Faculty Profiles - HASHIKAWA Kazunobu

Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note. Reviewed International journal

Masaya Akashi, Kousuke Matsumoto, Daisuke Takeda, Junya Yamashita, Nanae Yatagai, Kazunobu Hashikawa, Takahide Komori

Dentistry journal Vol. 7 ( 3 ) 2019.9

Language：Japanese

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles.

DOI： 10.3390/dj7030065

Impact of retropharyngeal lymph node dissection in the surgical treatment of hypopharyngeal cancer. Reviewed International journal

Masanori Teshima, Naoki Otsuki, Hirotaka Shinomiya, Naruhiko Morita, Tatsuya Furukawa, Koichi Morimoto, Tetsu Nakamura, Kazunobu Hashikawa, Naomi Kiyota, Ryohei Sasaki, Ken-Ichi Nibu

Head & neck Vol. 41 ( 6 ) page： 1738 - 1744 2019.6

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

OBJECTIVES: To evaluate the impact of retropharyngeal lymph node (RPLN) dissection in the surgical treatment of hypopharyngeal cancer. METHODS: Between 2007 and 2016, 98 previously untreated patients with pathological diagnosed hypopharyngeal squamous cell carcinoma underwent total pharyngolaryngectomy and bilateral neck dissection at Kobe University Hospital. Bilateral dissection of RPLN was simultaneously performed in all patients. Pharynx was reconstructed with free jejunal transfer in 94 patients and primarily closed in 4 patients. Postoperative chemoradiotherapy was performed in patients with high risk factors including metastasis to RPLN, multiple lymph node metastasis, extranodal invasion, and/or positive/close surgical margins. RESULTS: The median follow-up period was 25 months ranging from 1 to 105 months. RPLN adenopathy was preoperatively identified in 9 patients in FDG-positron emission tomography. All of them had pathologically diagnosed RPLN metastases, which had been controlled in all patients during the observation periods. Among the other 89 patients, 7 patients had RPLN metastasis. The 2-year overall survival rates of the patients with and without RPLN metastasis were 65.7% and 69.8% (P = .61), respectively. CONCLUSIONS: In the present study, patients with RPLN metastasis showed equally favorable oncological outcome compared with patients without RPLN metastasis. At least, ipsilateral RPLN dissection should be considered in the surgical treatment of advanced hypopharyngeal cancer and multiple neck lymph node metastasis regardless of primary subsite.

DOI： 10.1002/hed.25608

Long-Term Effects on Volume Change in Musculocutaneous Flaps after Head and Neck Reconstruction

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

JOURNAL OF RECONSTRUCTIVE MICROSURGERY Vol. 35 ( 4 ) page： 235 - 243 2019.5

A Novel Plastic Surgical Technique for Treating Congenital Entropion in Asians. International journal

Takanori Iwayama, Kazunobu Hashikawa, Takeshi Fukumoto

Plastic and reconstructive surgery. Global open Vol. 7 ( 4 ) page： e2122 2019.4

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

Congenital entropion is an ocular condition involving malpositioning of the eyelid, which can result in ocular pain, conjunctival epiphora, or photophobia. Noninvasive treatment is effective in some cases; however, surgical treatment is indicated when keratitis and ocular irritating symptoms occur. There is no consensus regarding the most appropriate surgical technique. Moreover, some patients complain of changes in their appearance or unwanted incision scars after surgery. In particular, individuals with certain types of Asian heritage exhibit a lower eyelid morphology that differs from that of white individuals, caused by orbital fat locational difference. Subciliary muscle bulges cause swelling in the lower eyelid called Namidabuluro and are considered to create a youthful and beautiful appearance in Asians. Accordingly, some Asian individuals tend to be sensitive about changes to the appearance of the lower eyelid. To our knowledge, no report has yet described changes to Namidabukuro during congenital entropion repair in Asians. We describe a novel surgical technique for congenital entropion repair with the creation of cosmetically natural Namidabuluro in an East Asian cohort. The study included 8 lower eyelids of 4 Japanese female patients. Scarring was not noticeable in any of the 4 cases. Eversion of the cilia and the creation of cosmetically natural Namidabuluro were accomplished in all cases. There has been no case of recurrence yet. The novel surgical technique we developed enables not only the treatment of congenital entropion but also the creation of cosmetically acceptable Namidabuluro, resulting in increased patient satisfaction.

