Faculty Profiles - HASHIKAWA Kazunobu

Comparison between primary closure and skin grafts of the free fibula osteocutaneous flap donor site Reviewed

レックリングハウゼン病の下眼瞼外反に対し耳介軟骨移植とCaraji anchor suture systemで吊上げを行った1例

高須啓之, 橋川和信, Nomura Tadashi, 寺師浩人

日本頭蓋顎顔面外科学会誌 Vol. 32 ( 3号 ) page： 213 2016.10

骨盤内臓全摘術後に有茎大網弁及び遊離広背筋皮弁充填術を施行した一例

北川敬之, Nomura Tadashi, 橋川和信, 寺師浩人, 山下公大

日本形成外科学会会誌 Vol. 36 ( 10号 ) page： 533 2016.10

Masaya Akashi, Kazunobu Hashikawa, Hiroyuki Takasu, Kazuhiro Watanabe, Junya Kusumoto, Akiko Sakakibara, Takumi Hasegawa, Tsutomu Minamikawa, Takahide Komori

Oral and Maxillofacial Surgery Vol. 20 ( 3 ) page： 233 - 7 2016.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Verlag

Purpose: This study aimed to compare the size of skin paddles, the postoperative course, and donor site complications between primary closure and skin grafts of the free fibula flap donor site. Methods: Thirty-five consecutive patients were enrolled. Medical records were retrospectively reviewed for risk factors for delayed healing, size of skin paddles, time to resumption of gait with a mobility aid and self-ambulation, early donor site morbidity, and late donor site complaints. Results: The harvested skin paddles were significantly wider in the skin graft group than in the primary closure group (P = 0.02), with no difference in length (P = 0.1). The difference in time to resuming gait with a mobility aid was also significant (P = 0.01), but not the time to self-ambulation (P = 0.9). Two early donor site morbidities (5.7 %) and 12 late donor site complaints (34.3 %) were found. No significant difference in the incidence of early donor site morbidity was observed between two groups. Occurrence of late donor site complaints was not affected by any risk factors. Conclusions: The width of the harvested skin paddle, but not the length, is one of factors involved in donor site closure. Resumption of gait with a mobility aid, but not self-ambulation, may be delayed in skin graft patients.

DOI： 10.1007/s10006-016-0556-3

The usefulness of a surgical suture attached with a straight needle in lymphaticovenous anastomosis

治療抵抗性毛細血管奇形に対するパルス可変式色素レーザー・Nd:YAGレーザー併用療法の検討

Nomura Tadashi, 江尻浩隆, 榊原俊介, 柳英之, 武川力, 辻依子, 田原真也, 橋川和信, 寺師浩人

日本レーザー医学会誌 Vol. 37 ( 3号 ) page： 366 2016.9

Hashikawa K.

Japanese Journal of Plastic Surgery Vol. 59 ( 8 ) page： 819 - 825 2016.8

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Recent advances in microsurgery have enabled surgical anastomosis of small vessels with calibers less than 1 mm. An anastomosis of a small vein and a lymphatic vessel, lymphaticovenous anastomosis (LVA), is an effective surgical treatment for lymphedema. However, because of the particularities of lymphatic vessels such as their small caliber and thin vessel wall, LVA is a difficult treatment to perform. This report presents the usefulness of a surgical suture attached with a straight needle in LVA. Fifty cases where LVAs were carried out with the technique were retrospectively reviewed based on technical viewpoints with medical records including operative reports and videos. The gages of threads used in the procedure were 11-0 and 12-0, and all were made of monofilament nylon. The diameters of the needles were 40um, 50um, 60um and 80um. and the lengths of needles were 3 mm, 4 mm and 5 mm. The calibers of the anastomosed lymphatic vessels were 0.2 mm to 1.0 mm. Both end-to-end and end-to-side anastomoses were performed. All the patients developed no postoperative complications related to the procedure. The review of the cases showed: (1) a back-wall first technique was useful for the anastomosis of vessels with calibers of less than 1 mm; (2) a straight needle was useful for a posterior vessel wall; (3) in particular, direction was easy to control when stabbing a vessel wall with a straight needle; (4) an anterior wall was difficult to stab with a straight needle when the wall was very thick, which was much less frequent in LVA. Some technical refinements are necessary for a reliable procedure in lymphatic microsurgery. The combination of a usual back-wall first technique and a straight needle is an effective alternative in LVA.

