Faculty Profiles - HASHIKAWA Kazunobu

Blowing time ratio and high-resolution manometry to evaluate swallowing function of patients with oral and oropharyngeal cancer Reviewed

Komatsu Hirokazu, Furukawa Tatsuya, Iritani Keisuke, Tatehara Shun, Takahashi Miki, Iwaki Shinobu, Kakei Yasumasa, Hasegawa Takumi, Teshima Masanori, Shinomiya Hirotaka, Otsuki Naoki, Hashikawa Kazunobu, Kiyota Naomi, Sasaki Ryohei, Akashi Masaya, Nibu Ken-ichi

AURIS NASUS LARYNX Vol. 49 ( 3 ) page： 477 - 483 2022.6

Analysis of Orbital Blowout Fracture Location and Hess Area Ratio Reviewed

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

JOURNAL OF CRANIOFACIAL SURGERY Vol. 33 ( 4 ) page： 1042 - 1045 2022.6

A Case of a Rare Branching Pattern in the Carotid Artery Reviewed International journal

Sakai A, Hashikawa K, Sakakibara A, Murai N, Nomura T, Akashi M, Terashi H

Eplasty Vol. 22 2022.2

Roles of skull base surgery and particle radiotherapy for orbital malignant tumors involving the skull base Reviewed International journal

Teshima Masanori, Shinomiya Hirotaka, Kimura Hidehito, Hashikawa Kazunobu, Kiyota Naomi, Miyawaki Daisuke, Sasaki Ryohei, Kohmura Eiji, Nibu Ken-ichi

LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY Vol. 6 ( 6 ) page： 1347 - 1352 2021.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Laryngoscope Investigative Otolaryngology

Purpose: To investigate the oncological outcomes of orbital malignant tumors invading the skull base. Methods: A retrospective analysis was conducted on 16 patients with orbital malignant tumors invading the skull base. Eleven patients were treated with skull base surgery, four patients were treated with particle therapies, and one patient was treated with chemoradiotherapy (CRT) as initial treatment. Results: The most frequent histological type was adenoid cystic carcinoma in seven patients, followed by squamous cell carcinoma in two patients. Local recurrence occurred in two of the six surgically treated patients who did not receive postoperative radiotherapy (RT) or CRT. One of them was successfully salvaged by RT, and the other died of disease. With a median follow-up of 24 months, the 2-year overall, local control, and disease-free survival rates of all patients were 82.5%, 87.5%, and 59%, respectively. Conclusions: Patients with positive surgical margins were at risk of local recurrence. Postoperative RT should be considered for all surgically treated patients. Level of Evidence: 4.

DOI： 10.1002/lio2.687

Experimental study on the efficacy of a hybrid artificial nerve: The hot dog method Reviewed International journal

Tamura Ryosuke, Hashikawa Kazunobu, Sakakibara Shunsuke, Osaki Takeo, Kitano Daiki, Maruguchi Hayato, Nomura Tadashi, Sugiyama Daisuke, Terashi Hiroto

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS Vol. 44 ( 10 ) page： 711 - 717 2021.10

Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Artificial Organs

Introduction: We hypothesized that hybrid artificial nerves might overcome the limitations of a nerve conduit by isolating nerve fascicles from autologous nerves. Nerve sacrifice during harvest, a drawback of conventional autologous nerve transplantation, may be reduced by the hot dog method. The hot dog method (based on the morphology of hybrid artificial nerves) adds nerve conduits to autologous nerve fascicles. Methods: Forty-eight rats with a 10-mm sciatic nerve defect were divided into six groups (n = 8 per group) according to the neural reconstruction method: autologous nerve transplantation, the hot dog method, nerve conduit, nerve fascicle transplantation, sham control, and nerve fascicle isolation were classified as Groups I, II, III, IV, V, and VI, respectively. The sciatic nerve function was assessed in these groups, a histological evaluation was performed, and statistical analyses were conducted based on these data. Results: Group III (nerve conduit) and Group IV (nerve fascicle transplantation) showed the lowest functional and axonal regenerative effects, followed by Group II (hot dog method) and Group I (autologous nerve transplantation). Group VI (nerve fascicle isolation) tended to achieve better recovery in motor function and axonal regeneration than Group I (autologous nerve transplantation). Conclusions: The hot dog method is simple, safe, and easy to execute. This method can serve as a new neural reconstruction method that uses artificial nerves.

DOI： 10.1177/03913988211026000

Clinical Evaluation of Unsintered Hydroxyapatite Particles/Poly L-Lactide Composite Device in Craniofacial Surgery Reviewed International journal

Osawa Sayuri, Hashikawa Kazunobu, Naruse Hidemi, Terashi Hiroto

JOURNAL OF CRANIOFACIAL SURGERY Vol. 32 ( 6 ) page： 2148 - 2151 2021.9

Language：English Publishing type：Research paper (scientific journal) Publisher：The Journal of craniofacial surgery

ABSTRACT: A total of 47 patients who underwent the craniofacial implantation of unsintered hydroxyapatite particles and a poly-L-lactide device were evaluated for clinical local findings and computed tomography (CT) images after about 6 months. Long-term follow-up of 3 patients was done from 5 to 11 years. The patients underwent CT imaging pre- and postoperatively, while local clinical examination was done upon follow-up. For the 3 patients who were followed up for more than 5 years, implant changes were evaluated by using CT. Computed tomography revealed 3 patients of dislocation, 2 patients of insufficient bone union, and 3 patients of implant breakage. All patients healed well with no complications requiring a secondary operation. The CT findings of the long-term cases revealed the following: a plate and screw were still present 5 years postsurgery (patient 1), mesh implants were completely resorbed after 9 years and 6 months (patient 2), and plates were almost resorbed after 11 years but some of their shapes remained (patient 3).The unsintered hydroxyapatite/poly-L-lactide device is useful in the maxillofacial region in terms of strength and radiographic contrast. However, since the absorption rate is slow, it is necessary to keep in mind its long-term radiographic detectability and the possibility of late-onset granuloma.

DOI： 10.1097/SCS.0000000000007491

Wire Myography for Continuous Estimation of the Optimal Concentration of Topical Lidocaine as a Vasodilator in Microsurgery Reviewed International journal

Ogawa Haruo, Kusumoto Junya, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto, Sakakibara Shunsuke

JOURNAL OF RECONSTRUCTIVE MICROSURGERY Vol. 37 ( 06 ) page： 541 - 550 2021.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Reconstructive Microsurgery

Background Intraoperative vasospasm during reconstructive microvascular surgery is often unpredictable and may lead to devastating flap loss. Therefore, various vasodilators are used in reconstructive microsurgery to prevent and relieve vasospasm. Lidocaine is a vasodilator commonly used in microvascular surgery. Although many reports have described its in vitro and in vivo concentration-dependent vasodilatory effects, limited studies have examined the pharmacological effects of lidocaine on blood vessels in terms of persistence and titer. Methods In this study, the vasodilatory effect of lidocaine was examined by using the wire myograph system. Abdominal aortas were harvested from female rats, sliced into rings of 1-mm thickness, and mounted in the wire myograph system. Next, 10, 5, 2, and 1% lidocaine solutions were applied to the artery, and the change in vasodilation force, persistence of the force, and time required to reach equilibrium were measured. Results The vasodilatory effect was confirmed in all groups following lidocaine treatment. Although strong vasodilation was observed in the 10% lidocaine group, it was accompanied by irreversible degeneration of the artery. Vasodilation in the 1% lidocaine group was weaker than that in the other groups 500 seconds after lidocaine addition (p < 0.05). Between the 5 and 2% lidocaine groups, 5% lidocaine showed a stronger vasodilatory effect 400 to 600 seconds after lidocaine addition (p < 0.01); however, there was no significant difference in these groups after 700 seconds. Additionally, there was no difference in the time required for the relaxation force to reach equilibrium among the 5, 2, and 1% lidocaine groups. Conclusion Although our study confirmed the dose-dependent vasodilatory effect of lidocaine, 5% lidocaine showed the best vasodilatory effect and continuity with minimal irreversible changes in the arterial tissue.

DOI： 10.1055/s-0040-1722759

Occurrence and Treatment Outcome of Late Complications After Free Fibula Flap Reconstruction for Mandibular Osteoradionecrosis Reviewed International journal

Yamashita Junya, Akashi Masaya, Takeda Daisuke, Kusumoto Junya, Hasegawa Takumi, Hashikawa Kazunobu

CUREUS JOURNAL OF MEDICAL SCIENCE Vol. 13 ( 3 ) page： e13833 2021.3

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

Purpose: This study aimed to evaluate the occurrence and treatment outcome of late complications after free fibula osteocutaneous flap reconstruction for mandibular osteoradionecrosis (ORN).

Methods: We enrolled 15 consecutive patients (14 men, one woman; median age 65 years, range 57-80 years) who underwent free fibula reconstruction for advanced mandibular ORN during 2013-2017 with two or more years of follow-up. Late complications included infection, plate exposure, and recurrence at the resection margin. The effect of perioperative antibiotic administration on late complications was also assessed.

Results: Late complications occurred in 33.3% (5/15) of patients, including two infections (local and distant), two plate exposures, and two recurrences (plate exposure and recurrence occurred in one patient). Perioperative antibiotic administration duration did not significantly affect the occurrence of postoperative late complications. All late complications were treated without problems.

Conclusions: Late complications after ORN reconstructive surgery are not uncommon, but can be treated properly.

DOI： 10.7759/cureus.13833

Perineal reconstruction with pedicled rectus abdominis myocutaneous flap after posterior pelvic exenteration -A 3D model study Reviewed International journal

Kitano Daiki, Osaki Takeo, Sakakibara Shunsuke, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS Vol. 80 page： 105629 2021

Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports

Introduction: Limited literature exists regarding the positional relationship between the pedicled-rectus abdominis myocutaneous (p-RAMC) flap and residual pelvic organs post posterior pelvic exenteration (PPE). Presentation of case: Four patients underwent PPE and reconstruction with a p-RAMC flap. After harvesting the p-RAMC flap with the deep inferior epigastric artery and veins as the vascular pedicle, the intra-pelvic shortest pathway of the flap was created. We dissected the subcutaneous tissues of the flap donor site toward the perineal defect along the inner wall of the pelvis. The pubic origin of the rectus abdominis muscle was preserved. A three-dimensional model was constructed using an image processing software. The vascular pedicle ran almost linearly along the inner wall of the pelvis. The muscle belly was placed on the pelvic floor through the posterior wall of the urinary bladder which filled the dead space of the resected area. All flaps survived without significant complications. Discussion: Assigning the cranial side of the flap to the perineum and caudal side to the pelvic floor could reduce postoperative intrapelvic complications. By preserving the pubic origin of the rectus abdominis muscle, a shock absorber of the pedicle of the flap was created, preventing over-traction of the flap while passing through the intrapelvic pathway. Conclusion: A p-RAMC flap via intra-pelvic shortest pathway is an ideal reconstructive method for large skin defect in perineal area after PPE.

DOI： 10.1016/j.ijscr.2021.02.015

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

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.[Skin Cancer (Japan) 2016 ; 31 : 233-237]

DOI： 10.5227/skincancer.31.233

Fibular osteocutaneous flap

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

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

Use of the Adherent Soft Silicone Dressing for Negative Pressure Wound Therapy

Sakakibara Shunsuke, Osawa Sayuri, Nomura Tadashi, Hashikawa Kazunobu, Terashi Hiroto

Japanese Journal of Surgical Wound Care Vol. 6 ( 4 ) page： 125 - 131 2015

Language：Japanese Publisher：Japan Society for Surgical Wound Care

Negative pressure wound therapy (NPWT) has been introduced as a useful technique for wound treatment. However, some complications have been reported, such as infection, bleeding and pain, which make it impossible for patients to continue further treatment. Air leak is another problem, especially in hairy regions, such as the head and genital area. We have introduced a silicone gel adhesive dressing for NWPT, instead of using the film included in the original kit. The use of the silicone gel adhesive dressing greatly reduces pain, which was occurs when detaching the film. In addition, it plays a role in reducing air leak in hairy regions. Although there remains the problem of its high cost, silicone gel adhesive dressing for NPWT is quite useful.

DOI： 10.11310/jsswc.6.125

顔面基底細胞癌に対する外科治療−特に眼瞼および外鼻について−

野村正, 橋川和信, 寺師浩人

Ｓｋｉｎ　Ｃａｎｃｅｒ Vol. 30 ( 3 ) page： 157 - 162 2015

Contour-specific Foot Reconstruction

NOMURA Tadashi, OSAKI Takeo, ISHINAGI Hiroyoshi, MORIWAKI Aya, TAKASU Hiroyuki, EJIRI Hirotaka, SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, TERASHI Hiroto

Journal of Japanese Society of Reconstructive Microsurgery Vol. 27 ( 3 ) page： 79 - 88 2014

Language：Japanese Publisher：Japanese Society of Reconstructive Microsurgery

The goal for foot reconstruction is to restore the structure and walking function. To achieve this goal, it is important to assess precisely the defects in anatomical structure, residual function, reconstructive procedure, and postoperative therapy, including rehabilitation and fitting of braces or footwear. We experienced twelve free tissue transfers and thirteen pedicle skin flaps for foot reconstruction in our hospital or branch hospitals. In all cases, tailored braces or footwear were used postoperatively under advice from a prosthetist. The free flaps we selected were: one rectus abdominis musculo-cutaneous flap, six latissimus dorsi musculo-cutaneous flaps, three groin flaps, a free scalp flap, and a scapular flap. Two of the patients who underwent free latissimus dorsi musculo-cutaneous transfer had a failed procedure due to vascular thrombus. The pedicled flaps we used were: six distally based sural flaps, five medial plantar flaps, and two lateral calcaneal flaps. Partial flap necrosis was encountered in two of six distally based sural flaps. Ulceration developed in one flap due to bulkiness. As restoring foot contour is ideal for foot reconstruction, we conclude that using thin flaps or thinning of flaps avoids bulkiness. Subsequent footwear fitting is also very important.

DOI： 10.11270/jjsrm.27.79

The Various Flap Monitoring after Free Flap Transfer

SAKAKIBARA Shunsuke, NOMURA Tadashi, TAKASU Hiroyuki, HASHIKAWA Kazunobu, TERASHI Hiroto

Journal of Japanese Society of Reconstructive Microsurgery Vol. 27 ( 3 ) page： 72 - 78 2014

Language：Japanese Publisher：Japanese Society of Reconstructive Microsurgery

The development of microvascular surgery has been contributed the patients' quality of life after the expanded resection of malignant tumor or large tissue defect caused by trauma. On the other hand, vascular complication, such as thrombosis, relates to the flap necrosis and strict monitoring of flap condition is necessitated. We basically monitor the flap every 4 hours for 5 days by inspection or palpation. In addition, we have been introduced blood glucose measurement, regional oxygen saturation index ( rSO2 ), pulse oximeter ( SpO2 ) and indocyanine green fluorescent ( ICG ) imaging for flap auxiliary monitoring. Because each of those methods has advantage and disadvantage, understanding of characteristics of each methods may helps us the earlier detection of vascular trouble, which directly relate to the flap salvage rate.

DOI： 10.11270/jjsrm.27.72

Review of Critical Limb Ischemia Patients Requiring Major Amputations Because of Invasive Infection after Revascularization

Summary of the chairmen

HASEGAWA Kazuki, HASHIKAWA Kazunobu

Journal of Japanese Society of Oral Oncology Vol. 26 ( 3 ) page： 53 - 53 2014

Nishio Yumi, Sakakibara Shunsuke, Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 5 ( 4 ) page： 189 - 193 2014

Language：Japanese Publisher：Japan Society for Surgical Wound Care

In patients with critical limb ischemia ( CLI ) who have an intractable ulcer of the lower limbs, there is a higher level of need for an amputation due to severe infection after revascularization. Three out of the thirteen patients with CLI ended up with major amputations in the past five years. A comparative study was performed between these patients and those who were cured by only minor amputations. Patient factors in the comparative study included age, sex, medical history of diabetes and chronic kidney disease, diabetes medication, history of lower limb amputation on the other side, complement-reactive protein ( CRP ) levels before and after revascularization and in the early period after local surgery, and serum albumin ( Alb ) before local surgery. The patient risk factors of major amputation were late diabetic nephropathy, history of lower limb amputation on the other side and under-nutrition. There was a possibility of major amputations if patients had high CRP levels early after they completed local surgeries compared with those after revascularization. Perioperative CRP levels may be one of the indicators to use in order to avoid major amputations.

DOI： 10.11310/jsswc.5.189

A case of an uncontrollable fistula after incisional drainage of submandibular necrotizing fasciitis treated by Negative Pressure Wound Therapy with a V.A.C.® ATS system

SAKAKIBARA Akiko, SAKAKIBARA Shunsuke, MINAMIKAWA Tsutomu, SHIGETA Takashi, HASHIKAWA Kazunobu, KOMORI Takahide

Japanese Journal of Oral and Maxillofacial Surgery Vol. 60 ( 2 ) page： 71 - 75 2014

Language：Japanese Publisher：Japanese Society of Oral and Maxillofacial Surgeons

Necrotizing fasciitis is treated by incisional drainage or immediate debridement. Generally, an infected wound should not be sutured or closured, but should be allowed to secondarily heal as an open wound. Treatment of necrotizing fasciitis involving the neck or submandibular region requires careful attention to major blood vessels or nerves. We therefore could not perform debridement radically. The wound should be continuously irrigated or applied ointment, but the presence of a fistula sometimes leads to prolonged wound healing. We describe our experience with an uncontrollable fistula attributed to debridement of submandibular necrotizing fasciitis, although irrigation had been continued for 6 weeks. After performing Negative Pressure Wound Therapy, with a V.A.C.® ATS system good granulation tissue proliferated in 3 days, and the fistula disappeared. The wound completely healed in 1 week. Furthermore, the clinical course has been good, with no recurrence of a fistula after 3 months. We report a case of early healing of an uncontrollable fistula treated by a V.A.C.® ATS system.

DOI： 10.5794/jjoms.60.71

CAT classification system and CAT concept for reconstruction of oncological mandibular defects (Review Article)

Hashikawa Kazunobu

Journal of Japanese Society of Oral Oncology Vol. 26 ( 3 ) page： 57 - 62 2014

Language：Japanese Publisher：Japanese Society of Oral Oncology

This article reports a new classification system and a practical theory in surgical reconstruction for segmental mandibular defects after oncological ablative surgery: the "CAT classification system" and the "CAT concept". The CAT classification system classifies a mandibular defect with three letters indicating reference points: "C" signifies loss of the condylar head of the mandible, "A" the mandibular angle and "T" the mental tubercle. For example, the defect is described as "A" when the mandibular angle is segmentally resected, as "CA" when the condylar head and the mandibular angle are resected, as "CAT" when the entire hemi-mandible is resected, as "ATT" when the angle and the bilateral mental tubercle are resected, as "body" when only the mandibular body is resected and the angle and the mental tubercle are preserved, and as "neck" when only the mandibular ramus is resected and the condylar head and the angle are preserved. The CAT concept is a theory that is necessary and sufficient to reconstruct three reference points of the CAT classification system ("C", "A" and "T") in order to reconstruct oncological segmental mandibular defects. Previous studies showed that the CAT system and CAT concept are highly practical and useful in the standardization of mandibular reconstructive surgery.

