-emerald into the distal hypoglossal nerve sheath, both at two months.). Results: The labeled axons derived from the hypoglossal nucleus were observed passing through the grafted nerve to the facial nerve. On the other hand, retrogradely labeled neurons were observed at both the hypoglossal and facial nuclei with some double-labeled neurons, suggesting that collateral sprouting had occurred. Conclusions: We suggest that the newly constructed neural circuits we observed are conducive to the treatment of facial nerve palsy.

DOI： 10.1016/j.reth.2015.05.003