Four-dimensional computed tomography evaluation of jaw movement following mandibular reconstruction: A pilot study Reviewed

Masaya Akashi, Yasuyuki Shibuya, Satoru Takahashi, Kazunobu Hashikawa, Takumi Hasegawa, Yasumasa Kakei, Noriyuki Negi, Toshinori Sekitani, Takahide Komori

Journal of Cranio-Maxillofacial Surgery Vol. 44 ( 5 ) page： 637 - 641 2016.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Churchill Livingstone

Purpose The purpose of this study was to analyze jaw movement during mastication in patients who underwent mandibular reconstruction following segmental mandibulectomy, including mouth opening and mastication time, based on four-dimensional computed tomography (4D CT) images. Material and methods This study included six surgical patients, who underwent segmental mandibulectomy and simultaneous reconstruction with a free fibula osteocutaneous flap, and four controls. 4D CT was performed during mastication of a cookie to evaluate the movement of the jaw during natural function. The maximum mouth opening, mastication time, and movement of the mandibular angle during mastication were evaluated from the 4D CT images. Results 4D CT images enabled visualization of jaw movement during mastication. When compared with the controls, the maximum mouth opening during mastication and excursion of the mandibular angle, especially on the diseased side, tended to decrease in surgical patients
however, this did not occur with mastication time. The numerical differences between the diseased and nondiseased side in surgical patients tended to be higher than the crosswise differences in controls. Conclusion 4D CT images revealed differences in jaw function between patients who underwent mandibular reconstruction and controls. 4D CT could be used to evaluate postoperative outcomes following mandibular reconstruction.

DOI： 10.1016/j.jcms.2016.01.027

Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone. Reviewed International journal

Hirotaka Shinomiya, Shingo Hasegawa, Daisuke Yamashita, Yasuo Ejima, Yoshida Kenji, Naoki Otsuki, Naomi Kiyota, Shunsuke Sakakibara, Tadashi Nomura, Kazunobu Hashikawa, Eiji Kohmura, Ryohei Sasaki, Ken-Ichi Nibu

Head & neck Vol. 38 page： E949 - E953 2016.4

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

BACKGROUND: The purpose of this study was to analyze outcomes for the treatment of locally advanced temporal bone cancer by means of concomitant chemoradiotherapy (CCRT) with a combination of cisplatin (CDDP), 5-fluorouracil (5-FU), and docetaxel (TPF). METHODS: Between 2006 and 2011, 34 patients with squamous cell carcinoma of the temporal bone were treated at Kobe University Hospital. Medical records were retrospectively reviewed to obtain information concerning patient characteristics, extent of disease, treatment, adverse events, and oncologic results. RESULTS: Ten patients were treated with CCRT using TPF regimen. The 5-year overall survival rate and disease-free survival rate were both 60%. Of special interest is that even for patients with unresectable T4 disease, the 5-year overall survival rate was 56%. CONCLUSION: The results of our study indicate that CCRT with TPF for locally advanced temporal bone cancer is an effective and promising regimen. © 2015 Wiley Periodicals, Inc. Head Neck 38: E949-E953, 2016.

DOI： 10.1002/hed.24133

A comparison of radial forearm free-flap reconstruction and non-reconstruction after partial maxillectomy. Reviewed

創内持続陰圧洗浄療法を用いた下腿コンパートメント症候群後皮膚潰瘍の治療

高須啓之, 森脇綾, 橋川和信, Nomura Tadashi, 寺師浩人

日本形成外科学会会誌 Vol. 36 ( 3号 ) page： 144 2016.3

A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography Reviewed

OkumuraK, Hashikawa Kazunobu, SakakibaraS, OnishiH, Terashi Hiroto

Eplasty Vol. 16 page： e11 2016.2

A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography.