DOI： 10.5843/jsot.26.57

Clinical Evaluation of Cases with Maxillectomy Reconstructed by Both Free Flap and Dento-maxillary Prosthesis

発症後長期経過した顔面神経不全麻痺例に対するクロスリンク型神経移植術 Reviewed

橋川和信

Facial Nerve Research Vol. 34 page： 32 - 34 2014

顔面神経麻痺再建法における定義ならびに呼称～Fukushima提言～ Reviewed

橋川和信

日形会誌. Vol. 34 page： 783 - 796 2014

KOBAYASHI Masaki, SHIBUYA Yasuyuki, ISHIDA Yu, MINAMIKAWA Tsutomu, YOKOO Satoshi, HASHIKAWA Kazunobu, KOMORI Takahide

Vol. 35 ( 2 ) page： 37 - 45 2012.12

Novel theory for surgical reconstruction of segmental mandibular defect : CAT concept

HASHIKAWA Kazunobu, SUGIYAMA Daisuke, YOKOO Satoshi, TAHARA Shinya

Vol. 38 ( 1 ) page： 84 - 89 2012.4

The Fillet Toe Flap in Toe Amputation

Sakakibara Shunsuke, Terashi Hiroto, Sakurai Sayuri, Hashikawa Kazunobu, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 3 ( 3 ) page： 123 - 128 2012

Language：Japanese Publisher：Japan Society for Surgical Wound Care

Toe amputation for chronic ulcers associated with osteomyelitis or malignant tumor requires additional metatarsal bone resection for covering the stump ; alternatively, the stump is kept raw and skin is grafted after the formation of granulation. The fillet toe flap is one of the options for primary coverage of the stump when the lesion is restricted to half the side of the toe and the digital artery is preserved after the lesion is resected. Minimization of the level of amputation is related to improvements in ADL after surgery. Moreover, because long rest causes disuse atrophy, early healing is desirable. Although the fillet toe flap is used only in special cases, it could be used as a sensory flap. We believe the use of the fillet toe flap deserves more widespread consideration in toe amputation.

DOI： 10.11310/jsswc.3.123

Brow Lift via an Infrabrow Approach for Facial Palsy

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke

Vol. 31 page： 136 - 138 2011.12

True pedicled fibular graft による脛骨遠位骨欠損の再建

高須啓之, 寺師浩人, 橋川和信, 政岡浩輔, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 31 ( 10 ) page： 716 - 720 2011.10

The Elementary Analysis by X-ray Fluorescense : An Examination of Implant on Upper Eyelid

SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, SUGIMOTO Isao, KAJITA Satoru, TAHARA Shinya

Vol. 27 ( 3 ) page： 292 - 296 2011.9

仙尾骨・皮膚全層欠損に対して両側 hatchet 型大殿筋皮弁による再建を行った1例

田村亮介, 牧口貴哉, 橋川和信, 寺師浩人, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 31 ( 1 ) page： 43 - 46 2011.1

Iliac Cancellous Bone Graft for Orbital Floor Reconstruction

Hashikawa Kazunobu, Sakakibara Shunsuke, Terashi Hiroto, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 2 ( 3 ) page： 97 - 103 2011

Language：Japanese Publisher：Japan Society for Surgical Wound Care

Various grafts with autogenous bone, cartilage, and alloplastic substitutes have been used for orbital floor reconstruction in surgery of facial fractures. Nevertheless, none has been the gold standard of graft material. We have demonstrated good clinical results in cases of pure blowout fracture in which the orbital floor was reconstructed with iliac cancellous bone sheets used as graft material. Here, we detail our surgical technique for orbital floor reconstruction with iliac cancellous bone. The outline of our procedure is as follows: 1)to approach the orbital floor, mainly the subciliary incision is used, 2)the orbital content herniating into the maxillary sinus is repositioned, and the fracture and defect site are exposed subperiosteally, 3)a bone block, a few millimeters thick, is harvested from the inner aspect of the ileum, 4)the cortical bone of the harvested block is burred away and thinned to about a 1 mm-thick cancellous bone sheet, 5)the sheet can be adequately trimmed with surgical scissors, 6)the sheet is placed onto the orbital floor to cover the defect, without any fixation. The iliac cancellous bone graft is as pliable and flexible as to fit the delicate curve of the orbital floor, and as soft as to cut easily with surgical scissors. We consider it the most appropriate material for orbital reconstruction.

DOI： 10.11310/jsswc.2.97

Facial-Hypoglossal Nerve Cross-Link Surgery and Subsequent Facial Neuromuscular Retraining for Sequelae of Facial Palsy Reviewed

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke, TAHARA Shinya

Journal of Japanese Society of Reconstructive Microsurgery Vol. 24 ( 3 ) page： 267 - 274 2011

Language：English Publisher：Japanese Society of Reconstructive Microsurgery

Weakness, hypertonicity, loss of isolated control and/or synkinetic movement of the facial mimetic muscle are common sequelae after facial palsy, unlike disruption of nerve continuity as in Bell's palsy or Hunt's syndrome. Here we describe a surgical procedure and postsurgical rehabilitation for the treatment of such sequelae. The surgical procedure comprises facial and hypoglossal nerve cross-linking that connects the nerves by an interpositional nerve graft with end-to-side anastomosis. For postsurgical physical rehabilitation, patients are instructed in the following techniques for facial neuromuscular retraining: 1) to practice isolated facial motion in front of a mirror (mirror-biofeedback technique); 2) to avoid gross voluntary movement both during practice and in daily life; and 3) to frequently massage and stretch the affected facial muscle. Between December 2005 and May 2008, twenty patients with sequelae after facial palsy were treated by our rehabilitation technique. Sixteen patients showed improvement in abnormal facial movement, while four did not. None of the patients developed facial synkinesis associated with tongue motion. Our surgical procedure and postsurgical rehabilitation exercises are alternative techniques for the sequelae of facial palsy.

DOI： 10.11270/jjsrm.24.267

A Dyeing Procedure for the Excision of Congenital Auricular Sinuses

四肢リンパ浮腫に対するリンパ管静脈吻合術 Reviewed

橋川和信

形成外科 Vol. 54 page： 1263 - 1274 2011

顔面神経麻痺後遺症に対する顔面-舌下神経クロスリンク手術と術後リハビリテーション Reviewed

橋川和信

日本マイクロ会誌 Vol. 24 page： 267 - 74 2011

TAMURA Ryosuke, MAKIGUCHI Takaya, HASHIKAWA Kazunobu, SAKAKIBARA Syunsuke, TERASHI Hiroto, TAHARA Shinya

Vol. 26 ( 2 ) page： 81 - 84 2010.6

Trace Elementary Analysis of Fillers and Implants by X-ray Fluorescence

KAJITA Satoru, SAKAKIBARA Shunsuke, SUGIMOTO Isao, HASHIKAWA Kazunobu, TAHARA Shinya

Vol. 30 ( 1 ) page： 1 - 5 2010.1

Facial-Hypoglossal Nerve Cross-Link Surgery for Involuntary Eye Closure with Tongue Movement as a Sequela of Hunt's Syndrome : A Case Report

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke, ISHIDA Yasuhisa

Vol. 29 page： 93 - 96 2010.1

Validity and utility of CAT classification system for oncological mandibular defects A multi-institutional study

Hashikawa Kazunobu, Sugiyama Daisuke, Yokoo Satoshi, Hyodo Ikuo, Motomura Hisashi, Kubo Tateki, Kurita Tomoyuki, Yoshimoto Seiichi, Takushima Akihiko, Yamashita Tetsuro, Sakuraba Minoru, Yagihara Kazuhiro, Nakagawa Masahiro, Yano Tomoyuki, Ishida Katsuhiro, Sakurai Hiroyuki, Terao Yasunobu, Tanaka Katsumi, Kimata Yoshihiro, Tahara Shinya

Toukeibu Gan Vol. 36 ( 3 ) page： 309 - 315 2010

Language：Japanese Publisher：Japan Society for Head and Neck Cancer

Background: We have previously proposed the CAT classification system, a simple and clear-cut system for classifying segmental mandibular defects after oncological surgery: “C” refers to the loss of the condylar head of the mandible, “A” the mandibular angle and “T” the mental tubercle. Here, we report a statistical and mathematical taxonomical study on the validity and utility of the classification system. Methods: Data were collected from 17 medical institutions in Japan on 259 patients who had undergone surgical ablation and simultaneous microsurgical oromandibular reconstruction (osteocutaneous free flap or soft tissue free flap with reconstruction-plate) attributed to head and neck cancer. The mandibular defects were classified according to the CAT system and the two commonly used systems HCL and Urken, and the validity and utility of the CAT system were tested as follows: 1) the tendency among the numbers of the three reference points of the CAT system (C, A and T) and the esthetic outcome of each patient were analyzed by Jonckheere's trend test, 2) each of the classified patterns of the three systems was analyzed by cluster analysis based on the esthetic results using Ward's method. Results: 1) There was a statistically significant trend among the numbers of the three reference points in the CAT system and the esthetic outcome, 2) each of the grouped clusters in the CAT system was clinically explicable and demonstrated a significant difference in the esthetic outcome; the two other systems did not yield such information. Conclusion: The CAT classification system is valid and useful for oncological segmental mandibular defects.

DOI： 10.5981/jjhnc.36.309

Free Flap Transfer for Secondary Deformity of Post-traumatic Anophthalmic Orbit without Eyelid / orbital Bone Defect

Hashikawa Kazunobu, Sakurai Sayuri, Takasu Hiroyuki, Terashi Hiroto, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 1 ( 3 ) page： 119 - 124 2010

Language：Japanese Publisher：Japan Society for Surgical Wound Care

In the treatment of secondary deformities of anophthalmic orbits after severe trauma, free flap transfer is adopted for patients with eyelid and / or orbital rim defects. For some, however, free flap transfer is a requisite although no such defects are present. Here, we retrospectively review cases for which free flap transfer was carried out for secondary deformities of post-traumatic anophthalmic orbits without eyelid / orbital bone defects. From 1999 to 2008, seven patients with secondary deformities of post-traumatic anophthalmic orbits without eyelid or orbital bone defects were treated at Kobe University Hospital. Of the seven, three were treated with free flap transfers: two with a free forearm flap because of the inability to wear an eye prosthesis subsequent to the sudden onset of severe contracture of the eye socket, and one with a denuded DIEP flap for upper eyelid depression attributed to severe lack of and contracture of subcutaneous tissue. Even when the eyelid and the orbital bone are not injured, progressive contraction of the eye socket and severe lack of subcutaneous tissue are indications for free flap transfer in the treatment of secondary deformities of post-traumatic anophthalmic orbits.

DOI： 10.11310/jsswc.1.119

Internal Jugular Vein Thrombosis After Microsurgical Reconstruction in the Head and Neck Region

顔面神経麻痺後遺症に対する顔面-舌下神経クロスリンク手術と術後リハビリテーション Reviewed

橋川和信, 田原真也

日本マイクロ学会会誌 (In press(掲載確定)) 2010

YANAGISAWA Akira, HASHIKAWA Kazunobu, YOKOO Satoshi, TERASHI Hiroto, TAHARA Shinya

Vol. 22 ( 3 ) page： 258 - 265 2009.9

Simple Reconstruction of Subtotal Maxillectomy Defects Using Free Flaps

NOMURA Tadashi, NONOMURA Hideaki, EJIRI Hirotaka, UOZUMI Masaki, HASHIMOTO Dai, HASHIKAWA Kazunobu, TAHARA Shinya

Vol. 25 ( 1 ) page： 60 - 67 2009.3

Surgical Procedures in Static Reconstruction for Facial Palsy Reviewed

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke, ICHINOSE Akihiro

Vol. 28 page： 114 - 119 2009.2

Neural Circuit Analysis with Neural Tracer on Rat Model of Cross-Link Nerve Grafting between Facial and Hypoglossal Nerve

SAKAKIBARA Shunsuke, ISHIDA Yasuhisa, HASHIKAWA Kazunobu

Vol. 28 page： 48 - 50 2009.2

A case of low-grade myofibroblastic sarcoma of the maxilla

MURATA Maho, UMEDA Masahiro, NISHI Chikako, HASHIKAWA Kazunobu, USAMI Yu, KOMORI Takahide

Japanese Journal of Oral and Maxillofacial Surgery Vol. 55 ( 4 ) page： 184 - 188 2009

Language：Japanese Publisher：Japanese Society of Oral and Maxillofacial Surgeons

Low-grade myofibroblastic sarcoma is an uncommon neoplasm of atypical myofibroblasts with fibromatosis-like features. The lesion has only been characterized in the last two decades, and the concept of neoplastic myofibroblasts remains controversial. We encountered a patient with low-grade myofibroblastic sarcoma of the maxilla. A 70-year-old woman was referred to our hospital because of swelling of the anterior maxilla. She had undergone repeated surgical procedures of the lesion at other hospitals. The tumor invaded the hard palate, nasal cavity, bilateral maxillary sinus, and cheek skin. The biopsy specimen showed a low-grade myofibroblastic sarcoma, and she underwent wide resection of the lesion and reconstructive surgery using a free forearm flap. Histologic examination revealed diffuse, fascicular proliferation of spindle cells with focal cellular atypia. The tumor cells showed positive reactions for α-SMA and vimentin, which indicated differentiation to myofibroblasts, and the lesion was diagnosed as a low-grade myofibroblastic sarcoma. The patient is free from tumor 13 months after surgery.

DOI： 10.5794/jjoms.55.184

Cross-sectional analysis of Quality-of-Life of patients undergoing reconstructive surgery for tongue cancer

Yoshimoto Seiichi, Kimata Yasuhiro, Kurita Tomoyuki, Hashikawa Kazunobu, Ishida Katsudai, Sakuraba Minoru, Sakurai Hiroyuki, Tanaka Katsumi, Yano Tomoyuki, Hyodo Ikuo

Toukeibu Gan Vol. 35 ( 4 ) page： 374 - 379 2009

Language：Japanese Publisher：Japan Society for Head and Neck Cancer

Organs with important functions for daily life are concentrated in the head and neck area, and maintaining post-treatment Quality-of-Life (QOL) is also important when treating cancers of the head and neck, in addition to improving survival rate. Free flap reconstruction techniques are expected to contribute to maintaining post-treatment QOL, but these techniques have not been adequately evaluated in Japan. We performed a cross-sectional analysis of QOL, using the Japanese version of the UWQOL (version 4) from the University of Washington in the United States, with 202 patients from 10 institutions who had undergone reconstructive surgery for tongue cancer. In addition to the survey form, we collected clinical information (age, sex, time since surgery, flap donor site, whether radiotherapy was administered, and other factors), and analyzed whether differences in postoperative QOL were seen depending on each of these factors and the hospital at which the surgery was performed. Although a relationship was found between QOL following reconstructive surgery for tongue cancer and the extent of resection, age and whether radiotherapy was administered, fairly good QOL was maintained overall.

DOI： 10.5981/jjhnc.35.374

Brill Bit Breakage During Fixation of Facial Bone

顔而-舌下神経クロスリンク型神経移植術-顔面神経麻痺に対するsurgical rehabilitationの新展開

橋川和信

医学のあゆみ 228 page： 928 - 929 2009

KONISHI Kazuhito, HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke, OHMORI Makoto, TAHARA Shinya

Vol. 24 ( 4 ) page： 245 - 251 2008.12

A Case of Distal Venous Arterialization for Ischemic Hand

ISHIDA Yasuhisa, HASHIKAWA Kazunobu, NAGATA Ikuko, TERASHI Hiroto, TAHARA Shinya

Vol. 21 ( 4 ) page： 438 - 442 2008.12

Novel classification system for oncological mandibular defect : CAT classification

HASHIKAWA Kazunobu, YOKOO Satoshi, TAHARA Shinya

Vol. 34 ( 3 ) page： 412 - 418 2008.10

豊胸術後多発皮下硬結の治療経験

藤井美樹, 橋川和信, 杉本庸, 田原真也, 杉本孝郎

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 28 ( 3 ) page： 147 - 151 2008.3

Anterograde Labeling for Hypoglossal Nerve Reviewed

SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, ISHIDA Yasuhisa, NAGATA Ikuko, OMORI Makoto, TERASHI Hiroto, TAHARA Shinya

Vol. 21 ( 1 ) page： 28 - 32 2008.3

FACIAL-HYPOGLOSSAL NERVE "CROSS-LINK" WITH INTERPOSITIONAL GREAT AURICULAR NERVE JUMP GRAFT FOR INVOLUNTARY EYE CLOSURE AS A SEQUELA OF BELL'S PALSY

HASHIKAWA Kazunobu

Facial N Res Jpn Vol. 27 page： 192 - 195 2008.1

Simultaneous Application of Percutaneous Monitoring Angiography and Sclerotherapy for Venous Malformation

SAKURAI Atsushi, NOMURA Tadashi, NAGATA Ikuko, MAKIGUCHI Takaya, HASHIKAWA Kazunobu, TERASHI Hiroto, TAHARA Shinya

Vol. 15 ( 4 ) page： 91 - 94 2008.1

Anatomical Analysis of the Length of Levator Aponeurosis in Asian Cadavers

MIZUGUCHI Kei, HASHIKAWA Kazunobu, ICHINOSE Akihiro, TERASHI Hiroto, TAHARA Shinya

Vol. 28 ( 1 ) page： 9 - 12 2008.1

Novel classification system for oncological mandibular defect: CAT classification

Hashikawa Kazunobu, Yokoo Satoshi, Tahara Shinya

Toukeibu Gan Vol. 34 ( 3 ) page： 412 - 418 2008

Language：Japanese Publisher：Japan Society for Head and Neck Cancer

We propose a new classification system for segmental mandibular defects after oncological ablative surgery. The system describes a mandibular defect with three letters - C, A and T -. “C” reflects loss of the condylar head of mandible, “A” the mandibular angle and “T” the mental tubercle. The defect is classified as “A” when the mandibular angle is segmentally resected, as “CA” when the condylar head and the mandibular angle are resected, as “CAT” when the entire hemi-mandible is resected, as “ATT” when the angle and the bilateral mental tubercle are resected, as “body” when only the mandibular body is resected and the angle and the mental tubercle are preserved, and as “neck” when only the mandibular ramus is resected and the condylar head and the angle are preserved. This CAT classification system is simple, clear-cut, and a new alternative for oncological mandibular defects.

DOI： 10.5981/jjhnc.34.412

A Retrospective Statistical Analysis of Hypopigmentation after Q-Switched Ruby / Alexandrite Laser Irradiation for Aberrant Mongolian Spot.