DOI： 10.1097/GOX.0000000000002122

Two cases of debulking surgery for lower limb diffuse plexiform neurofibroma with transcatheter arterial embolisation

Two cases of debulking surgery for lower limb diffuse plexiform neurofibroma with transcatheter arterial embolisation Reviewed

Kitano D, Osaki Takeo, Nakasone M, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

Int J Surg Case Rep Vol. 55 page： 132 - 135 2019.1

Kitano Daiki, Osaki Takeo, Nakasone Mika, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS Vol. 55 page： 132 - 135 2019

悪性腫瘍切除後顔面再建のストラテジー－とくに比較的大きな全層欠損について－

橋川和信

Ｓｋｉｎ　Ｃａｎｃｅｒ Vol. 34 ( 2 ) page： 78 - 82 2019

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

丸口勇人, Nomura Tadashi, 町田怜央, 村上英毅, 高須啓之, Hashikawa Kazunobu, 寺師浩人

日本形成外科学会会誌 Vol. 38 ( 12号 ) page： 652 - 658 2018.12

Association between pain severity and clinicohistopathologic findings in the mandibular canal and inferior alveolar nerve of patients with advanced mandibular osteoradionecrosis Reviewed

Yujiro Hiraoka, Masaya Akashi, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Takumi Hasegawa, Kazunobu Hashikawa, Hiroto Terashi, Takahide Komori

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Vol. 126 ( 3 ) page： 264 - 271 2018.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Mosby Inc.

Objective: Pain is one of the most problematic symptoms in patients with osteoradionecrosis of the jaws. This study investigated the associations between pain severity and morphologic alterations of the mandibular canal and inferior alveolar nerve, in respective computerized tomography images and resected specimens of mandibular osteoradionecrosis. Study Design: We assessed 14 lesions in 13 patients who underwent segmental mandibulectomy for surgical debridement and simultaneous reconstruction with free fibula flap (1 patient exhibited bilateral lesions). The extent of the mandibular canal bone defect on preoperative coronal computerized tomography images and the number of inferior alveolar nerve fascicles in resected specimens were evaluated. Comparisons were made between the slight pain and extreme pain groups. In most of the patients in the extreme pain group, either mandibular canal bone defects were absent or entire circumferential defects were present
inferior alveolar nerve fascicles were either distinguishable or completely absent in the resected specimens. Results: Although there was no statistically significant association between extreme pain and computerized tomography or histopathologic findings, the histopathologically indistinguishable inferior alveolar nerve fascicles was significantly associated with slight pain. Conclusions: The degree of degeneration of mandibular canal and inferior alveolar nerve may be associated with pain severity in patients with mandibular osteoradionecrosis.

DOI： 10.1016/j.oooo.2018.03.017

Long-Term Effects on Volume Change in Musculocutaneous Flaps after Head and Neck Reconstruction Reviewed

Sakakibara A, Kusumoto J, Sakakibara S, Hasegawa Takumi, Akashi Masaya, Minamikawa Tsutomu, Furudoi Shungo, Hashikawa Kazunobu, Komori Takahide

J Reconstr Microsurg 2018.9

Complications in Salvage Surgery for Nasal and Paranasal Malignant Tumors Involving the Skull Base. Reviewed International journal

Masanori Teshima, Hirotaka Shinomiya, Naoki Otsuki, Hidehito Kimura, Masaaki Taniguchi, Kazunobu Hashikawa, Eiji Kohmura, Ken-Ichi Nibu

Journal of neurological surgery. Part B, Skull base Vol. 79 ( 3 ) page： 224 - 228 2018.6

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

Objective Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design Retrospective study. Setting Kobe University Hospital. Participants Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor. Prior to skull base surgery, radiotherapy, chemoradiotherapy (CRT), particle radiotherapy, chemotherapy, or surgery were applied in 3, 15, 4, 5, and 3 patients, respectively. Main Outcome Measures Main outcome measures were postoperative complications in patients who underwent skull base surgery after concomitant CRT and/or particle therapy. Results Major postoperative complications were observed in 14 surgical procedures (29%; 2 patients with cerebral herniation, 3 with cerebrospinal fluid leakages, 3 with meningitis, 1 with hydrocephalus, 6 with epidural abscesses, 2 with local infections, and 2 with partial flap necrosis). Four patients developed ≥2 complications. One patient died of postoperative lung infarction. Three (16.7%) of 18 patients without prior treatment and 9 (50%) of 18 patients who underwent preoperative radiotherapy/CRT had severe postoperative complications. Two (50%) of four patients treated with particle radiotherapy had postoperative complications. Conclusions CRT or particle radiotherapy were significantly associated with a high risk of severe postoperative complications after skull base surgery. Meticulous care should be taken in patients treated with radiotherapy/particle therapy prior to skull base surgery.

DOI： 10.1055/s-0037-1606382