Okumura K, Hashikawa K, Sakakibara S, Onishi H, Terashi H

Eplasty Vol. 16 page： e11 2016

Akashi M, Shibuya Y, Takahashi Y, Kusumoto J, Sakakibara A, Hasegawa T, Minamikawa T, Hashikawa K, Komori T

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. Vol. 28 ( 2 ) page： 111 - 117 2016

常勤形成外科医不在施設における乳房一次再建症例の検討 Reviewed

Nomura Tadashi, 榊原俊介, 西藤勝, 河野範男, 橋川和信, 寺師浩人

Oncoplastic Breast Surgery Vol. 1 ( 2 ) page： 1 - 6 2016

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Oncoplastic Breast Surgery Society

<p>　In this article, we present data on immediate breast reconstruction at two hospitals without a full-time plastic surgeon, performing a retrospective chart review of patients. A reconstructive surgeon performed physical examinations on all patients and obtained their informed consent preoperatively. We explained to the patients about the limitations of reconstructive methods, for example, that free deep inferior epigastric artery flap transfer and primary silicone breast implant reconstruction were unavailable. From October 2012 to January 2016, we performed 30 immediate breast reconstructions (28 patients, 30 sites) in these hospitals ; 19 sites with autologous breast reconstruction by pedicled flap (latissimus dorsi musculocutaneous flap 18, rectus abdominis musculocutaneous flap 1) and, 11 sites (9 patients) with the tissue expander. The average length from consulting a plastic surgeon to the operation date was 26.0±14.9 days. As reconstructive methods are limited in our collaborations, this limitation was explained to the patients. Therefore, it was necessary for the reconstructive surgeon to perform a physical examination preoperatively.</p>

DOI： 10.20699/jopbs.1.2_82

CiNii Research

"Sensory switching" in elbow reconstruction Reviewed

Shunsuke Sakakibara, Kazunobu Hashikawa, Hiroto Terashi

Journal of Brachial Plexus and Peripheral Nerve Injury Vol. 10 ( 1 ) page： e30 - e33 2015.12

Language：English Publishing type：Research paper (scientific journal) Publisher：BioMed Central Ltd.

In the treatment of the soft tissue defect of the elbow, flap reconstruction is necessitated in many cases because of thinness of soft tissue at this region. In addition, reacquirement of tactile sensation is desirable because of the anatomical and specific functions of the elbow. Of three cases treated for elbow defects, one was reconstructed with a pedicled island forearm flap containing the lateral cutaneous nerve of the forearm, another was reconstructed with a venoneuro-accompanying artery fasciocutaneous flap (VNAF flap) containing the basilic vein, and the third with the VNAF flap containing the cephalic vein. The three cases demonstrated a sudden change of sensory territory 4 to 6 months after surgery, which was confirmed by touching the reconstructed region with patients' eye-closed: from its original territory to the elbow in a "switching"-like action. Here we describe and discuss the concept of "sensory switching".

DOI： 10.1055/s-0035-1549369

CT Evaluation of Morphology of Transferred Fibula for Implant Placement in Reconstructed Mandible Reviewed

Masaya Akashi, Yasuyuki Shibuya, Satoshi Wanifuchi, Junya Kusumoto, Akiko Sakakibara, Akira Kimoto, Takumi Hasegawa, Hiroaki Suzuki, Kazunobu Hashikawa, Takahide Komori

IMPLANT DENTISTRY Vol. 24 ( 5 ) page： 541 - 546 2015.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background:Dental rehabilitation with osseointegrated implants in reconstructed mandibles remains one of the most challenging procedures for oral and maxillofacial surgeons. Satisfactory outcome requires appropriate assessment of graft morphology. There are few analyses of the morphology of fibulae in reconstructed mandibles, although cadaver studies on fibular shape have been performed.Materials and Methods:In this study, we used postoperative computed tomography to retrospectively evaluate the shape, height, and orientation of fibulae transferred after mandibulectomy in 19 patients.Results:The average height of transferred fibulae was 14.3 mm (range, 10.8-20.5 mm). The cross-sectional morphology of transferred fibulae could be classified into 2 types: apex and nonapex. The former type included knife-edged and triangular shapes; the latter included square and circular shapes.Conclusion:When implant insertion is planned in a reconstructed mandible, the orientation of the apex of transferred fibula should be evaluated preoperatively to allow for adjustments in implant procedure because the ridge at the apex of the fibula is narrow.