Nagata Ikuko, Sugimoto Isao, Hashikawa Kazunobu, Terashi Hiroto, Sugiyama Daisuke, Kumagai Syunichi, Tahara Shinya

Nippon Laser Igakkaishi Vol. 29 ( 1 ) page： 26 - 29 2008

Language：Japanese Publisher：Japan Society for Laser Surgery and Medicine

Q-switched lasers, developed on the theory of selective photothermolysis, are effective in the treatment of dermal melanocytosis; however, any incidental complications can cause considerable anxiety. A retrospective study on hypopigmentation was carried out on 53 regions of 42 patients undergoing treatment for aberrant mongolian spots after Q-switched laser irradiation, between July 2000 and June 2006 at the Department of Plastic Surgery, Kobe University Graduate School of Medicine. The association between patient factors (age, gender; region of irradiation - trunk, extremity - type of laser, fluence of energy, and frequency of laser irradiation) and hypopigmentation after laser irradiation was examined by multiple logistic regression analysis. Twenty-four cases (45.3%) exhibited hypopigmentation. Treatment on the trunk was associated with a greater incidence of hypopigmentation than treatment at extremities (odds ratio: 16.257,[95%CI, 2.367-111.660],P=0.005). Patient factors of age, gender, type of laser, fluence of energy, and frequency of laser irradiation were not statistically significant. These results are worthy of discussion and need to be verified from multiple aspects.

DOI： 10.2530/jslsm.29.26

口腔内に移植した遊離前腕皮弁に対するレーザー脱毛の経験

武川力, 橋川和信, 杉本庸, 寺師浩人, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 27 ( 11 ) page： 770 - 773 2007.11

Thrombosis in Anastomosed Vein with Suspected Involvement of Deep Vein Thrombosis

NARUSE Hidemi, HASHIKAWA Kazunobu, TSUJI Yoriko, KEMMOKU Kazutaka, EJIRI Hirotaka, YOKOO Satoshi, TAHARA Shinya

Vol. 20 ( 2 ) page： 147 - 152 2007.6

Problems of Microsurgical Arterial Reconstruction in Adult Living Donor Liver Transplants

SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, TAHARA Shinya

Vol. 20 ( 1 ) page： 71 - 76 2007.3

Step-Surgery Concept : An Alternative Reconstructive Strategy for Full-Thickness Facial Defect

HASHIKAWA Kazunobu, TERASHI Hiroto, YOKOO Satoshi, YANAGI Hideyuki, TAHARA Shinya

Vol. 20 ( 1 ) page： 46 - 53 2007.3

Traumatic Lacrimal Canaliculi Injury ; Experience of Ten Cases

TERASHI Hiroto, HASHIKAWA Kazunobu, TAHARA Shinya

Vol. 22 ( 3 ) page： 203 - 208 2006.12

Simultaneous Percutaneous Monitoring Angiography in Sclerotherapy for Venous Malformation

SAKURAI Atsushi

Vol. 14 ( 2 ) page： 42 2006.11

Our Screening Trial for Body Dysmorphic Disorders in Plastic Surgery Patients

SATO Makoto, NAGATA Ikuko, HASHIKAWA Kazunobu, ICHINOSE Akihiro, TAHARA Shinya

Vol. 26 ( 8 ) page： 518 - 524 2006.8

大腿骨頭壊死に対する遊離腓骨皮弁移植の経験

柳英之, 橋川和信, 塚本金作, 森大祐

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 26 ( 6 ) page： 403 - 406 2006.6

E-mail Consultation on Our Web Site

SUGIMOTO Isao, HASHIKAWA Kazunobu, ICHINOSE Akihiro, TERASHI Hiroto, TAHARA Shinya

Vol. 24 ( 4 ) page： 226 - 230 2004.4

Functional and aesthetic reconstruction of full-thickness cheek, oral commissure and vermilion

Yokoo S, Tahara S, Tsuji Y, Nomura T, Hashikawa K, Hanagaki H, Furudoi S, Umeda M, Komori T

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY Vol. 29 ( 6 ) page： 344 - 350 2001.12

Language：English Publisher：Journal of Cranio-Maxillofacial Surgery

Purpose: This paper presents surgical techniques for reconstruction of the cheek, oral commissure and vermillion in the repair of full-thickness cheek defects after resection of buccal-mucosal squamous cell carcinoma. Patients and Methods: Four reconstructions in one-stage surgery with either a free radial forearm flap or a rectus abdominis musculocutaneous flap for cheek and oral commissure were carried out. There were combined with a new approach for vermillion advancement flaps. Most challenging was the need not only for morphological reconstruction of the orifice, but also for physiological reestablishment of sphincteric and sensory functions in the vermillion. Results: Morphological and physiological reconstruction of the lip with sphincteric and sensory functions was attained. Conclusion: This valuable reconstruction technique was demonstrated in large, full thickness defects involving the cheek, oral commissure and vermilion. © 2001 European Association for Cranio-Maxillofacial Surgery.

DOI： 10.1054/jcms.2001.0249

冷凍保存された自家頬骨体の移植により整復した頬骨骨折症例の経験

横尾聡, 櫻井淳, 橋川和信, 山王俊明, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 20 ( 12 ) page： 756 - 760 2000.12

Reliability of the Deep System in Venous Drainage of the Free Radial Forearm Flap

YOKOO Satoshi, TAHARA Shinya, HASHIKAWA Kazunobu, ICHINOSE Akihiro

Vol. 20 ( 10 ) page： 597 - 602 2000.10

Relationship Between the Preoperative Period and the Postsurgical Outcome of a Blowout Fracture

SANNO Toshiaki, TAHARA Shinya, HASHIKAWA Kazunobu

Vol. 16 ( 2 ) page： 62 - 65 2000.9

Role of the Perforating Vein in the Vascular Pedicle of the Free Radial forearm Flap

YOKOO Satoshi, TAHARA Shinya, HASHIKAWA Kazunobu, SANNO Toshiaki, NAKAHARA Minoru

Vol. 19 ( 5 ) page： 272 - 276 1999.5

前腕の皮弁挙上 Invited Reviewed

大﨑健夫, 橋川和信

Vol. 207 page： 45 - 50 2024.3

傷をきれいにするための切開と閉鎖 Invited

橋川和信

関節外科 Vol. 42 ( 12 ) page： 1416 - 1420 2023.12

自動制御による顔面骨切りロボットの開発　Le Fort I骨切り術を安全に実施するために Invited Reviewed

丹羽幸司, 野崎貴裕, 矢澤真樹, 橋川和信

形成外科 Vol. 66 page： S64 - S67 2023.6

クロスリンク型神経移植術のこれまでとこれから Reviewed

橋川和信, 榊原俊介

Vol. 42 page： 1 - 2 2023.3

形成外科の基本手技　再建術総論 Invited

橋川和信, 亀井讓

手術 Vol. 76 ( 12 ) page： 1817 - 1826 2022.11

日本におけるCSTを利用した同種顔面移植術研究の黎明 Invited Reviewed

橋川和信

形成外科 Vol. 65 ( 6 ) page： 710 - 713 2022.6

Treatment for chronic eyelid symptoms in Bell’s palsy and Ramsay-Hunt syndrome Reviewed

Hashikawa Kazunobu

Facial N Res Jpn Vol. 40 page： 51 - 52 2022.5

側頭骨内に広範に破壊・浸潤を来した若年成人顔面神経鞘腫の1例　根治切除の戦略と課題 Reviewed

下田光, 柿木章伸, 横井純, 上原奈津美, 藤田岳, 橋川和信, 木村英仁, 丹生健一

Vol. 40 page： 197 - 201 2022.5

Dye Laser Treatment for Capillary Malformations (Port-wine Stains) of Infants Reviewed

Nomura Tadashi, Osaki Takeo, Osawa Sayuri, Takeda Reiko, Hasegawa Yasuko, Sakakibara Shunsuke, Hashikawa Kazunobu, Terashi Hiroto

Nippon Laser Igakkaishi Vol. 42 ( 1 ) page： 18 - 22 2021.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society for Laser Surgery and Medicine

About 3 decades have passed since the pulsed-dye laser for the treatment of capillary malformation (port-wine stain) has spread. At present, the long-pulsed pulse dye laser has become the first-choice treatment in Japan. Devices with less purpura formation have been available in recent years. Early irradiation for infants tends to be recommended, but redarkening is still a serious problem. The development of the adjunctive drug or therapy which raise the effect of the dye laser is expected

DOI： 10.2530/jslsm.jslsm-42_0004

Results of free flap reconstruction for patients aged 80 years or older with head and neck cancer. Reviewed

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

The Kobe journal of medical sciences Vol. 65 ( 4 ) page： E132 - E137 2020.2

Otsuki N, Furukawa T, Avinçsal MO, Teshima M, Shinomiya H, Oshikiri T, Nakamura T, Nomura T, Hashikawa K, Nibu KI

Auris, nasus, larynx Vol. 47 ( 1 ) page： 123 - 127 2020.2

Cardiac metastasis in a living patient with oral cancer. Reviewed International journal

Hisami Fujio, Naoki Otsuki, Yuto Horichi, Shungaku Yanagisawa, Mari Nishio, Masanori Teshima, Hirotaka Shinomiya, Kazunobu Hashikawa, Ken-Ichi Nibu

Auris, nasus, larynx Vol. 46 ( 6 ) page： 902 - 906 2019.12

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

Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography-computed tomography scan.

DOI： 10.1016/j.anl.2018.10.018

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

Computed Tomographic Evaluation of Posttreatment Soft-Tissue Changes by Using a Lymphedema Scoring System in Patients with Oral Cancer

Akashi Masaya, Teraoka Shun, Kakei Yasumasa, Kusumoto Junya, Hasegawa Takumi, Minamikawa Tsutomu, Hashikawa Kazunobu, Komori Takahide

LYMPHATIC RESEARCH AND BIOLOGY Vol. 16 ( 2 ) page： 147 - 153 2018.4

Ultrasonography-guided Cannula Method for Hyaluronic Acid Filler Injection with Evaluation using Laser Speckle Flowgraphy Reviewed

IWAYAMA TAKANORI, Hashikawa Kazunobu, Osaki Takeo, Yamashiro K, Horita N, Fukumoto T

PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN Vol. 6 ( 4 ) page： e4776 - e1776 2018.4

Ultrasonography-guided Cannula Method for Hyaluronic Acid Filler Injection with Evaluation using Laser Speckle Flowgraphy

Iwayama Takanori, Hashikawa Kazunobu, Osaki Takeo, Yamashiro Kenjiro, Horita Nobuyuki, Fukumoto Takeshi

PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN Vol. 6 ( 4 ) page： e1776 2018.4

静脈奇形に対する硬化療法におけるオレイン酸エタノールアミンとポリドカノールの比較検討 Reviewed

倉本康世, Nomura Tadashi, 江尻浩隆, 川北育子, 櫻井敦, Hashikawa Kazunobu, 寺師浩人

形成外科 Vol. 61 ( 4号 ) page： 450 - 456 2018.4

腫瘍切除に伴う顔面神経麻痺の予防と治療腫瘍切除後の顔面神経即時再建術の結果に影響を及ぼす因子は何か同一施設・同一術式による連続症例の検討 Reviewed

Hashikawa Kazunobu

Facial Nerve Research Vol. 37 page： 11 - 12 2018.2

Potential role of post-treatment follow-up FDG-PET CT to detect mandibular osteoradionecrosis: A case report Reviewed

Akashi Masaya, WanifuchiS, KusumotoJ, KishimotoM, KakeiY, Hashikawa Kazunobu, Komori Takahide

Mol Clin Oncol Vol. 8 ( 1 ) page： 61 - 67 2018.1

Potential role of post-treatment follow-up FDG-PET CT to detect mandibular osteoradionecrosis: A case report

Akashi Masaya, Wanifuchi Satoshi, Kusumoto Junya, Kishimoto Megumi, Kakei Yasumasa, Hashikawa Kazunobu, Komori Takahide

MOLECULAR AND CLINICAL ONCOLOGY Vol. 8 ( 1 ) page： 61 - 67 2018.1

A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Reviewed

TakasuH, Hashikawa Kazunobu, NomuraT, SakakibaraS, Osaki Takeo, Terashi Hiroto

Eplasty Vol. 17 page： e37 2017.12

Axial four-dimensional computed tomographic images to analyze crosswise differences in protrusive condylar movement in patients who underwent mandibulectomy and free flap reconstruction Reviewed

Masaya Akashi, Toshinori Sekitani, Yumi Ohtsuki, Yasumasa Kakei, Junya Kusumoto, Takumi Hasegawa, Michinori Maeda, Noriyuki Negi, Kazunobu Hashikawa, Yasuyuki Shibuya, Satoru Takahashi, Takahide Komori

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY Vol. 45 ( 11 ) page： 1778 - 1783 2017.11

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

Objective: Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction.
Methods: We enrolled seven healthy volunteers (median age 30 years, range 27-38 years) and seven patients (median age 65 years, range 52-80 years), who underwent mandibulectomy (segmental in five, hemi in one, marginal in one) and free flap reconstruction (using the fibula in six and the radial forearm in one). Six study subjects were instructed to masticate a cookie during the 4DCT scan (the seventh made chewing motions). The distance between the most anterior and posterior positions of the bilateral condyles on 4DCT (axial view) images was then measured and compared between controls and patients using the Manne-Whitney U-test.
Results: The crosswise difference in the distances of condylar protrusion was significantly greater in patients than in the controls.
Conclusion: Axial 4DCT images can visualize a bilateral condylar protrusive path. Axial 4DCT images for patients who have undergone mandibulectomy and reconstruction may be useful for evaluation of functional movement of condyles. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jcms.2017.08.025

Literature Review of Criteria for Defining Recipient-Site Infection after Oral Oncologic Surgery with Simultaneous Reconstruction

Masaya Akashi, Junya Kusumoto, Akiko Sakakibara, Kazunobu Hashikawa, Shungo Furudoi, Takahide Komori

SURGICAL INFECTIONS Vol. 18 ( 7 ) page： 755 - 764 2017.10

Language：English Publisher：MARY ANN LIEBERT, INC

Background: The lack of uniformity of criteria for defining recipient-site infection after oral oncologic surgery with simultaneous reconstruction is problematic despite numerous studies on this issue. This study aimed to investigate the difference in the criteria for defining recipient-site infection after oral oncologic surgery with reconstruction.
Methods: A Medline search was performed via PUBMED using the following combinations of key terms that were tagged in the title, abstract, or both: "surgical site infectionhead neck," "surgical site infectionoral cancer," "antibiotic prophylaxishead neck," and "surgical site infectionoral carcinoma." Search results were filtered between 2005 and 2017. Articles in which there was no mention of the criteria for definition of surgical-site infection were excluded.
Results: The number of articles that met the inclusion criteria was 24. The lack of uniformity in the criteria for defining recipient-site infection in each article appeared to be attributable mainly to differences in whether an orocutaneous fistula and superficial incisional infection were regarded as recipient-site infection.
Conclusion: Reconsideration of the categorization of orocutaneous fistula as infection, regardless of the etiology, and differentiation of superficial and deep incisional infections are necessary for correct assessment of recipient-site infection in oral oncologic surgery.

DOI： 10.1089/sur.2017.101

Rhinoplasty via the midface degloving approach for nasal deformity due to nasal polyps: A case report of Woakes’ syndrome Reviewed

色素レーザー照射後に潰瘍を生じた乳児血管腫症例の検討 Reviewed

Nomura Tadashi, 江尻浩隆, 森脇綾, 岩山隆憲, 榊原俊介, 高須啓之, 石椛寛芳, 長谷川泰子, 橋川和信, 寺師浩人

日本レーザー医学会誌 Vol. 38 ( 3号 ) page： 315 2017.10

Misato Ueda, Kazunobu Hashikawa, Takanori Iwayama, Hiroto Terashi

Oral and Maxillofacial Surgery Cases Vol. 3 ( 3 ) page： 64 - 69 2017.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Inc

Nasal polyps are inflammatory proliferative tumors arising from the mucosa of the nasal cavity and paranasal sinuses. Although many cases concerning nasal polyps have been reported, those involving external nasal deformities are rare. We report a case of nasal polyposis filling the nasal cavity and paranasal sinuses, leading to external nasal and facial deformities. The condition above is known as Woakes’ syndrome, which is characterized by severe recurrent nasal polyps with deformity of the nasal pyramid, leading to broadening of the nose. We performed nasal osteotomy and facial bone-shaving via the midface degloving approach, which improved the patient's facial appearance.

DOI： 10.1016/j.omsc.2017.05.001

Upregulated Expression of Transient Receptor Potential Cation Channel Subfamily V Receptors in Mucosae of Patients with Oral Squamous Cell Carcinoma and Patients with a History of Alcohol Consumption or Smoking Reviewed

Computed Tomographic Evaluation of Posttreatment Soft-Tissue Changes by Using a Lymphedema Scoring System in Patients with Oral Cancer Reviewed

Akashi Masaya, TeraokaS, KakeiY, KusumotoJ, Hasegawa Takumi, MinamikawaT, Hashikawa Kazunobu, Komori Takahide

Lymphat Res Biol 2017.7

【頭頸部動静脈奇形の最新治療】動静脈奇形に対する手術療法 nidusを見極めるわれわれの試み Reviewed

Nomura Tadashi, 江尻浩隆, 櫻井敦, 川北育子, Hashikawa Kazunobu, 寺師浩人

形成外科 Vol. 60 ( 6号 ) page： 649 - 660 2017.6

膝窩リンパ節転移を認めた母趾悪性黒色腫の1例 Reviewed

北川敬之, Nomura Tadashi, Hashikawa Kazunobu, Fujiwara Susumu, 田島翔子, Nishigori Chikako, Terashi Hiroto

Skin Cancer Vol. 31 ( 3号 ) page： 233 - 237 2017.3

Akiko Sakakibara, Shunsuke Sakakibara, Junya Kusumoto, Daisuke Takeda, Takumi Hasegawa, Masaya Akashi, Tsutomu Minamikawa, Kazunobu Hashikawa, Hiroto Terashi, Takahide Komori

PLOS ONE Vol. 12 ( 1 ) page： e0169723 2017.1

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Objectives
Transient receptor potential cation channel (subfamily V, members 1-4) (TRPV1-4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1-4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1-4 expression.
Materials and Methods
Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1-4 by immunohistochemical staining and quantification of TRPV1-4 mRNA in human oral mucosa. In addition, we compared the TRPV1-4 levels in mucosa from patients with SCC to those in normal oral mucosa.
Results
The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1-4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels.
Conclusion
Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention.

DOI： 10.1371/journal.pone.0169723

A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy.

Takasu H, Hashikawa K, Nomura T, Sakakibara S, Osaki T, Terashi H

Eplasty Vol. 17 page： e37 2017

Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report. Reviewed International journal

Tadashi Nomura, Shunsuke Sakakibara, Aya Moriwaki, Teruya Kawamoto, Satoshi Suzuki, Takeshi Ishimura, Kazunobu Hashikawa, Hiroto Terashi

Eplasty Vol. 17 ( 2 ) page： e6 2017

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

Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

Heterogeneity of Necrotic Changes between Cortical and Cancellous Bone in Mandibular Osteoradionecrosis: A Histopathological Analysis of Resection Margin after Segmental Mandibulectomy Reviewed

Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report.

