岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 岡山大学病院頭頸部がんセンターにおける医科歯科合同手術の現状解析とその意義 191 196 EN Nobuyoshi Mizukawa Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Tomoo Onoda Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Hiroshi Matsumoto Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Seiko Takeda Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Youhei Noda Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Satoshi Onoda Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Mai Fukushima Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Munechika Tsumura Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Tetsuo Takeuchi Departments of Dental Laboratory, Head and Neck Cancer Center, Okayama University Hospital Narushi Sugiyama Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Yoshihiro Kimata Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital 　　We have been collaborating with head and neck surgeons, plastic surgeons and oral surgeons in surgeries for many patients with head and neck carcinomas（ especially oral carcinomas） since 2006（ fiscal year 2005）. The Head and Neck Cancer Center was established at Okayama University Hospital in 2012. 　This Center was the first of its kind at a national university hospital in Japan. 　At the Center, 174 operations on head and neck carcinomas and 96 reconstructive operations were performed in 2014（ fiscal year）. 　Medical and dental collaborative operations have been increasing almost every year since the 2005 fiscal year. There were 45 collaborative operations in the 2014 fiscal year, which included 30 cases of bone or metal plate reconstruction or plate reinforcement of the jaws. 　There were 76 medical and dental collaborative operations in the 7 years before the establishment of the Center, with a mean of 10.9 operations per year. Since the establishment of the Center, there have been 112 cases over 3 years with a mean of 37.3 operations per year. The number of surgeries has been markedly increased by the establishment of the Head and Neck Cancer Center. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 70 3 2016 Structure of a New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy 205 211 EN Ken-ichi Kozaki Department of Dental Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shigehisa Kawakami Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takayuki Konishi Division of Physical Medicine and Rehabilitation, Okayama University Hospital Keiji Ohta Dental Laboratory Division, Okayama University Hospital Jitsuro Yano Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoo Onoda Department of Otolaryngology-Head and Neck Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroshi Matsumoto Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nobuyoshi Mizukawa Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital Yoshihiro Kimata Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazunori Nishizaki Department of Otolaryngology-Head and Neck Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Seiji Iida Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akio Gofuku Graduate School of Natural Science and Technology, Okayama University Masanobu Abe Department of Computer Science, Okayama University Shogo Minagi Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Dream Speech Project Case Report 10.18926/AMO/54420 A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAPʼs effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 120 3 2008 頭頸部癌における頭頸部外科，形成外科，口腔外科３科合同手術における口腔外科の役割：下顎再建症例における３Ｄ石膏造形モデルを利用した術前プレート屈曲法 299 305 EN Nobuyoshi Mizukawa Susumu Tominaga Yoshihiro Kimata Tomoo Onoda Narushi Sugiyama Eiki Yamachika Yousuke Yamada Takuji Kimura Tetsuo Takeuchi Takaaki Ueno Shin Takagi The collaboration of various medical teams is crucial for the appropriate treatment of cancer patients. However, in Japan, it is very difficult for oral surgeons to cooperate with head and neck surgeons due to conflicts in the treatment of those patients. There have been few studies on this subject. In the current work, we report on the collaboration of head and neck surgeons, plastic surgeons and oral surgeons in operations on two patients with gingival carcinomas in the mandible. We first prepared plaster 3D models of the patients'mouths by means of ink-jet from CT data. We pre-bent the reconstruction plates using the preoperative 3D models. Therefore, we could save the time required to bend the plate. Plaster models are cheaper than resin models. It is also easy to model the surgery using the plate. During the operation, head and neck surgeons resected the tumors, plastic surgeons performed reconstruction with vascularized bone or skin graft, and oral surgeons (dentists) did plate fixation and took charge of the patients'occlusion. This method resulted in patients having good occlusion after the operation. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 00301558 119 3 2008 頭頸部癌における耳鼻咽喉科, 形成外科, 口腔外科3科合同手術の意義 : 2症例における口腔外科の役割を中心に 267 272 EN Nobuyoshi Mizukawa Susumu Tominaga Yoshihiro Kimata Tomoo Onoda Shigenobu Nomiya Narushi Sugiyama Tomoaki Kawamoto Eiki Yamachika Takaaki Ueno Shin Takagi There is a medical team approach used in many hospitals for oral cancer patients. The members are head & neck surgeons and plastic surgeons, or oral surgeons and plastic surgeons. However, in Japan, it is very difficult for oral surgeons to cooperate with head & neck surgeons, except in the case of extractions and oral health care, because both surgeons treat oral carcinomas and there is therefore a conflict in their scope of practice. We believe it desirable for head & neck surgeons to treat oral cancer patients with tumors extending to other regions, and oral surgeons should be in charge of occlusion in head and neck carcinomas. We treated two patients with oral carcinomas in collaboration with head and neck surgeons and plastic surgeons, with head & neck surgeons resecting the tumors, plastic surgeons reconstructing, and oral surgeons (dentists) taking charge of the occlusion for patients in the operating room. This collaboration resulted in patients having good position of the temporomandibular joint and occlusions after the operation. We therefore conclude that this collaborative team approach may be of benefit to the patients. No potential conflict of interest relevant to this article was reported.