DOI： 10.1097/ID.0000000000000290

Sequential evaluation for bone union of transferred fibula flaps in reconstructed mandibles: panoramic X-ray versus computed tomography Reviewed

難治性下腿潰瘍の1例

北川敬之, Nomura Tadashi, 橋川和信, 寺師浩人, 柳沢曜

日本形成外科学会会誌 Vol. 35 ( 10号 ) page： 626 2015.10

M. Akashi, K. Hashikawa, Y. Kakei, A. Sakakibara, T. Hasegawa, T. Minamikawa, T. Komori

INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY Vol. 44 ( 8 ) page： 942 - 947 2015.8

Language：English Publishing type：Research paper (scientific journal) Publisher：CHURCHILL LIVINGSTONE

The purpose of this study was to sequentially evaluate bone union of fibular grafts in mandibular reconstruction. Patients who underwent routine follow-up computed tomography (CT) and panoramic X-ray imaging during a period of >= 2 years were enrolled. On panoramic X-ray images, bone union was scored as 0 (absent callus formation) or 1 (complete callus formation). On CT images, a scale of 0 to 2 was used (0, absent callus formation; 1, complete callus formation only on the labial side; 2, complete callus formation on both the labial and lingual side). A total of 56 bone junctions were evaluated in 20 patients. Five of 56 junctions (9%) in four of 20 patients (20%) showed radiological non-union (panoramic X-ray score = 0, CT score = 0 or 1) at 2 years after surgery. All bone junctions with radiological nonunion were located at the mandibular angle. No categorical values, including diabetes mellitus and radiation therapy, were significantly associated with radiological non-union. In conclusion, assessing at least two sides (i.e. labial and lingual sides) on CT images is adequate to evaluate bone union in transferred fibula flaps. Careful fixation at the mandibular angle may improve the rate of bone union.

DOI： 10.1016/j.ijom.2015.04.014

Does Salivary Duct Repositioning Prevent Complications After Tumor Resection or Salivary Gland Surgery? Reviewed

Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report Reviewed

SakakibaraS, TokiyoshiT, Hashikawa Kazunobu, Terashi Hiroto

Eplasty Vol. 15 page： e23 2015.6

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

JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY Vol. 73 ( 5 ) page： 1003 - 1007 2015.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

Purpose: Tissue that is resected for the treatment of oral tumors often includes salivary gland ducts. At their institution, the authors conserve and transfer as much of the salivary duct as possible during these procedures to avoid obstructive complications. Differentiating these obstructive complications from a metastatic node can be challenging and can confound subsequent oncologic management. This study compared and examined the effectiveness of salivary duct repositioning in decreasing the incidence of obstructive complications.
Materials and Methods: Cases of oromandibular disease treated with salivary duct resection at Kobe University Graduate School of Medicine from 2008 to 2013 were retrospectively analyzed. Thirty-two cases (25 patients) of Wharton duct resection and 31 cases (31 patients) of Stensen duct resection were included. The incidence of complications after salivary duct repositioning, duct ligation, and retention of the sublingual gland around the Wharton duct was compared.
Results: Wharton ducts were repositioned in 30 cases and ligated in 2 cases. Complications, including oral swelling at the Wharton duct, were observed in 5 cases of repositioning and 2 cases of ligation. Stensen ducts were repositioned in 9 cases and ligated in 22 cases. The only complication reported was a single case of salivary fistula after ligation.
Conclusions: Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct. (c) 2015 American Association of Oral and Maxillofacial Surgeons

DOI： 10.1016/j.joms.2014.12.006