Nomura T, Sakakibara S, Moriwaki A, Kawamoto T, Suzuki S, Ishimura T, Hashikawa K, Terashi H

Eplasty Vol. 17 page： e6 2017

Masaya Akashi, Kazunobu Hashikawa, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Shungo Furudoi, Hiroto Terashi, Takahide Komori

BIOMED RESEARCH INTERNATIONAL Vol. 2017 page： 3125842 2017

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：HINDAWI LTD

Background. This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. Methods. Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals. Results. Ten of eleven (91%) cortices near the inferior border of the mandible at the anterior margins were necrotic. All cancellous bones at the anterior margins were viable. Seven of eleven (64%) cortices near the inferior border of the mandible at the posterior margins were necrotic. Three of eleven (27%) cancellous bones at the posterior margins were necrotic. Conclusion. Necrotic changes are more prevalent in cortices than in cancellous bones in mandibular osteoradionecrosis, probably due to a decrease of periosteal blood supply caused by radiotherapy.

DOI： 10.1155/2017/3125842

Modified partial maxillary swing approach for myxofibrosarcoma in pterygopalatine fossa Reviewed

Hikari Shimoda, Koichiro Yonezawa, Hirotaka Shinomiya, Naoki Otsuki, Kazunobu Hashikawa, Ryohei Sasaki, Eiji Komura, Ken-ichi Nibu

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK Vol. 38 ( 12 ) page： E2519 - E2522 2016.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Background. Extirpation of tumors arising in the pterygopalatine fossa is challenging because of its anatomic complexity.
Methods and Results. A 67-year-old man was referred to our department with a diagnosis of a tumor in his left pterygoid fossa. An incisional biopsy through the canine fossa was diagnosed as myxofibrosarcoma. The upper part of the maxilla was swung laterally to remove the tumor while the hard plate was preserved. The defect was reconstructed using rectus abdominis musculocutaneous free and ipsilateral temporal. The postoperative course was uneventful, without facial palsy or mastication disorders.
Conclusion. Our experience with this case suggests that the modified partial maxillary swing approach with preservation of the hard palate and orbital floor in combination with infratemporal and cervical approaches is useful for lesions in the pterygoid process without causing severe complications. (C) 2016 Wiley Periodicals, Inc.

DOI： 10.1002/hed.24558

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

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

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

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

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.

DOI： 10.20699/jopbs.1.2_82

"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

Evaluation of Bone Height of the Free Fibula Flap in Mandible Reconstruction

Makiguchi Takaya, Yokoo Satoshi, Hashikawa Kazunobu, Miyazaki Hidetaka, Terashi Hiroto

JOURNAL OF CRANIOFACIAL SURGERY Vol. 26 ( 3 ) page： 673 - 676 2015.5

Evaluation of bone height of the free fibula flap in mandible reconstruction Reviewed

MakiguchiT, YokooS, Hashikawa Kazunobu, MiyazakiH, Terashi Hiroto

J Craniofac Surg Vol. 26 ( 3 ) page： 673 - 6 2015.5

Three-Dimensional Venous Visualization with Phase-Lag Computed Tomography Angiography for Reconstructive Microsurgery Reviewed

Shunsuke Sakakibara, Hiroyuki Onishi, Kazunobu Hashikawa, Masaya Akashi, Akiko Sakakibara, Tadashi Nomura, Hiroto Terashi

JOURNAL OF RECONSTRUCTIVE MICROSURGERY Vol. 31 ( 4 ) page： 305 - 312 2015.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：THIEME MEDICAL PUBL INC

Background Most free flap reconstruction complications involve vascular compromise. Evaluation of vascular anatomy provides considerable information that can potentially minimize these complications. Previous reports have shown that contrast-enhanced computed tomography is effective for understanding three-dimensional arterial anatomy. However, most vascular complications result from venous thromboses, making imaging of venous anatomy highly desirable.
Methods The phase-lag computed tomography angiography (pl-CTA) technique involves 64-channel (virtually, 128-channel) multidetector CT and is used to acquire arterial images using conventional CTA. Venous images are three-dimensionally reconstructed using a subtraction technique involving combined venous phase and arterial phase images, using a computer workstation.
Results This technique was used to examine 48 patients (12 lower leg reconstructions, 34 head and neck reconstructions, and 2 upper extremity reconstructions) without complications. The pl-CTA technique can be used for three-dimensional visualization of peripheral veins measuring approximately 1 mm in diameter.
Conclusion The pl-CTA information was especially helpful for secondary free flap reconstructions in the head and neck region after malignant tumor recurrence. In such cases, radical dissection of the neck was performed as part of the first operation, and many vessels, including veins, were resected and used in the first free-tissue transfer. The pl-CTA images also allowed visualization of varicose changes in the lower leg region and helped us avoid selecting those vessels for anastomosis. Thus, the pl-CTA-derived venous anatomy information was useful for exact evaluations during the planning of free-tissue transfers.

DOI： 10.1055/s-0034-1400070

Postoperative abnormal response of C-reactive protein as an indicator for infectious complications after oral oncologic surgery with primary reconstruction Reviewed

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

JOURNAL OF OTOLARYNGOLOGY-HEAD & NECK SURGERY Vol. 44 ( 1 ) page： 13 2015.4

Language：English Publishing type：Research paper (scientific journal) Publisher：BIOMED CENTRAL LTD

Background: C-reactive protein (CRP) screening has been reported to be reliable for detection of infectious complications. Postoperative abnormal response of CRP can predict wound infection in colorectal surgery. This study aimed to determine the efficacy of CRP monitoring to detect infectious complications in oral oncologic surgery.
Methods: One hundred patients who underwent oral cancer resection with primary reconstruction were enrolled. Postoperative kinetics of CRP were classified into a normal or abnormal response.
Results: A normal CRP response after surgery was observed in 61 patients and an abnormal response was observed in 39. There were postoperative infectious complications in 21 patients, with surgical site infections in 13 patients (early onset in six and late onset in seven). Non-wound infections were found in nine patients. Sensitivity, specificity, the positive predictive value, and the negative predictive value for abnormal CRP response as a predictor for early infectious complications were 100%, 70.1%, 35.9%, and 100%, respectively.
Conclusion: Postoperative serial CRP screening is a useful test as an indicator of infectious complications in oral oncologic surgery. Normal CRP responses can rule out almost all early infectious complications.

DOI： 10.1186/s40463-015-0066-6

Long-term Follow-up Study of Radial Forearm Free Flap Reconstruction After Hemiglossectomy Reviewed

Masaya Akashi, Kazunobu Hashikawa, Akiko Sakakibara, Takahide Komori, Hiroto Terashi

JOURNAL OF CRANIOFACIAL SURGERY Vol. 26 ( 1 ) page： 48 - 51 2015.1

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

Previous studies on postoperative long-term results in patients who underwent reconstructive free flap transfer following hemiglossectomy had some issues, including the heterogeneity of the patient population and the observation period. The present study aimed to evaluate changes of reconstructed tongues in patients who underwent radial forearmfree flap (RFFF) after hemiglossectomy with long-term follow-up. We enrolled 23 patients who underwent RFFFafter hemiglossectomy with a postoperative follow-up of 5 years or more. Postoperative status (eating, speech, sensation function) was assessed by concisemedical inquiries. Morphological changes of flaps were evaluated by reviewing clinical photographs. Hemiglossectomy involving the base of the tongue was performed in 4 cases (17.4%) and was limited to the mobile tongue in 19 cases (82.6%). The mean follow-up was 85.4 months (range, 60-122 months). All patients experienced gradually improved postoperative status. The most significant improvement was found between 1 and 5 years after surgery (P = 0.007), but not between 1 and 3 years (P = 0.075) or between 3 and 5 years (P = 0.530). In almost all of the flaps, there were few morphological changes throughout the follow-up period. Postoperative status in patients who underwent reconstructive RFFF following hemiglossectomy improved sequentially.

DOI： 10.1097/SCS.0000000000001176

下顎再建における血管柄付き遊離腓骨皮弁の限界ー骨吸収、整容性、末梢動脈疾患の観点からー Reviewed

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

Sakakibara S, Tokiyoshi T, Hashikawa K, Terashi H

Eplasty Vol. 15 page： e23 2015

横尾聡, 橋川和信, 宮崎英隆, 牧口貴哉, Komori Takahide

口腔腫瘍 Vol. 27 ( 3 ) page： 49 - 56 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Society of Oral Oncology

We have classified maxillofacial asymmetry from two viewpoints: the fact that all humans have an asymmetrical face, regardless of whether it appears to be normal and symmetrical, and the ability of humans to visually perceive asymmetry. In this study, based on this classification, we investigated skeletal factors influencing self-recognition after surgery in maxillofacial asymmetry patients, and attempted to apply the factors for mandibular reconstruction. We also investigated the limitation of the fibula with regard to these factors and grafted bone resorption and absolute indications. It was suggested that the positional adjustment of the chin (C: center of the mandible) is important, and that changes in the mandibular angle (A) markedly influence self-recognition of asymmetry in patients of mandibular reconstruction. Considering postoperative recognition of asymmetry, grafted fibular bone resorption, and the importance of preserving the peroneal artery for patients and prepositions towards peripheral arterial disease (PAD), the indication of mandibular reconstruction with a free fibular bone flap should be limited to the mandibular straight-line region (B: body of the mandible) not requiring osteotomy with a conserved mandibular angle.

DOI： 10.5843/jsot.27.49

Development of a novel method for decellularizing a nerve graft using a hypertonic sodium chloride solution Reviewed

開頭術後頭部皮膚潰瘍の原因に関する検討とその対策死腔形成と脳室-腹腔シャントが及ぼす影響について Reviewed

Nomura Tadashi, Hashikawa Kazunobu, 榊原俊介, 高須啓之, 寺師浩人

日本頭蓋顎顔面外科学会誌 Vol. 30 ( 4号 ) page： 171 - 178 2014.12

Yasuhisa Ishida, Shuhsuke Sakakibara, Hiroto Terashi, Kazunobu Hashikawa, Tetsuji Yamaoka

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS Vol. 37 ( 11 ) page： 854 - 860 2014.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：WICHTIG EDITORE

Purpose: Acellular nerves are a reconstruction material and provide scaffolds for nerve regeneration. Numerous methods to develop acellular nerves have been described. However, these methods pose problems that can be attributed to incomplete acellular processing and destruction of the extracellular matrix (ECM); the former may lead to rejection response, while the latter may damage the scaffold. In order to overcome problems associated with the above-mentioned methods, we developed a novel method that employs a hypertonic sodium chloride solution to decellularize nerve graft material.
Methods: Rat sciatic nerves were harvested, dipped in hypertonic sodium chloride solution (1 M), and shaken for 24 h. We then washed the nerves in phosphate-buffered saline for 7 days with shaking and evaluated the acellular nerves by hematoxylin-eosin (H-E) staining, immunostaining, and electron microscopy. We then transplanted the grafts to the sciatic nerve of another rat and evaluated the outcomes by H-E staining, immunostaining (anti-neurofilament antibody, anti-S-100 antibody), anterograde nerve tracing, and electron microscopy.
Results: We found that our method successfully decellularized the grafts, but was mild enough to leave the ECM intact. Two months after transplantation, immunostaining and anterograde nerve tracing confirmed that Schwann cells infiltrated the grafts and induced neurofilament extension.
Conclusions: Our methodology preserves the ECM, is simple to develop, and does not involve substances that harm biogenic tissue. Acellular nerve tissue processed in this way could become a substitute material for bridging nerve gaps. Our method could also aid in the development of other acellular tissues.

DOI： 10.5301/ijao.5000365

Is Immobilization of the Ankle and Metatarsophalangeal Joint Effective in Suppressing the Spread of Infection in Diabetic Foot Ulcers? Reviewed

Shunsuke Sakakibara, Yoriko Tsuji, Kazunobu Hashikawa, Hiroto Terashi

INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS Vol. 13 ( 3 ) page： 226 - 229 2014.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS INC

Diabetics with foot-related problems might eventually need to undergo major or minor amputation because of infection or cellulites. It has been suggested that immobilization of the ankle and the metatarsophalangeal joint suppresses the spread of infection; however, there is no evidence to support this inference. Here, we demonstrate by histological analysis how the immobilization works. The tendon from the amputated toe is harvested, and a hematoxylin-eosin stained paraffin-embedded section is prepared and analyzed. Necrosis occurred in only a single fiber of the tendon, and intact and necrotic or infected tendon fibers were found intermingled. The reciprocal movements of the tendon and the joint (extension and flexion) may be the pathogenic cause of cellulites and infection, leading to the massage effect and the spread of bacteria along the tendon itself. We suggest that immobilizing the ankle and the metatarsophalangeal joint with a removable contacting cast would suppress the spread of infection in foot ulcers.

DOI： 10.1177/1534734614545873

Intima/medulla reconstruction and vascular contraction-relaxation recovery for acellular small diameter vessels prepared by hyperosmotic electrolyte solution treatment Reviewed

両側pure type眼窩ブローアウト骨折症例の検討 Reviewed

高須啓之, Hashikawa Kazunobu, Sakakibara Shunsuke, 寺師浩人

日本頭蓋顎顔面外科学会誌 Vol. 30 ( 3号 ) page： 147 - 153 2014.9

Shunsuke Sakakibara, Yasuhisa Ishida, Kazunobu Hashikawa, Tetsuji Yamaoka, Hiroto Terashi

JOURNAL OF ARTIFICIAL ORGANS Vol. 17 ( 2 ) page： 169 - 177 2014.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：SPRINGER JAPAN KK

This study aims at the evaluation of blood vessel reconstruction process of decellularized small diameter vessels prepared by a hyperosmotic electrolyte solution treatment not only histologically but also physiologically in rat transplantation model. Complete cell removal by a hyperosmotic electrolyte solution treatment was confirmed by hematoxylin/eosin staining and scanning electron microscopic observation. All acellular vessels transplanted into the rat abdominal aorta were patent up to 14 months. One week post-transplantation, the vWF-positive cells were observed on the luminal surface but the layer formation did not complete. Five weeks following transplantation, the vWF-positive endothelial cells were located on the intima consistent with intact endothelial cells. Beneath the endothelial cells, alpha-SMA-positive smooth muscle cells were distributed. The harvested vessels displayed formation of tunica intima (endothelial cells) and tunica medulla (smooth muscle cell) layers. We also examined the physiological properties of the vessels 12 months post-transplantation using a wire myograph system. The transplanted vessels contracted upon addition of norepinephrine and relaxed upon addition of sodium nitroprusside as well as the native vessels. In conclusion, the acellular vessels prepared with hyperosmotic electrolytic solution showed excellent and long-term patency, which may be related to the successful preservation of vascular ECM. In addition, the acellular vessels revealed the intima/medulla regeneration with the physiological contraction-relaxation functions in response to the each substance.

DOI： 10.1007/s10047-014-0760-6

Comparison of Malignant Skin Tumor Thickness and Relative Depth of Invasion Estimates from Preoperative MR-Microscopy and Pathological Evaluation Reviewed

ビデオで伝えたい私の手術ビデオで伝えたい遊離前腕皮弁の挙上方法

Nomura Tadashi, 榊原俊介, 高須啓之, 橋川和信, 寺師浩人, 明石昌也, 田原真也

日本形成外科学会会誌 Vol. 34 ( 5号 ) page： 394 2014.5

顎下部壊死性筋膜炎に伴う切開排膿後の難治性瘻孔にV.A.C. ATS治療システムによる局所陰圧閉鎖療法を用いた1例 Reviewed

榊原晶子, Sakakibara Shunsuke, Minamikawa Tsutomu, 重田崇至, Hashikawa Kazunobu, Komori Takahide

日本口腔外科学会雑誌 Vol. 60 ( 2号 ) page： 71 - 75 2014.2

Risk factors and surgical refinements of postresective mandibular reconstruction: a retrospective study Reviewed

Sakakibara A, Hashikawa Kazunobu, Yokoo S, Sakakibara Shunsuke, Komori Takahide, Tahara S

Plast Surg Int Vol. 2014 page： 893746 2014

Risk factors and surgical refinements of postresective mandibular reconstruction: a retrospective study.

Sakakibara A, Hashikawa K, Yokoo S, Sakakibara S, Komori T, Tahara S

Plastic surgery international Vol. 2014 page： 893746 2014

Reiko Nakayama-Takeda, Shunsuke Sakakibara, Masato Kurokawa, Kazunobu Hashikawa, Hiroto Terashi

DERMATOLOGIC SURGERY Vol. 39 ( 12 ) page： 1767 - 1773 2013.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

BackgroundTumor thickness and relative depth of invasion are prognostic parameters considered when developing treatment plans for malignant skin tumors. Although conventional magnetic resonance (MR) imaging techniques cannot identify small tumors, use of microscopy coils considerably improves spatial resolution. Some studies have shown that this technique is efficacious in preoperative assessment of relative depth of invasion; however, its ability to provide accurate measurements of tumor thickness remains unconfirmed.
ObjectiveThe purpose of this pilot study was to evaluate the usefulness of preoperative MR-microscopy in determining tumor thickness and relative depth of invasion of malignant skin tumors.
Methods and MaterialsMagnetic resonance images of malignant skin tumors in seven female patients (six with basal cell carcinoma and one with malignant melanoma) were obtained using a 1.5 T system and a 47-mm or 23-mm microscopy coil. Tumors were then excised, fixed, dehydrated, embedded, and stained with hematoxylin and eosin. We then compared MR-microscopy and pathology values for thickness and relative depth of invasion of each tumor.
ResultsBoth techniques produced similar measurements of tumor thickness and relative depth of invasion.
ConclusionsMR-microscopy is very useful for accurate preoperative estimation of not only relative depth of invasion, but also thickness of malignant skin tumors.

DOI： 10.1111/dsu.12371

Evaluation of venous anatomy with phase-lag CTA (pl-CTA)

Sakakibara S., Onishi H., Nomura T., Hashikawa K., Terashi H.

Japanese Journal of Plastic Surgery Vol. 56 ( 12 ) page： 1271 - 1280 2013.12

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Three-dimensional imaging with multidetector-row computed tomography (MDCT) provides useful information for the evaluation of arteries before an operation. However, the obtained information has been restricted only to arteries. We developed a phase lag-CT angiography (pl-CTA) method that allows three-dimensional visualization of the venous anatomy. The principle of pl-CTA is simple and consists of a phase lag and subtraction of images using a workstation. pl-CTA provides a greater amount of venous anatomical information compared to that obtained by the usual CTA.

Utility of fixation with a custom-made device for intractable digital ulcers in the proximal interphalangeal joints associated with systemic sclerosis; report of two cases

Makiguchi T., Terashi H., Hashikawa K., Yokoo S., Tsuji Y., Tahara S.

Japanese Journal of Plastic Surgery Vol. 56 ( 12 ) page： 1313 - 1318 2013.12

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Intractable cutaneous ulcers on the fingers are a common complication of systemic sclerosis (SSc). These are associated with pain and require daily treatment, which may decrease the quality of life of the patients. Digital ulcers (DUs) in the Proximal interphalangeal (PIP) joints can become intractable because the bone protrudes toward the dorsal side owing to joint flexion contracture, which induces poor circulation and persistently exerts pressure on the atrophic skin and subcutaneous tissues. In ulcers associated with a pocket, the shearing force of the joint movement, as in the case of decubitus ulcers, can also cause the ulcers to become intractable. Various treatment methods are available for vascular compromise, including pharmacotherapy, surgical revascularization, and local treatment in a moist environment; however, there are few reports of specific techniques to address the bony prominences and the shearing force. We performed fixation with a long-term-use, removable custom-made device on the palmar surfaces of the fingers, for (1) decompression of the dorsal subcutaneous tissues, (2) prevention of deviation due to joint stabilization, and (3) prevention of further flexion contractures. Herein, we report two cases of DU on the dorsal side of the PIP joint that was complicated with SSc, both of which had excellent outcomes following the use of this procedure.

全身性強皮症に合併したPIP関節部指難治性潰瘍に対して装具固定が有用であった2例 Reviewed

牧口貴哉, 寺師浩人, Hashikawa Kazunobu, 横尾聡, 辻依子, 田原真也

形成外科 Vol. 56 ( 12号 ) page： 1313 - 1318 2013.12

Functional Outcomes of the Facial Nerve After Postoperative Radiation Therapy for High-Risk Parotid Gland Malignancies Underwent Radical Surgery With Facial Nerve Resection and Reconstructive Surgery

Muraoka O., Nishimura H., Miyawaki D., Yoshida K., Ejima Y., Okamoto Y., Hashikawa K., Otsuki N., Nibu K., Sasaki R.

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS Vol. 87 ( 2 ) page： S460 - S460 2013.10

Preoperative MR angiography for free fibula osteocutaneous flap transfer Reviewed

Masaya Akashi, Tadashi Nomura, Shunsuke Sakakibara, Akiko Sakakibara, Kazunobu Hashikawa

MICROSURGERY Vol. 33 ( 6 ) page： 454 - 459 2013.9

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Introduction: Magnetic resonance angiography (MRA) is currently considered the most useful test to evaluate the vascular anatomy of the lower leg prior to free fibula osteocutaneous flap transfer. This study aimed to confirm the validity of preoperative MRA. Methods: In 19 patients underwent free fibula osteocutaneous flap transfer for maxillary and mandibular reconstruction, the MRA and intraoperative findings and the postoperative complications were retrospectively analyzed. The location and number of distal septocutaneous perforators (dSCPs) that were preoperatively identified and harvested with flaps were documented. Results: Preoperative MRA detected dSCPs with 100 % sensitivity. MRA findings also revealed the diversity of vascular structures, such as the tibio-peroneal bifurcation location and the anatomical relationship between the peroneal vessels and the fibula. No patients suffered postoperative ischemic complications in the donor leg. The total flap survival rate was 95 %. Conclusions: Preoperative MRA effectively excluded large vessel anomalies and peripheral vascular disease, and precisely identified the septocutaneous perforators. Additionally, preoperative MRA contributed to a safer fibular osteotomy by predicting the anatomical relationship between the peroneal vessels and the fibula. (c) 2013 Wiley Periodicals, Inc.

DOI： 10.1002/micr.22128

再発口腔中咽頭癌に対する遊離皮弁再建に関する検討

Akashi Masaya, Hashikawa Kazunobu, 寺師浩人

日本マイクロサージャリー学会学術集会プログラム・抄録集40周年記念 page： 163 2013.9

One-Stage Umbilicus Reconstruction After Resection of Urachal Cyst Reviewed

Makoto Omori, Kazunobu Hashikawa, Shunsuke Sakakibara, Hiroto Terashi, Shinya Tahara, Yoshie Shibaoka, Kensaku Kimura, Katsuhiro Sano

ANNALS OF PLASTIC SURGERY Vol. 71 ( 1 ) page： 93 - 95 2013.7

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

Umbilical reconstruction after total excision of the umbilicus represents a challenging problem for reconstructive surgeons. We describe herein a new method for one-stage umbilical reconstruction after resection of a urachal cyst. This case series included 6 patients, with laparoscopic urachal cyst removal in 5 and conventional transcutaneous surgery in 1. One-stage umbilical reconstruction was performed in all cases. When a conventional transcutaneous approach is indicated, umbilical reconstruction can be undertaken through the same skin incision used for total resection of the urachal cyst. Two triangular flaps were designed just below the umbilical defect. Flaps were rotated 180 degrees and sutured together to form one big triangular flap. This flap was then folded to create the new umbilicus. A deep umbilicus with good shape was constructed in all cases, and all patients were satisfied with the outcome. This method is simple, easy, and produces a natural-looking umbilicus.

DOI： 10.1097/SAP.0b013e318248b830

Osteolipoma in the Glabella: Pathogenesis Associated With Mesenchymal Lipoma-Derived Stem Cells

Makiguchi Takaya, Terashi Hiroto, Hashikawa Kazunobu, Yokoo Satoshi, Kusaka Junko

JOURNAL OF CRANIOFACIAL SURGERY Vol. 24 ( 4 ) page： 1310 - 1313 2013.7

Osteolipoma in the glabella: pathogenesis associated with mesenchymal lipoma-derived stem cells Reviewed

Makiguchi T, Terashi H, Hashikawa Kazunobu, Yokoo S, Kusaka J

J Craniofac Surg Vol. 24 ( 4 ) page： 1310 - 3 2013.7

外傷後に生じたclaw toe変形に対し長趾屈筋腱移行術を施行した1例

高須啓之, Hashikawa Kazunobu, Akashi Masaya, 寺師浩人

日本形成外科学会会誌 Vol. 33 ( 6号 ) page： 469 2013.6

がん切除後下顎骨再建における再建理論「CATコンセプト」臨床症例における実践結果 Reviewed

Hashikawa Kazunobu, Akashi Masaya, 野村正, 寺師浩人

頭頸部癌 Vol. 39 ( 2号 ) page： 166 2013.5

再発口腔中咽頭癌に対する遊離皮弁再建における問題点 Reviewed

Akashi Masaya, Hashikawa Kazunobu, 寺師浩人

頭頸部癌 Vol. 39 ( 2号 ) page： 198 2013.5

当科における照射後再発下咽頭癌に対する救済手術の検討

小松弘和, Morimoto Koichi, 斎藤幹, 大月直樹, Hashikawa Kazunobu, 丹生健一

頭頸部癌 Vol. 39 ( 2号 ) page： 182 2013.5

舌半側切除術後の遊離前腕皮弁再建症例における長期観察結果

Akashi Masaya, Hashikawa Kazunobu, 榊原晶子, 寺師浩人

頭頸部癌 Vol. 39 ( 2号 ) page： 161 2013.5

Supercharged pectoralis major musculocutaneous flap Reviewed

Hashikawa Kazunobu, Terashi Hiroto

J Craniofac Surg Vol. 24 ( 2 ) page： e179 - 82 2013.3

Supercharged Pectoralis Major Musculocutaneous Flap

Makiguchi Takaya, Yokoo Satoshi, Miyazaki Hidetaka, Takayama Yu, Ogawa Masaru, Hashikawa Kazunobu, Terashi Hiroto

JOURNAL OF CRANIOFACIAL SURGERY Vol. 24 ( 2 ) page： E179 - E182 2013.3

Treatment strategy of a huge ameloblastic carcinoma Reviewed

Takaya Makiguchi, Satoshi Yokoo, Hidetaka Miyazaki, Aiko Nobusawa, Masaru Ogawa, Kazunobu Hashikawa, Hiroto Terashi

Journal of Craniofacial Surgery Vol. 24 ( 1 ) page： 287 - 290 2013.1

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

Ameloblastic carcinoma is a very rare malignant odontogenic tumor. We report a case of secondary-type ameloblastic carcinoma that extended transversally over almost half of the side of the face. Malignant transformation and identification of the malignant region in the large tumor were achieved using L-3-[F]fluoro-α-methyltyrosine (FAMT)-positron emission tomography (PET)
FAMT is transported into cancer cells by L-type amino acid transporter 1 and shows high specificity for malignant tumors. The malignant region determined by microscopic evaluation of resected samples was similar to the region showing high FAMT uptake in PET. Using preoperative FAMT-PET and magnetic resonance imaging, we were able to achieve total resection of the very large tumor, while avoiding excessive resection that could cause severe functional loss or a poor aesthetic facial appearance. We used a modified Weber-Fergusson incision along the nasolabial fold to the labiajugal fold and reconstruction with a pectoralis major muscle flap, and this gave a good aesthetic outcome. Safe surgical resection was possible because preoperative three-dimensional computed tomography angiography was used to identify the position of the main trunk of the external carotid artery, which was closely aligned with the tumor in a posterior direction in the infratemporal fossa region. Copyright © 2013 by Mutaz B. Habal, MD.

DOI： 10.1097/SCS.0b013e3182710311

Comparison of reinnervation for preservation of denervated muscle volume with motor and sensory nerve: An experimental study Reviewed

上顎切除後に遊離皮弁と顎義歯による再建を併用した症例の臨床的検討 Reviewed

Shibuya Yasuyuki, Minamikawa Tsutomu, Yokoo Satoshi, Hashikawa Kazunobu, Komori Takahide

顎顔面補綴 Vol. 35 ( 2号 ) page： 83 - 91 2012.12

神経端側縫合の将来展望端側神経縫合を利用した腫瘍切除後顔面神経即時再建ループ型神経移植連続10症例の検討 Reviewed

Hashikawa Kazunobu, 榊原俊介

Facial Nerve Research Vol. 32 page： 26 - 28 2012.11

顔面神経再建方法の分類と呼称について「ジャンプグラフト」「クロスリンク」 Reviewed

Hashikawa Kazunobu

Facial Nerve Research Vol. 32 page： 38 - 40 2012.11

Makoto Omori, Shunsuke Sakakibara, Kazunobu Hashikawa, Hiroto Terashi, Shinya Tahara, Daisuke Sugiyama

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY Vol. 65 ( 7 ) page： 943 - 949 2012.7

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Prevention of the atrophy of denervated muscles is essential for a good outcome in facial contouring and oral reconstruction. In this study, we compared the effectiveness of end-to-end and end-to-side neurorrhaphy of the motor nerve, and end-to-end neurorrhaphy of the sensory nerve, all of which are frequently used in such reconstruction for the prevention of muscle atrophy.
Wistar rats were divided into four groups: group 1, motor nerve division of semimembranosus without repair; group 2, motor nerve division and end-to-end coaptation to the saphenous nerve; group 3, motor nerve division and end-to-side coaptation to the sciatic nerve; and group 4, motor nerve division and end-to-end repair.
Measurement of semi-membranosus volume, histological evaluation and staining of neuromuscular junctions that were carried out 3 months postoperatively revealed that muscle volume preservation was larger in groups 3 and 4 than in the other two groups (p < 0.05), but slightly superior in group 4 (p < 0.05). There was no statistical difference between groups 2 and 1; histologically, muscle architecture was better preserved in group 2 than in group 1; reactivation of the neuromuscular junctions was observed in all except group 1.
End-to-side repair of motor nerves is one of the better options for the preservation of muscle volume when end-to-end nerve repair is not indicated. Sensory protection may also provide some advantages in the preservation of muscle volume. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2012.01.018

Intractable skin ulcerations associated with ion beam therapy

【下肢～足切断術の新しいアプローチ】趾切断時におけるfillet toe flapの利用 Invited Reviewed

Sakakibara Shunsuke, Terashi Hiroto, Sakurai Sayuri, Hashikawa Kazunobu, Tahara Shinya

創傷 Vol. 3 ( 3号 ) page： 123 - 128 2012.7

Shibaoka Y., Hashikawa K., Sarayama Y., Niwa Y., Terashi H., Omori M., Murakami M., Tahara S.

Japanese Journal of Plastic Surgery Vol. 55 ( 5 ) page： 527 - 537 2012.5

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Ion beam therapy has lately attracted considerable attention as an effective means for beating cancers. Ion beam experts say that it produces less harmful side effects than regular radiation because of its physical features. Sometimes, however, it induces severe skin damage as a side effect. We experienced seven cases of intractable ulcerations associated with ion beam therapy. Original diseases of our cases are composed of three hepatocellular carcinomas, three soft tissue sarcomas, one squamous cell carcinoma in the head and neck region. From these seven cases, we found two important clinical features of the ulcerations due to ion beam. First, severe skin necrosis or ulcerations occur frequently when cancers are located shallowly in the body, for instance hepatocellular carcinoma and soft tissue sarcomas in the extremities. Second, the outbreak of ulceration after ion beam therapy is much earlier than that of chronic ulcerations after regular radiation therapy. Conservative therapy is not effective to cure the ulcerations. We should achieve sufficiently deep debridement and reconstruct the defect by a flap rich in blood supply.

Novel theory for surgical reconstruction of segmental mandibular defect

Risk Factors of Anastomotic Thrombosis in 200 Head and Neck Free Flaps among Asian Patients Reviewed

MakiguchiT, Hashikawa Kazunobu, SugiyamaD, YokooS, TerashiH, NibuK, KumagaiS, TaharaS

Surg Sci Vol. 3 ( 5 ) page： 237 - 241 2012.5

リンパ浮腫を伴う絞扼輪症候群における術後リンパ流の検討 Reviewed

Sakakibara Shunsuke, Ogawa Haruo, Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本形成外科学会会誌 Vol. 32 ( 5号 ) page： 352 2012.5

粒子線治療に伴う難治性皮膚潰瘍の検討 Reviewed

Shibaoka Mie, Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

形成外科 Vol. 55 ( 5号 ) page： 527 - 537 2012.5

糖尿病性足潰瘍におけるカンジダ性骨髄炎の1例 Reviewed

Sakakibara Shunsuke, Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 32 ( 5号 ) page： 354 2012.5

広頸筋皮弁と頸部島状皮弁の口腔再建における適応と問題点

横尾聡, 高山優, 牧口貴哉, 宮崎英隆, 古森孝英, 橋川和信, 寺師浩人, 田原真也

頭頸部癌 Vol. 38 ( 2 ) page： 196 - 196 2012.5

顎口腔領域の広範囲欠損に対する遊離腹直筋皮弁と遊離腓骨皮弁によるdouble free flap reconstruction

牧口貴哉, 宮崎英隆, 小川将, 高山優, 橋川和信, 寺師浩人, 古森孝英, 田原真也, 横尾聡

頭頸部癌 Vol. 38 ( 2 ) page： 198 - 198 2012.5

がん切除後下顎骨再建における新しい理論「CATコンセプト」(第1報) その概念と妥当性の検討 Reviewed

Hashikawa Kazunobu, Sugiyama Daisuke, Yokoo Satoshi, Tahara Shinya

頭頸部癌 Vol. 38 ( 1号 ) page： 84 - 89 2012.4

NOVEL TREATMENT OF LYMPHORRHEA WITH FLUORESCENT LYMPHOGRAPHY

Shunsuke Sakakibara, Kanako Yuasa, Hiroto Terashi, Kazunobu Hashikawa, Shinya Tahara

WOUND REPAIR AND REGENERATION Vol. 20 ( 1 ) page： A10 - A10 2012

Hashikawa Kazunobu, Sugiyama Daisuke, Yokoo Satoshi, Tahara Shinya

Japanese Journal of Head and Neck Cancer Vol. 38 ( 1 ) page： 84 - 89 2012

Language：English Publisher：Japan Society for Head and Neck Cancer

We propose the "CAT concept", a new theory for surgical reconstruction after oncological segmental mandibulectomy. The essence of the theory is to reconstruct three reference points on the mandible - "C" (condylar head) "A" (mandibular angle) and "T" - necessary and sufficient for its surgical reconstruction. An anthropometric analysis of the mandible of ten preserved human cadavers showed that the mandibular contour can be made merely 3 to 7 mm smaller than the original when the CAT concept is adopted, suggesting that the concept sufficiently satisfies the condition for surgical reconstruction of the mandible. A review of our 45 clinical cases of mandibular reconstruction after oncological ablation demonstrated a positive trend between the number of reconstructed or non-resected reference points of the CAT concept and the esthetic outcome of each patient (Fisher's exact test, p<0.01), suggesting that the concept satisfies the necessary condition. Given these results, we concluded that the CAT concept is a highly practical theory for the surgical reconstruction of segmental mandibular defects.

DOI： 10.5981/jjhnc.38.84

頭頸部free flap連続200例を対象とした血栓形成危険因子の検討

True pedicled fibular graftによる脛骨遠位骨欠損の再建 Reviewed

Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 31巻, 10号, pp. 716-720 2011.10

縦隔炎・胸骨骨髄炎においてデブリードマンの範囲決定にMRIは有効か? Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 31巻, 10号, pp. 725-725 2011.10

頭皮からの分層植皮術におけるわれわれの工夫 Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 31巻, 10号, pp. 729-729 2011.10

がん切除後下顎骨再建術における新しい概念 CATコンセプト

Hashikawa Kazunobu

日本口腔外科学会雑誌 Vol. 57巻, Suppl., pp. 96-96 2011.9

下顎プレート再建での合併症への対応プレート除去を伴う場合

Furudoi Shungo, Hashikawa Kazunobu

日本口腔外科学会雑誌 Vol. 57巻, Suppl., pp. 216-216 2011.9

蛍光X線分析法による微量元素解析上眼瞼インプラントの解析より Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 27巻, 3号, pp. 292-296 2011.9

顎口腔再建におけるフェーズコントラスト型CT Angiographyの有用性について

Hashikawa Kazunobu, Furudoi Shungo, Shibuya Yasuyuki

日本口腔外科学会雑誌 Vol. 57巻, Suppl., pp. 215-215 2011.9

牧口貴哉, 橋川和信, 宮崎英隆, 根岸明秀, 寺師浩人, 丹生健一, 田原真也, 横尾聡

The Kitakanto Medical Journal Vol. 61 ( 3 ) page： 462 - 462 2011.8

Super-microsurgeryトレーニング用血管モデルの開発リアルさへのこだわり Reviewed

Hashikawa Kazunobu, Sakakibara Shunsuke, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 179-179 2011.7

マイクロサージャリーに有用な画像診断学の進歩

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 83-83 2011.7

リンパ浮腫患者のリンパ管組織構造の一考察 Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 196-196 2011.7

基礎疾患のある患者に対するマイクロサージャリー頭頸部へのfree flap移植術における吻合部血栓のリスク因子について同一施設連続症例を対象とする患者因子の検討 Reviewed

Hashikawa Kazunobu, Sakakibara Shunsuke, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 66-66 2011.7

新しい皮弁血流モニター法 INVOS:無侵襲混合血酸素飽和度監視装置を用いて(第2報) Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 168-168 2011.7

脛骨遠位骨欠損再建におけるTrue pedicled fibular graftの有用性 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 135-136 2011.7

術中の血管吻合前に、動的皮膚組織灌流圧(dynamic skin perfusion pressure:d-SPP)を測定して、吻合方法を選択した3症例 Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 195-195 2011.7

高張塩溶液脱細胞化法による脱細胞化神経とその評価

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 120-121 2011.7

高張塩溶液脱細胞化法による脱細胞化血管の開発とその評価 Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 24巻, 2号, pp. 117-117 2011.7

Oral candidiasis mimicking tongue cancer Reviewed

Tomohisa Shibata, Daisuke Yamashita, Shingo Hasegawa, Miki Saito, Naoki Otsuki, Kazunobu Hashikawa, Shinya Tahara, Ken-ichi Nibu

AURIS NASUS LARYNX Vol. 38 ( 3 ) page： 418 - 420 2011.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Candida species inhabit the mucosal surfaces of healthy individuals. Major forms of oral candidiasis are pseudomembranous and atrophic form, but chronic hyperplastic candidiasis (CHC) is rarely seen. We encountered a nodule caused by candidal infection on a forearm flap in the oral cavity mimicking a recurrent tongue cancer, which revealed as CHC by histopathological examination. Like other forms of oral candidiasis, the nodule well responded to the treatment of antifungal agents and eventually disappeared: When an intraoral nodule is observed, the possibility of CHC should be taken into consideration. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2010.11.007

下顎骨再建術におけるイノベーション CAT分類・CATコンセプト Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 27巻, 2号, pp. 141-141 2011.6

がん切除後下顎骨再建における指標「CATコンセプト」多施設症例データに基づく検証 Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 37巻, 2号, pp. 262-262 2011.5

上顎再建整容的改善への挑戦がん切除後上顎・眼窩再建に対する神戸大学の治療タクティクス Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 37巻, 2号, pp. 177-177 2011.5

舌癌切除後の前腕皮弁による再建術後に著明な内頸静脈、外頸静脈血栓を認め、皮弁壊死となった1例 Reviewed

Hashikawa Kazunobu, Sakakibara Shunsuke, Tahara Shinya

日本形成外科学会会誌 Vol. 31巻, 3号, pp. 205-205 2011.3

仙尾骨・皮膚全層欠損に対して両側hatchet型大臀筋皮弁による再建を行った1例 Reviewed

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 31巻, 1号, pp. 43-46 2011.1

形成外科領域におけるMR-Microscopyの有用性

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 31巻, 1号, pp. 69-69 2011.1

順行性有茎腓骨弁により脛骨遠位の再建を行った1例

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 31巻, 1号, pp. 65-65 2011.1

A Modified Transmetatarsal Amputation Reviewed

Hiroto Terashi, Ikuro Kitano, Yoriko Tsuji, Kazunobu Hashikawa, Shinya Tahara

JOURNAL OF FOOT & ANKLE SURGERY Vol. 50 ( 4 ) page： 441 - 444 2011

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

The incidence of the diabetic foot is increasing worldwide. Because evidence has shown that transmetatarsal amputation is associated with fewer failures in amputations of the diabetic foot with or without peripheral arterial disease, improving its management and surgical technique is a mission for the surgeon. Conventional transmetatarsal amputation has held firm, however, for more than 150 years. With a new concept for the transmetatarsal amputation method aimed at a better outcome, we propose a modified procedure for preserving the soft tissue between the metatarsal bones (the vasculature complex with the muscles, periostea, and vessels) and applying it to the distal bone stumps. The purpose of this method is to secure a functional foot by preserving the longitudinal arch. The new method was applied to 11 patients with diabetes mellitus or peripheral arterial disease, or both. All wounds closed successfully. Of the 11 patients, 8 were still alive with no complications. Of these 8 patients, 6 were able to ambulate with a custom-made shoe and 2 used a wheelchair, just as preoperatively. Of the 3 patients who died, 1 died a natural death, 1 died of sepsis, and 1 of cerebral infarction. We believe that the modified transmetatarsal amputation that we have described in this report is a potential breakthrough in the care of patients with forefoot gangrene and may gain acceptance over time. (C) 2011 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI： 10.1053/j.jfas.2011.03.018

リンパ管蛍光造影法によるリンパ漏の評価・治療 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本創傷治癒学会プログラム・抄録集40回 Vol. 巻, , pp. 68-68 2010.12

肘部骨露出創を有茎知覚付き皮弁で再建したのちに完全知覚再獲得がなされた症例の経験

Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 30巻, 11号, pp. 639-639 2010.11

仙尾骨・皮膚全層欠損の治療経験

田村亮介, 橋川和信, 牧口貴哉, 寺師浩人, 田原真也

日本形成外科学会会誌 Vol. 30 ( 11 ) page： 634 - 634 2010.11

がん切除後下顎骨区域欠損の新しい分類法「CAT分類」(第2報) 妥当性と有用性の検証 Reviewed

Hashikawa Kazunobu, Sugiyama Daisuke, Tahara Shinya

頭頸部癌 Vol. 36巻, 3号, pp. 309-315 2010.10

外傷後無眼球症の二次的義眼床変形に対するfree flapの適応について眼瞼皮膚、眼窩骨に欠損がない症例の検討 Reviewed

橋川和信, 櫻井沙由理, 高須啓之, Terashi Hiroto, 田原真也

創傷 Vol. 1 ( 3号 ) page： 119 - 124 2010.10

A Simplest Method of Flap Monitoring Reviewed

Shunsuke Sakakibara, Kazunobu Hashikawa, Makoto Omori, Hiroto Terashi, Shinya Tahara

JOURNAL OF RECONSTRUCTIVE MICROSURGERY Vol. 26 ( 7 ) page： 433 - 434 2010.9

下顎骨再建における再建プレート露出予防法 Wrap-Around法とRun-Through法

Hashikawa Kazunobu

日本口腔外科学会雑誌 Vol. 56巻, Suppl., pp. 98-98 2010.9

再建プレートを用いた下顎再建症例における術後合併症の検討

Furudoi Shungo, Shibuya Yasuyuki, Hashikawa Kazunobu

日本口腔外科学会雑誌 Vol. 56巻, Suppl., pp. 98-98 2010.9

口腔癌手術における嚥下改善手術に関する臨床的検討

Hashikawa Kazunobu, Furudoi Shungo, Shibuya Yasuyuki

日本口腔外科学会雑誌 Vol. 56巻, Suppl., pp. 140-140 2010.9

舌癌切除の前腕皮弁再建術後に著明な内頸・外頸静脈血栓を認め皮弁壊死となった1例

Hashikawa Kazunobu, Furudoi Shungo

日本口腔外科学会雑誌 Vol. 56巻, Suppl., pp. 191-191 2010.9

Blowing ratio as an evaluation tool for velopharyngeal function after oral and oropharyngeal cancer resection. Reviewed International journal

Chieri Katoh, Miki Saitoh, Miki Tsuneyuki, Hitoshi Tanimoto, Kazunobu Hashikawa, Shinya Tahara, Naoki Otsuki, Ken-ichi Nibu

Head & neck Vol. 32 ( 8 ) page： 1012 - 1018 2010.8

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

BACKGROUND: Our objective was to evaluate the value of the blowing test to measure the speech and swallowing function after resection of oral or oropharyngeal cancer. METHODS: Speech and swallowing functions of the patients after surgical resection of oral or oropharyngeal cancer were assessed by a speech intelligibility test, blowing time, questionnaires, and oropharyngeal pressures. Blowing time (pressure) ratio was determined by dividing blowing time (pressure) with open nose by blowing time (pressure) with closed nose. RESULTS: Blowing time ratio had significant correlation with blowing pressure ratio (p = .014), score of speech intelligibility test (p = .0014), questionnaire for aspiration (p = .029), nasopharyngeal backflow (CC = 0.676, p = .032), amount of food to swallow (p = .037), and oropharyngeal pressure during swallowing (p = .024). CONCLUSION: The present results demonstrated the value of blowing time ratio as a simple objective tool for speech and swallowing ability related to velopharyngeal function after resection of oral and oropharyngeal cancers.

DOI： 10.1002/hed.21283

Haemodynamic changes in the fingers after free radial forearm flap transfer: a prospective study using SPP

PVAハイドロゲル製微小血管モデルを用いる微小血管端側吻合のトレーニング/シミュレーション Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 26巻, 2号, pp. 223-223 2010.6

うっ血を生じた足背部逆行性皮弁に対し静脈吻合を付加して皮弁生着に成功した2症例 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 167-167 2010.6

下顎区域切除後のプレート再建に関する一考察 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 118-118 2010.6

ポリビニルアルコール(PVA)ゲルで作製した新しい吻合練習用微小血管モデルの使用経験 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 106-107 2010.6

再建プレートで下顎骨を再建する際のプレート露出予防法 wrap-around法とrun-through法 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 26巻, 2号, pp. 159-159 2010.6

皮弁血糖値測定による皮弁血流のモニタリング

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 179-179 2010.6

新世代の吻合練習用微小血管モデル EXSURG.Microvascular Model 使用経験

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 91-91 2010.6

新しい脱細胞化技術による代替小口径血管・末梢神経の開発 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 153-153 2010.6

手関節部での橈骨動脈の走行に破格を認めた1症例

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 23巻, 2号, pp. 120-120 2010.6

蛍光X線分光法による微量元素解析(第2報) Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 26巻, 2号, pp. 190-191 2010.6

0.5mm径PVAハイドロゲル製血管モデルを用いるスーパーマイクロサージャリーのトレーニング Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 36巻, 2号, pp. 181-181 2010.5

がん切除後下顎骨再建における指標「CATコンセプト」その概念と保存屍体を用いた検討 Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 36巻, 2号, pp. 198-198 2010.5

Akira Yanagisawa, Kazunobu Hashikawa, Daisuke Sugiyama, Takaya Makiguchi, Hideyuki Yanagi, Shunichi Kumagai, Satoshi Yokoo, Hiroto Terashi, Shinya Tahara

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY Vol. 63 ( 3 ) page： 539 - 543 2010.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Harvesting the radial forearm flap may cause circulatory problems in the donor arm. To investigate the influence on donor hands after radial forearm flap harvesting, we assessed the process of circulatory changes prospectively by measuring skin perfusion pressure (SPP) that is clinically useful in detecting vascular lesions.
The records of 17 patients (14 men and 3 women aged 59.7 +/- 11.8 years) who had undergone free radial forearm flap transfer for head and neck reconstruction, between December 2005 and April 2007, were analysed. SPP in the thumb (finger I), the middle finger (III) and the little finger (V) was measured in the 17 patients preoperatively and 1 month and 3, 6, 9 and 12 months postoperatively. All statistical tests were two sided, with a significance level defined as p < 0.05.
Preoperatively, baseline SPP was more dominant in finger I than in finger V. Postoperatively, SPP changed significantly in both fingers, while it showed no change in finger III and tended to be higher in finger I than in the other two.
Harvesting the free radial forearm flap reduces skin perfusion in the fingers of the donor arm and, we assume, leads to a re-distribution of blood flow to the fingers, with the residual ulnar artery still supplying more blood flow to finger I than to finger V. This suggests the presence of an autoregulating mechanism whereby blood perfusion to the fingers is controlled by the physiological demands of individual fingers. (C) 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2008.11.068

Reconstruction of the Orbital Floor With Sheets of Autogenous Iliac Cancellous Bone Reviewed

舌と眼瞼の病的共同運動が顔面-舌下神経クロスリンク手術により軽快した顔面神経不全麻痺症例の経験 Reviewed

Hashikawa Kazunobu

Facial Nerve Research Vol. 29巻, , pp. 93-96 2010.1

蛍光X線分析装置を用いたフィラー・インプラントの微量元素分析 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本形成外科学会会誌 Vol. 30巻, 1号, pp. 1-5 2010.1

NEW ACELLULAR SCALP DERMIS TO MAKE EX-VIVO PRODUCED SKIN EQUIVALENT WITH HAIR FOLLICLES

H. Terashi, S. Sakakibara, M. Hasegawa, T. Makiguchi, K. Hashikawa, S. Tahara, T. Yamaoka, A. Mahara, T. Fujisato

WOUND REPAIR AND REGENERATION Vol. 18 ( 1 ) page： A4 - A4 2010

【キズアトをいかにきれいにするか scarless wound healingのために】手術による瘢痕の治療瘢痕を少なくする縫合法と縫合糸の選択

牧口貴哉, 橋川和信, 田原真也

PEPARS ( 35 ) page： 1 - 7 2009.11

Language：Japanese Publisher：(株)全日本病院出版会

縫合糸や皮膚閉鎖に用いる材料の特性を十分に理解することは'キズアトをきれいにする'ために重要である。たとえ縫合技術が一流であっても、材料に対する理解が不十分であれば良好な結果を得ることはできない。瘢痕形成を考慮すると、組織反応が少なく、抗張力の持続するモノフィラミント合成非吸収糸であるナイロン糸を用いた真皮縫合が主流であった。しかし近年、長期間抗張力を維持する吸収糸が開発され、真皮縫合に使用される機会が増えてきた。長期的な縫合糸膿瘍、糸露出の危険性を考慮すると、PDS IIなどの抗張力の持続するモノフィラメントの合成吸収糸は有用である。真皮縫合の後、創縁の微妙な修正やズレの防止のために、縫合糸を用いた表皮縫合を行う。皮下縫合、真皮縫合で創縁がしっかりと外反、密着している状態では、表皮縫合をせずに皮膚表面接着剤、サージカルテープや半透過性透明フイルムも(1)抜糸の必要がない、(2)針糸刺入による組織損傷がない、(3)手術時間の短縮が可能、(4)縫合糸痕の心配がない、という点で有用な皮膚閉鎖法である。本稿では、真皮縫合に用いる縫合糸の選択および表皮縫合の方法について詳述する。(著者抄録)

上顎歯肉癌切除後の広範欠損にAbbe-Estlander flapと前腕皮弁による再建を行った一例 Reviewed

Furudoi Shungo, Hashikawa Kazunobu, Shibuya Yasuyuki

日本口腔外科学会雑誌 Vol. 55巻, Suppl., pp. 146-146 2009.9

新しい下顎骨区域欠損分類法 CAT分類 Reviewed

Hashikawa Kazunobu

日本口腔外科学会雑誌 Vol. 55巻, Suppl., pp. 125-125 2009.9

褥瘡滲出液中に含まれるタンパク質を考える(中間報告) 慢性創傷のモデルとして Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本褥瘡学会誌 Vol. 11巻, 3号, pp. 333-333 2009.8

心房細動が頭頸部Free Flapにおける吻合部血栓に与える影響 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 170-170 2009.6

神経の変則的縫合術移植床神経による筋(皮)弁の「再支配」ラットモデルを用いた脱神経萎縮防止効果の検討 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 92-93 2009.6

神経の変則的縫合術神経トレーサーを用いる神経回路解析実験におけるわれわれの工夫 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 90-90 2009.6

懸垂状を呈した後頭骨骨腫の1例 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 25巻, 2号, pp. 171-171 2009.6

遊離皮弁による頭蓋底悪性腫瘍切除後再建 `Step-Surgery Concept'を用いて Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 145-145 2009.6

頭頸部腫瘍切除後の二次再建頭頸部腫瘍切除後の二次的義眼床形成再建手術治療戦略と問題点 Reviewed

Hashikawa Kazunobu, Ichinose Akihiro, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 25巻, 2号, pp. 100-101 2009.6

頭頸部Free Flap連続250例を対象とした血栓形成危険因子の検討 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 25巻, 2号, pp. 124-125 2009.6

遊離皮弁による頭頸部再建術後の内頸静脈血栓症 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 169-169 2009.6

顔面神経麻痺の後療法顔面神経-舌下神経クロスリンク手術の術後リハビリテーション Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 22巻, 2号, pp. 84-85 2009.6

顔面部に用いられるフィラーの蛍光X線分析法による微量元素分析 Reviewed

Sugimoto Isao, Sakakibara Shunsuke, Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 25巻, 2号, pp. 168-168 2009.6

Shunsuke Sakakibara, Kazunobu Hashikawa, Hiroto Terashi, Shinya Tabara

JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY Vol. 67 ( 5 ) page： 957 - 961 2009.5

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

Purpose: Various autografts and synthetic materials such as titanium plates have been used for orbital floor reconstruction; however, no consensus on reconstruction methods has been reached. We have used iliac cancellous bone for this reconstruction with good results.
Patients and Methods: Patients (n = 101) enrolled in this study underwent orbital floor reconstruction of pure blowout fracture with an approximate I mm thinned and trimmed iliac cancellous bone without fixation of the graft. The results were assessed by CT; diplopia exceeding an angle of 45 degrees was evaluated as a poor outcome.
Results: Postoperatively, diplopia appeared in 15 patients and disappeared in 86 patients. At 6-month follow-up, CT showed that the morphology of the orbit was well maintained and no shedding or improper positioning of the grafted bone was observed in any of the patients. Moreover, CT images demonstrated ossification of the transplanted bone graft.
Conclusions: The method encompassing the use of the medulla of the iliac bone has several merits: 1) the graft bone is sufficiently pliable and flexible to fit the gently curving orbital floor; 2) being soft, it is easy to cut. Furthermore, no complication attributable to its fragility is observed at short- and long-term follow-up. The I mm thin medullar bone graft derives its robustness from its beamed structure. We consider the medulla of the iliac bone fitting autosomal material for the reconstruction of the orbital floor. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:957-961, 2009

DOI： 10.1016/j.joms.2008.08.014

Assessment of shapes of ischia with pressure ulcers

がん切除後下顎骨欠損の新しい分類法「CAT分類」 (第2報)有用性と妥当性の検証 Reviewed

Hashikawa Kazunobu, Sugiyama Daisuke, Tahara Shinya

頭頸部癌 Vol. 35巻, 2号, pp. 110-110 2009.5

Makiguchi T., Terashi H., Hashikawa K., Tamura R., Tahara S.

Japanese Journal of Plastic Surgery Vol. 52 ( 4 ) page： 445 - 450 2009.4

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

The process of the ischium may be a risk factor for intractable pressure ulcers, as is the process of the sacrum. How the ischium affects pressure ulcers is the subject of controversy, however, because little is known about the shapes of ischia with pressure ulcers. With 3-dimensional computed tomography (3D-CT), we assessed the extent of the prominence of the ischium and free bone fragments of eight patients with ischial ulcers who required surgery. In 6 out of 9 patients (67 %) the ischia of the side with pressure ulcers were less prominent than, and in 3 patients ischial bones of the side with pressure ulcers were as prominent as, the other side, demonstrating that in no case is the ischium of the side with the pressure ulcer more prominent than the other side. In the sitting position, the pelvis tends to lean toward the side of the less prominent ischium. Ischial pressure ulcers may be intractable because of the leaning, which increases interface pressure on the side of the pressure ulcer.

Two cases of antegrade venous anastomosis employed on distally-based flap from dorsal foot

上顎に発生した低悪性型筋線維芽細胞肉腫の1例 Reviewed

Murata Maho, Umeda Masahiro, Hashikawa Kazunobu, Komori Takahide

日本口腔外科学会雑誌 Vol. 55巻, 4号, pp. 184-188 2009.4

坐骨部褥瘡における骨形態の評価 Reviewed

Hashikawa Kazunobu

形成外科 Vol. 52巻, 4号, pp. 445-450 2009.4

Ogawa H., Nomura T., Ejiri H., Ito K., Hashikawa K., Tahara S.

Japanese Journal of Plastic Surgery Vol. 52 ( 3 ) page： 325 - 331 2009.3

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

When a surgeon treats a distal foot ulcer accompanying exposure of the bone or joint, reverse flow flap from the dorsal foot is a useful maneuver to employ. Reverse flow flaps are very useful for the reconstruction of distal extremities; however, venous congestion of the flap may occur. Although various theories of reverse venous drainage have been reported, the safety and certainty of reverse flow flap have not been verified. In this report, we use the reverse flow flap from the dorsal foot to treat distal foot ulcers. We performed venous anastomosis to persuade postoperative venous drainage antegradely. We present two case reports and discuss the reliability of venous anastomosis in reverse flow flap surgery.

Selection of operative methods for decubitus on calcaneal region

同一創部における合成吸収糸:polydioxanone糸と合成非吸収糸:ナイロン糸の瘢痕比較 Reviewed

Hashikawa Kazunobu, Tahara Shinya

瘢痕・ケロイド治療ジャーナル Vol. 巻, 3号, pp. 45-48 2009.3

第2足趾移植により再建した指末節periosteal chondromaの1例 Reviewed

Hashikawa Kazunobu, Sugimoto Isao

日本形成外科学会会誌 Vol. 29巻, 3号, pp. 185-186 2009.3

手に発生した静脈奇形に対する硬化療法 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本手の外科学会雑誌 Vol. 26巻, 1号, pp. S146-S146 2009.3

心房細動が頭頸部free flapにおける吻合部血栓に与える影響 Reviewed

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 29巻, 3号, pp. 209-209 2009.3

術前放射線化学療法併用直腸癌Miles手術後に創部潰瘍を生じた症例の治療経験 Reviewed

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 29巻, 3号, pp. 184-184 2009.3

長期安静保持を必要とする難治性潰瘍患者の静脈血栓塞栓症(VTE)予防について Reviewed

Hashikawa Kazunobu

日本形成外科学会会誌 Vol. 29巻, 3号, pp. 205-205 2009.3

陳旧性顔面神経麻痺の静的形成手術における神戸大学の取り組み Reviewed

Hashikawa Kazunobu, Sakakibara Shunsuke, Ichinose Akihiro

Facial Nerve Research Vol. 28巻, , pp. 114-119 2009.2

順行性神経トレーサー法による神経回路解析顔面-舌下神経cross-link手術をモデルとして Reviewed

Sakakibara Shunsuke, Hashikawa Kazunobu

Facial Nerve Research Vol. 28巻, , pp. 48-50 2009.2

New acellular scalp dermis to make ex-vivo produced skin equivalent with hair follicles

Terashi H., Yokoo S., Sakakibara S., Hashikawa K., Kurata S., Sunagawa T., Makiguchi T., Fujisato T., Itami S., Hasegawa M., Tahara S.

WOUND REPAIR AND REGENERATION Vol. 17 ( 1 ) page： A7 - A7 2009

超高静水圧処理法によるヒト頭皮由来無細胞真皮作製男性型脱毛症の再生外科的治療法へのステップ

Hashikawa Kazunobu, Tahara Shinya

日本創傷治癒学会プログラム・抄録集38回 Vol. 巻, , pp. 49-49 2008.12

手指壊疽に対するDistal Venous Arterializationの経験 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 21巻, 4号, pp. 438-442 2008.12

顔面骨骨折整復固定時のドリル破折症例に関する検討 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 4号, pp. 245-251 2008.12

Terashi H., Tsuji Y., Hashikawa K., Fujii M., Okumura K., Kitano I.

Japanese Journal of Plastic Surgery Vol. 51 ( 10 ) page： 1173 - 1182 2008.10

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

We have to reconsider the selection of operative methods for decubitus on calcaneal regions, unlike the reconstructive operative methods for the loading region on feet. This is because it depends upon the pathogenesis of decubitus, sensory level, and/or ambulatory condition whether the wound has the operative indication. We here classify the decubitus on calcaneal region into three patterns. 1. Bedfast patient 2. Diabetes mellitus (DM) and/or peripheral arterial disease (PAD) 3. Ambulatory paralytic patient.

Sclerotherapy for venous malformations; evaluation of simulation cavenography based on our classification of circulation of venous malformation

下顎骨再建のupdate 腫瘍切除後の一次下顎再建における治療指針の確立がん切除後下顎骨区域欠損の新しい分類法「CAT分類」(第1報) その概念と分類の実際 Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 34巻, 3号, pp. 412-418 2008.10

神戸大学口腔外科における口底再建の工夫

Furudoi Shungo, Shibuya Yasuyuki, Hashikawa Kazunobu, Tahara Shinya

日本口腔腫瘍学会誌 Vol. 20巻, 3号, pp. 204-204 2008.9

口腔癌広範切除後の早期気管孔閉鎖は必ずしも必要ではないレティナ装着を組み入れた口腔癌広範切除症例の標準治療

Furudoi Shungo, Shibuya Yasuyuki, Hashikawa Kazunobu, Tahara Shinya

日本口腔科学会雑誌 Vol. 57巻, 3号, pp. 362-362 2008.7

マイクロサージャリーの基本手技血管吻合神戸大学形成外科における基本的な微小血管吻合法 Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 21巻, 2号, pp. 117-117 2008.6

先天性耳瘻管摘出術における瘻管染色の工夫 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 2号, pp. 84-85 2008.6

内視鏡下経鼻腔的整復術(EER)は眼窩内側壁骨折治療の標準的術式となり得るか Reviewed

Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 2号, pp. 116-116 2008.6

眉間部に発生したOsteolipomaの1例発生起序を脂肪腫由来幹細胞の分化能の観点から推察 Reviewed

Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 2号, pp. 102-102 2008.6

術後車椅子、自動車運転座席、便座における接触圧評価を行った坐骨部褥瘡の1症例 Reviewed

Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

日本褥瘡学会誌 Vol. 10巻, 2号, pp. 136-142 2008.6

顔面に生じたSpitz母斑の2症例 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 2号, pp. 104-105 2008.6

顔面pseudolymphomaの一例 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本頭蓋顎顔面外科学会誌 Vol. 24巻, 2号, pp. 106-106 2008.6

頭頸部free flap連続200例を対象とした血栓形成危険因子の検討メタボリックシンドロームは危険因子か?

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 21巻, 2号, pp. 189-190 2008.6

顔面神経-舌下神経クロスリンク手術(仮)は顔面病的共同運動に対する治療法となり得るか?

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 21巻, 2号, pp. 144-144 2008.6

Nagata I., Sakurai A., Nomura T., Kenmoku K., Makiguchi T., Hashikawa K., Terashi H., Tahara S.

Japanese Journal of Plastic Surgery Vol. 51 ( 5 ) page： 555 - 560 2008.5

Language：Japanese Publisher：Japanese Journal of Plastic Surgery

Sclerotherapy for venous malformation is thought to be a simple, relatively safe, minimally invasive treatment that leaves no scars. Its effectiveness has often been reported, and it is the standard treatment in Japan. Here, we investigated the usefulness of simulation cavernography and sclerotherapy for venous malformation. We retrospectively analyzed 80 sclerotherapy sessions of 42 patients diagnosed with venous malformation and treated by sclerotherapy at Kobe University Hospital and in the Division of Plastic Surgery, National Hospital Organization Himeji Medical Center, from April 2000 to October 2006. The results of fluoroscopy were classified into four types according to the following procedures. Type I : Pooling of contrast medium in the cavity of the venous malformation was confirmed, and sclerotherapy was conducted continuously (50 sessions, 62.5%). Type II : A thick drainage vein was confirmed, another part was punctured, and sclerotherapy was conducted continuously (8 sessions, 10.0%). Type IIIa : A thick drainage vein was confirmed, and sclerotherapy was carried out by manually pressing the vein to prevent the sclerosant from flowing into the drainage vein (21 sessions, 26.3%). Type IIIb : A thick drainage vein was confirmed, another part was punctured, but sclerotherapy was discontinued (1 session, 1.25%). Had we carried out sclerotherapy without simulation cavernography, some side effects would probably have ensued in 37.5% of the cases. The results suggest that simulation cavernography and sclerotherapy are useful in the treatment of venous malformation.

Curious complication after oroesophageal reconstruction with free jejunal flap: Intrussusception-like deformity of transferred jejunum Reviewed

下顎骨再建のupdate 腫瘍切除後の一次下顎再建における治療指針の確立がん切除後下顎骨欠損の分類法について新しい分類法「CAT分類」の提案 Reviewed

Hashikawa Kazunobu, Tahara Shinya

頭頸部癌 Vol. 34巻, 2号, pp. 132-132 2008.5

神戸大学における悪性腫瘍切除後の遊離皮弁による頭蓋底一次再建 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

頭頸部癌 Vol. 34巻, 2号, pp. 153-153 2008.5

静脈奇形に対する硬化療法術中透視下病変造影の重要性 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

形成外科 Vol. 51巻, 5号, pp. 555-560 2008.5

異所性蒙古斑のレーザー治療後色素脱失に関する統計学的検討 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本レーザー医学会誌 Vol. 29巻, 1号, pp. 26-29 2008.4

神戸大学におけるケロイド切除後の電子線治療の方法と成績 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

瘢痕・ケロイド治療ジャーナル Vol. 巻, 2号, pp. 103-106 2008.3

順行性トレーサー法による舌下神経染色法 Reviewed

Hashikawa Kazunobu, Terashi Hiroto, Tahara Shinya

日本マイクロサージャリー学会会誌 Vol. 21巻, 1号, pp. 28-32 2008.3

Shunsuke Sakakibara, Shinya Tahara, Kazunobu Hashikawa, Ken-ichi Nibu

JOURNAL OF RECONSTRUCTIVE MICROSURGERY Vol. 24 ( 2 ) page： 89 - 92 2008.2

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：THIEME MEDICAL PUBL INC

Regions of oropharyngeal cancer, hypopharyngeal cancer, and cervical esophageal cancer in a 70-year-old man were surgically resected and reconstructed with a free jejunal flap. Postoperatively the patient showed severe dysphagia and a chimneylike protrusion in the oral cavity. In a second operation, a dorsal, longitudinal incision for phimosis was made to release the stenosis; however, the dysphagia persisted, and peristalis seemed to interfere with deglutition. Here, we discuss the cause of the dysphagia, a complication of total reconstruction of oroesophageal defects with a single free jejunal flap, and the procedures of reconstruction.

DOI： 10.1055/s-2008-1076092

血管奇形硬化療法における術中シミュレーション静脈奇形症例についての検討

Jump graft型顔面-舌下神経クロスリンク手術により不随意閉瞼が改善した顔面病的共同運動2例の経験 Reviewed

Hashikawa Kazunobu

Facial Nerve Research Vol. 27巻, , pp. 192-195 2008.1

櫻井敦, 野村正, 永田育子, 牧口貴哉, 橋川和信, 寺師浩人, 田原真也

日本シミュレーション外科学会会誌 Vol. 15 ( 4 ) page： 91 - 94 2008.1

Language：Japanese Publisher：日本シミュレーション外科学会

血管奇形に対する硬化療法に術中シミュレーションを導入し、その成績を報告した。対象は静脈奇形に対して硬化療法を施行し、造影記録を確認できた15症例(男性7名、女性8名)で、これらの症例に対して合計33回の治療を行った。術中シミュレーションの結果は以下の4タイプに分類した。造影剤が病変内に留まり、そのまま硬化療法を施行した症例(タイプ1,82%)。太い流出静脈や主要血管への流出が確認され、穿刺部位を変えて硬化療法を施行した症例(タイプ2,15%)。用手的圧迫で病変内に留まり、硬化療法を施行した症例(タイプ3a,0%)。用手的圧迫でも病変内に留まらず、硬化療法を断念した症例(タイプ3b,3%)。タイプ3aは硬化療法施行時にしばしば経験するが、今回の症例中では見られなかった。タイプ2と3bを併せると18%の症例で流出静脈を認めたが、いずれの症例も重篤な合併症は見られず、経過は良好であった。

Hybrid treatment for critical limb ischemia using skin perfusion pressure (SPP) as wound care management similar to Ten cases report

Nagata, I, H. Terashi, K. Hashikawa, Y. Tsuji, Kitano, I, S. Tahara

WOUND REPAIR AND REGENERATION Vol. 16 ( 1 ) page： A6 - A6 2008

Auricular cartilage graft for lower lid retraction in thyroid ophthalmopathy; "CLIC" comprehensive lid interlining cartilage graft

Hashikawa K., Tsuji Y., Azumi A., Terashi H., Tahara S.

Japanese Journal of Plastic and Reconstructive Surgery Vol. 50 ( 12 ) page： 1447 - 1453 2007.12

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

We describe two cases of hemilateral lower lid retraction in thyroid ophthalmopathy surgically treated with comprehensive lid interlining cartilage (CLIC) grafts, whereby the total lower lid is supported by 4.5×1 cm auricular cartilage. Case 1 : A 74-year-old man visited our department presenting with right lower lid retraction (4 mm lower than the contralateral side), The patient had three months earlier undergone right inferior rectus muscle recession to treat double vision. A CLIC graft to his right lower lid was carried out under local anesthesia. Case 2 : A 44-year-old man with right lower lid retraction (3 mm lower than the contralateral side) had 12 months earlier undergone right inferior rectus muscle recession. The patient underwent a CLIC graft under general anesthesia. In both cases, the retracted lower lid was corrected and restored to the level of the contralateral side I also, a natural symmetrical appearance of the mid-face was attained. CLIC grafting is an effective alternative treatment for lower lid retraction in thyroid ophthalmopathy patients.

Thin minigrafting technique for postburn leukoderma

毛髪付き培養複合皮膚作製へ向けてヒト頭皮由来無細胞真皮作製

寺師浩人, 横尾聡, 榊原俊介, 橋川和信, 倉田荘太郎, 砂川武, 牧口貴哉, 藤里俊哉, 板見智, 長谷川真澄, 田原真也

日本創傷治癒学会プログラム・抄録集 Vol. 37回 page： 55 - 55 2007.12

Miki Fujii, Hiroto Terashi, Kazunobu Hashikawa, Tadashi Nomura, Makoto Omori, Shinya Tahara

DERMATOLOGIC SURGERY Vol. 33 ( 11 ) page： 1368 - 1373 2007.11

Dynamic SPP(仮)が血行動態評価に有用であった重症虚血肢症例の経験

Hashikawa Kazunobu

日本シミュレーション外科学会会誌 Vol. 15巻, 3号, pp. 66-66 2007.9

Simple dressing technique using polyurethane foam for fixation of skin grafts

Atsushi Sakurai, Kazunobu Hashikawa, Satoshi Yokoo, Hiroto Terashi, Shinya Tahara

DERMATOLOGIC SURGERY Vol. 33 ( 8 ) page： 976 - 979 2007.8

Free scalp flapを用いた踵部潰瘍の治療経験

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 251-251 2007.6

Therapeutic strategy for the triad of acquired anophthalmic orbit

Kazunobu Hashikawa, Hiroto Terashi, Shinya Tahara

PLASTIC AND RECONSTRUCTIVE SURGERY Vol. 119 ( 7 ) page： 2182 - 2188 2007.6

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background: In treating patients with anophthalmic orbits, it is essential to achieve a long-lasting natural appearance and comfortable retention of eye prostheses. In 1992, the authors developed a therapeutic strategy based on a simple algorithm for treating the three common symptoms of acquired anophthalmic orbit: severe eye socket contracture is surgically treated with a radial forearm free flap transfer, upper lid depression is treated with lipoinjection, and lower lid retraction is treated with an auricular cartilage graft.
Methods: From 1992 to 2004, 18 acquired anophthalmic orbits (I I enucleated and seven exenterated) were treated at Kobe University Hospital based on the authors' therapeutic strategy. Aesthetic outcomes were evaluated according to patient and surgeon satisfaction.
Results: Sixteen patients underwent auricular cartilage grafts, eight received radial forearm free flap transfers, and seven were treated with lipoinjection. Optional revisional surgery was carried out in four cases. The aesthetic outcome was assessed as good in six patients, moderate in eight patients, and poor in four patients; the last four had undergone total maxillectomy with orbital exenteration or had eyelid defects because of previous cancer surgery.
Conclusions: The authors' therapeutic strategy for acquired anophthalmic orbit is simple and, with slight modification, fitting for most cases, although it necessitates innovative surgery in cases with orbital rim and/or eyelid defects.

DOI： 10.1097/01.prs.0000260706.07368.f1

Congenital melanocytic nevi and nevus spilus have a tendency to follow the lines of Blaschko: An examination of 200 cases

ブローアウト骨折の眼窩底再建におけるわれわれの工夫腸骨髄質骨プレートの有用性

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 87-87 2007.6

下顎再建に用いられた血管柄付き遊離腓骨の術後骨吸収についての統計学的検討

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 118-118 2007.6

下口唇有棘細胞癌切除後一期的再建方法(Free composite graftとOne-stage lip-switch flapの臨床的比較)

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 160-160 2007.6

口腔内に移植した遊離前腕皮弁に対するレーザー脱毛の経験

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 126-126 2007.6

眼窩下壁ブローアウト骨折の手術治療までの期間と手術成績

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 86-86 2007.6

甲状腺眼症の下眼瞼後退に対する耳介軟骨移植の経験 Comprehensive Lid Interlining Cartilage:CLIC法

Hashikawa Kazunobu

日本頭蓋顎顔面外科学会誌 Vol. 23巻, 2号, pp. 108-108 2007.6

深部静脈血栓症との関連が疑われた吻合部血栓の経験 Reviewed

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 147-152 2007.6

当院における肝動脈血行再建術

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 191-191 2007.6

遊離前腕皮弁採取による手部血行の変化皮膚灌流圧(SPP)測定による検討

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 245-245 2007.6

遊離前腕皮弁移植における神戸大学の取り組み

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 244-244 2007.6

顔面再建における神戸大学の治療戦略遊離皮弁移植と二次修正を組み合わせる再建法の評価と適応の検討

Hashikawa Kazunobu

日本マイクロサージャリー学会会誌 Vol. 20巻, 2号, pp. 188-188 2007.6

頭頸部free flap連続200例を対象とした血栓形成危険因子の検討メタボリックシンドロームは危険因子か?

Hashikawa Kazunobu

頭頸部癌 Vol. 33巻, 2号, pp. 159-159 2007.5

頭頸部再建 Conventional flap vs.Perforator flap 頭頸部再建におけるconventional flap、とくに前腕皮弁のreliabilityとversatilityについて

Hashikawa Kazunobu

頭頸部癌 Vol. 33巻, 2号, pp. 80-80 2007.5

Hiromi Hanayama, Hiroto Terashi, Kazunobu Hashikawa, Shinya Tahara

JOURNAL OF DERMATOLOGY Vol. 34 ( 3 ) page： 159 - 163 2007.3

Language：English Publishing type：Research paper (scientific journal) Publisher：BLACKWELL PUBLISHING

There have been few reports about the characteristics of the pigmentary arrangement of congenital melanocytic nevi (CMN) and nevus spilus (NS). Though the lines of Blaschko, which don't correspond to other lines such as Langer's lines and skin dermatomes, are well known to be followed by some rare pigmentary disorders, the relationship between these two disorders and the lines of Blaschko has not been discussed. Therefore, through an examination of 200 cases, we investigated whether or not the arrangement of CMN and NS follow the lines of Blaschko. Thirty-nine out of 92 cases (42.4%) of CMN and 67 out of 108 cases (62.0%) of NS were considered to follow the lines of Blaschko. Today, the idea is widely accepted that two functionally different cells proliferate during early embryogenesis of the skin which is caused from mosaicism and, as a result, the lines of Blaschko appear visually. In our results, we found that there were some cases of CMN and NS which showed a relationship with the lines of Blaschko, which is meaningful considering that the lesions and the lines are both related to pigmentary gene anomalies. The result was compared with CMN and NS by the chi(2) test. NS showed a predominant tendency to follow the lines with a significant difference (P = 0.0055). This may indicate that the lines of Blaschko reflect more clearly the proliferation of the epidermal cells than other cells in growth of the skin of the embryo. Further studies are required to elucidate the reason why some cases follow these lines and others do not.

DOI： 10.1111/j.1346-8138.2007.00242.x

Functional reconstruction of large anogenital defects with bilateral V-Y advancement posterior thigh fasciocutaneous flaps Reviewed

顔面の全層欠損に対する再建戦略 Step-Surgery Concept Reviewed

HASHIKAWA KAZUNOBU, TERASHI HIROTO, TAHARA SHINYA

日本マイクロサージャリー学会会誌 Vol. 20巻, 1号, pp. 46-53 2007.3

Miki Fujii, Hiroto Terashi, Kazunobu Hashikawa, Shinya Tahara

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY Vol. 60 ( 11 ) page： 1208 - 1213 2007

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Background: In patients with perianal extramammary Paget's disease, wide local A excision is recommended. In the reconstruction of the resulting large defects not only the closure of the defect but also the preservation of anogenital function need to be considered.
Methods: We used bilateral V-Y advancement posterior thigh fasciocutaneous flaps for reconstructing three large anogenital defects, including the total anal canal, resulting from wide tocal excisions attributed to extramammary Paget's disease. A temporary anus was constructed at the same time to allow the wound of the reconstructed anus to heal. After the surgery, the course of bowel function was followed up through interviews and manometric examinations.
Results: All defects were successfully reconstructed with the flaps, and bowel function recovered satisfactorily. Manometric examinations were carried out in two cases; anal pressures were recorded regularly and used as parameters of the recovery of bowel function before closing the artificial anus. Eventually, the patients recovered the function of defecation.
Conclusions: We recommend the bilateral V-Y advancement posterior thigh fasciocutaneous flaps together with manometric studies as one of the most effective techniques for managing large anogenital defects. The use of sensate flaps, the restoration of original structures and manometric studies are conducive to successful outcomes. (C) 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2007.02.005

REFINEMENT OF SURGICAL PROCEDURES IN RADIAL FOREARM FREE FLAP TRANSFER

HASHIKAWA Kazunobu, TERASHI Hiroto, TAHARA Shinya

Vol. 32 ( 3 ) page： 247 - 252 2006.10

仙骨部褥瘡に対する外科的療法の適応基準化と周術期管理方法に関する一考察神戸大学形成外科専門医アンケート調査 Reviewed

TERASHI HIROTO, HASHIKAWA KAZUNOBU

日本褥瘡学会誌 Vol. 8巻, 4号, pp. 560-565 2006.10

外傷性涙小管断裂の10例 Reviewed

TERASHI HIROTO, HASHIKAWA KAZUNOBU

日本頭蓋顎顔面外科学会誌 Vol. 22巻, 3号, pp. 203-208 2006.9

身体醜形障害を疑う患者に対する当科での取り組み Reviewed

HASHIKAWA KAZUNOBU, ICHINOSE AKIHIRO

日本形成外科学会会誌 Vol. 26巻, 8号, pp. 518-524 2006.8

Orthognathic surgery for occlusal reconstruction of old malunited jaw fracture

Yokoo S., Komori T., Furudoi S., Shibuya Y., Tateishi C., Hashikawa K., Tahara S., Hanagaki H.

Kobe Journal of Medical Sciences Vol. 52 ( 3 ) page： 37 - 47 2006.6

Language：Japanese Publisher：Kobe Journal of Medical Sciences

Old malunited jaw fractures of nine patients who underwent orthognathic surgery for occlusal reconstruction were clinically evaluated. Early surgery on fractures of the jaw is the optimal treatment when due attention must be paid to occlusion. Since occlusal revision surgery subsequent to inaccurate diagnosis and inappropriate surgery is certainly very difficult and often unsuccessful, surgeons need to pay special attention to this situation.

Simple reconstruction with titanium mesh and radial forearm flap after globe-sparing total maxillectomy: a 5-year follow-up study Reviewed

仙骨部褥瘡に対するrhomboid perforator flapの経験 Reviewed

HASHIKAWA KAZUNOBU, TERASHI HIROTO

日本褥瘡学会誌 Vol. 8巻, 2号, pp. 208-211 2006.6

Kazunobu Hashikawa, TAHARA, Shinya, ISHIDA, Haruhiko, YOKOO, Satoshi, Toshiaki Sanno, TERASHI, Hiroto, NIBU, Kenichi

Plastic And Reconstructive Surgery Vol. 117 ( 3 ) page： 963 - 967 2006.3

Orthognathic surgery for occlusal reconstruction of old malunited jaw fracture

Yokoo Satoshi, Komori Takahide, Furudoi Shungo, Shibuya Yasuyuki, Tateishi Chizu, Hashikawa Kazunobu, Tahara Shinya, Hanagaki Hirofumi

The Kobe journal of the medical sciences Vol. 52 ( 3 ) page： 37 - 47 2006

Publisher：神戸大学

Old malunited jaw fractures of nine patients who underwent orthognathic surgeryfor occlusal reconstruction were clinically evaluated. Early surgery on fractures of thejaw is the optimal treatment when due attention must be paid to occlusion. Sinceocclusal revision surgery subsequent to inaccurate diagnosis and inappropriate surgeryis certainly very difficult and often unsuccessful, surgeons need to pay special attentionto this situation.

Orthognathic surgery for occlusal reconstruction of old malunited jaw fracture.

Yokoo S, Komori T, Furudoi S, Shibuya Y, Tateishi C, Hashikawa K, Tahara S, Hanagaki H

The Kobe journal of medical sciences Vol. 52 ( 3-4 ) page： 37 - 47 2006

REFINEMENT OF SURGICAL PROCEDURES IN RADIAL FOREARM FREE FLAP TRANSFER

HASHIKAWA Kazunobu, TERASHI Hiroto, TAHARA Shinya

Toukeibu Gan Vol. 32 ( 3 ) page： 247 - 252 2006

Publisher：Japan Society for Head and Neck Cancer

We have carried out about 600 head and neck reconstructions with radial forearm free flap transfer and basic/clinical studies on flap circulation and surgical procedures. Knowledge obtained and refinement of surgical procedures in flap elevation, venous anastomosis and donor site coverage introduced at Kobe University Hospital are as follows: 1) Deep and superficial venous systems of the flap are connected by including the cubital perforating vein in the venous pedicle. 2) Our studies have revealed that the deep venous system has dominant blood flow compared with the superficial system. Consequently, drainage of the former system is crucial in reducing venous disturbance of the flap. 3) “Network venous anastomosis”, where the two separate venous systems of the flap are anastomosed with the two venous systems of the neck (the internal and external jugular veins) including their connecting perforating vein, imitates the anatomical venous drainage in the forearm, providing a reliable, fail-safe drainage system. 4) Skin grafts preserving subdermal vascular networks provide aesthetically more optimal results in covering the donor site of the flap. 5) Fixation of skin grafts to the donor site of the flap with polyurethane foam and film without using the tie-over procedure is an easy and time-saving method requiring no assistants.

DOI： 10.5981/jjhnc.32.247

Total lower lid support with auricular cartilage graft

Hashikawa K, Tahara S, Nakahara M, Sanno T, Hanagaki H, Tsuji Y, Terashi H

PLASTIC AND RECONSTRUCTIVE SURGERY Vol. 115 ( 3 ) page： 880 - 884 2005.3

Positive narrowing pharyngoplasty with forearm flap for functional restoration after extensive soft palate resection

Hashikawa K, Tahara S, Terashi H, Ichinose A, Nomura T, Omori M, Sanno T

PLASTIC AND RECONSTRUCTIVE SURGERY Vol. 115 ( 2 ) page： 388 - 393 2005.2

Three-dimensional reconstruction after oral oncologic surgery using single free radial forearm flaps or free rectus abdominis musculocutaneous flaps Reviewed

YOKOO, Satoshi, KOMORI, Takahide, Furudoi Syungo, UMEDA, Masahiro, Nomura Tadashi, Hashikawa Kazunobu, ICHINOSE, Akihiro, TAHARA, Shinya

Journal Of Oral Science Vol. 46 ( 1 ) page： 65 - 70 2004.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Nihon University School of Dentistry

This study reviews reconstruction of complex three-dimensional oral and maxillofacial defects using the single free radial forearm flap or the single free rectus abdominis musculocutaneous flap. Between 1996 and 2003, 124 patients underwent oral and maxillofacial reconstruction in the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine. Outcomes for 22 patients who underwent three-dimensional reconstruction of multiple surfaces were evaluated. Reconstruction was performed after resection of malignant tumors in all 22 patients. Single FAFs were utilized for 11 patients and single RAMs for the remaining 11. Flap survival rate was 100%. No major donor morbidity was observed, and all surviving patients (20/22) were able to perform normal daily living activities. Single FAF and RAM are useful materials for one-stage reconstruction of complex three-dimensional oral and maxillofacial defects requiring replacement of skin, mucosa, and intervening soft tissues. Good to excellent aesthetic results can be attained in most patients. (J. Oral Sci. 46, 65-70, 2004)

DOI： 10.2334/josnusd.46.65

Do multiple venous anastomoses reduce risk of thrombosis in free-flap transfer? Efficacy of dual anastomoses of separate venous systems

Ichinose A, Terashi H, Nakahara M, Sugimoto I, Hashikawa K, Nomura T, Ogata N, Yokoo S, Tahara S

ANNALS OF PLASTIC SURGERY Vol. 52 ( 1 ) page： 61 - 63 2004.1

Language：Japanese Publisher：Annals of Plastic Surgery

Whether or not multiple venous anastomoses reduce the risk of free-flap failure is a subject of controversy. We report here, for the first time, on the importance of selecting 2 separate venous systems of the flap for dual anastomoses. The efficacy of multiple anastomoses was verified through a retrospective review of 310 cases of the free radial forearm flap transfer. Dual anastomoses of separate venous systems (the superficial and the deep) showed a lower incidence of venous insufficiency than single anastomosis did (0.7% versus 7.5%; P < 0.05). On the other hand, dual anastomoses of a sole venous system showed no significant difference in the incidence of venous insufficiency compared with single anastomosis (11.5% versus 7.5%; P = 0.48). Our results suggest that dual venous anastomoses of separate venous systems is conducive to reduced risk of flap failure and affords protection against venous catastrophe through a self-compensating mechanism that obviates thrombosis of either anastomosis.

DOI： 10.1097/01.sap.0000096425.18223.60

Endoscopic endonasal reduction for blowout fracture of the medial orbital wall

Therapeutic importance of transplantation of a vascularised free flap for an oromandibular injury with infection and severe scar contracture Reviewed

YOKOO, Satoshi, KOMORI, Takahide, Sakurai A, Hashikawa K, Nomura T, Sanno T, ICHINOSE, Akihiro, TAHARA, Shinya

The British Journal Of Oral & Maxillofacial Surgery Vol. 41 ( 6 ) page： 380 - 382 2003.12

Sanno T, Tahara S, Nomura T, Hashikawa K

PLASTIC AND RECONSTRUCTIVE SURGERY Vol. 112 ( 5 ) page： 1228 - 1237 2003.10

Language：Japanese Publisher：Plastic and Reconstructive Surgery

Endoscopic endonasal reductions have been addressed in 63 patients with blowout fracture of the medial orbital wall since 1992. The operations were carried out under general anesthesia with a magnified operative space projected on a television monitor by a charge coupled device video camera attached to the endoscope. The middle nasal turbinate was fractured toward the nasal septum, the uncinate process was cut off, and the bulla was opened. The ethmoidal bony partition and the mucous membrane were removed; however, the fractured bone chips of the medial orbital wall were preserved. The herniated orbital contents were pressed back into the orbital cavity, and the medial wall was set with 2-mm-thick bent silicone plates placed in the ethmoidal sinus. The plates were removed in the outpatient clinic 2 months after the operation. The surgical results of 21 patients treated with endoscopic reduction were compared with those of four patients treated with transfacial reduction with an iliac bone graft. All of the patients had isolated medial wall fracture and became aware of diplopia within 15 degrees in any direction from the primary position (straight gaze) before the operation; the follow-up period covered 6 months. The patients were classified into two categories according to postoperative double vision: "good," indicating no double vision or diplopia of more than 45 degrees, and "poor," diplopia of less than 45 degrees. Improvement of diplopia was observed in all patients without any complication. Of the 21 patients who underwent endoscopic reductions, 17 were classified as "good" and four as "poor." On the other hand, of the four patients who underwent transfacial reductions, three were classified as "good" and one as "poor." Significant differences were not observed between the surgical results of our two methods. Endoscopic endonasal reduction showed greater aesthetic advantages and, moreover, required no grafting. This technique is suggested as one of the most reasonable treatments of medial orbital wall fractures.

DOI： 10.1097/01.PRS.0000080723.29129.64

Replantation of an avulsed zygomatic bone as a freeze-preserved autologous graft: a case report Reviewed

YOKOO, Satoshi, TAHARA, Shinya, Sakurai Atsushi, Hashikawa Kazunobu, TERASHI, Hiroto, Furudoi Syungo, UMEDA, Masahiro, KOMORI, Takahide

Journal Of Cranio-Maxillo-Facial Surgery Vol. 31 ( 2 ) page： 115 - 119 2003.4

Importance of the deep vein in the drainage of a radial forearm flap: A haemodynamic study

Ichinose A, Tahara S, Terashi H, Yokoo S, Nakahara M, Hashikawa K, Kenmoku K

SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY Vol. 37 ( 3 ) page： 145 - 149 2003

Importance of the deep vein in the drainage of a radial forearm flap: A haemodynamic study

Ichinose A., Tahara S., Terashi H., Yokoo S., Nakahara M., Hashikawa K., Kenmoku K.

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery Vol. 37 ( 3 ) page： 145 - 149 2003

Language：Japanese Publisher：Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery

The free radial forearm flap has two drainage veins, the cutaneous and the deep, but no established consensus has been reached on the selection of the drainage pedicle. In our study, the flow volumes of the veins were examined by colour Doppler ultrasonography after 20 forearm flaps had been raised. The volume through the deep vein was significantly higher than that through the cutaneous vein (p < 0.01). In comparing the total flow (both veins open), the flow rate through the deep vein alone (cutaneous vein occluded) was over 80% in 13 cases, 60%-80% in seven, and under 60% in none; that through the cutaneous vein alone (deep vein occluded) was 60%-80% in eight, 40%-60% in eight, under 40% in four, and over 80% in none. Our results show the importance of the deep vein, as indicated by its high drainage capacity from the early stages of flap transfer.

DOI： 10.1080/2844310310007746

Devices for facial aesthetic improvement in the treatment of skeletal mandibular protrusion

Importance of the deep vein in the drainage of a radial forearm flap: a haemodynamic study.

Ichinose A, Tahara S, Terashi H, Yokoo S, Nakahara M, Hashikawa K, Kenmoku K

Scandinavian journal of plastic and reconstructive surgery and hand surgery Vol. 37 ( 3 ) page： 145 - 9 2003

Yokoo S, Komori T, Tateishi C, Komurasaki H, Omori M, Hashikawa K, Tahara S

AESTHETIC PLASTIC SURGERY Vol. 26 ( 4 ) page： 251 - 254 2002

Language：Japanese Publisher：Aesthetic Plastic Surgery

Some techniques for the treatment of mandibular protrusion with consideration for aesthetic improvement of the face as a whole are described. The aesthetic inferiority complex in the mind of patients with masticatory disorders as the chief complaint should not be underestimated. Three techniques were used in this study; preoperative orthodontic treatment, preservation of the patient's self-image, and maintenance of beautiful relationship between the midfacial line and the nasolabial fold as well as the nasal ala.

DOI： 10.1007/s00266-002-2036-4

Functional reconstruction of mobile tongue and suprahyoid muscles after resection of cancer of the tongue

Functional reconstruction of mobile tongue and suprahyoid muscles after resection of cancer of the tongue

Yokoo S, Komori T, Umeda M, Takenono I, Hashikawa K, Hanagaki H, Tahara S

BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY Vol. 39 ( 4 ) page： 252 - 255 2001.8

Yokoo S., Komori T., Umeda M., Takenono I., Hashikawa K., Hanagaki H., Tahara S.

British Journal of Oral and Maxillofacial Surgery Vol. 39 ( 4 ) page： 252 - 255 2001

Language：Japanese Publisher：British Journal of Oral and Maxillofacial Surgery

The mobile tongue and the suprahyoid muscles were reconstructed in a man who had had a total resection of the mobile tongue with the oral floor and bilateral radical neck dissection (extensive resection of the bilateral suprahyoid muscles) for cancer of the tongue. A rectus abdominis musculocutaneous flap with the tenth intercostal nerve anastomosed to the remaining hypoglossal nerve was used for the reconstruction. The rectus abdominis muscle was inserted between the mandible and the hyoid bone, taking account of the anatomical positions of the tongue and suprahyoid muscles; the rectus sheath was then firmly sutured to the mandible and hyoid bone. This procedure created firm tendinous insertions between the mandible and hyoid bone. After the operation, the reconstructed tongue showed no sign of atrophy, and the reconstructed suprahyoid muscles (rectus abdominis muscle) could be moved, and the hyoid bone could be raised. © 2001 The British Association of Oral and Maxillofacial Surgeons.

DOI： 10.1054/bjom.2001.0636