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Glial choristoma is considered a developmental malformation characterized by brain heterotopias without connection to the central nervous system. In this article, we report a rare case of glial choristoma occurring on the dorsum of the tongue with cleft palate in a 3-month-old male infant. Complete surgical excision was performed prior to palatoplasty. There were no postoperative complications or evidence of recurrence after 5 years of follow-up.

For a sagittal split ramus osteotomy to be secure, the relation between the outer and inner contours of the cortex at the inferior border of the mandible is critical. The lowest point of the outer contour is not always immediately below that of the inner contour, and the former is placed more lingually than the latter in about a third of all cases. This tendency is much more noticeable in skeletal class I and II malocclusions than class III. It is therefore important to examine the lowest point of the inferior border in every case, and to carry the inferior part of the buccal cut on to the lingual side if necessary.

The purpose of this study is to evaluate the incidence, risk factors and postoperative nausea and vomiting (PONV) in patients who underwent orthognathic surgery.The subjects were 139 patients aged 17-52 years (47 males and 92 females) who underwent orthognathic surgery in the Hokkaido University Hospital from January 2001 to December 2003. Ninety-four Sagittal splitting ramus osteotomy (SSRO), 34 Le Fort I osteotomy and SSRO (Le Fort I+SSRO), and 11 surgically assisted rapid palatal expansion (SARPE) were performed. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen. There were no cases of maxillomandibular fixation. The factors investigated included age, gender, type of surgery, amount of bleeding, operation time, anesthesia time, anesthesia induction drugs, fentanyl dose and incidence of PONV. A statistical study was performed using logistic regression analysis to confirm the statistical significance among age, gender, amount of bleeding, operation time, anesthesia time, difference of anesthesia induction drugs, fentanyl dose, and incidence of PONV. A Chi-square test for independence was used to confirm the statistical significance between the type of surgery and incidence of PONV. Differences were considered significant for a P

The patient was a 19-year-old male with mandibular prognathism, open bite and a thin symphysis. The chief complaints were difficulty in biting with the anterior teeth and anterior crowding. The problems were: 1) mandibular prognathism; 2) skeletal open bite; 3) a narrow upper dental arch; 4) severe lingual inclination of the lower incisors and a thin symphysis; and 5) crowding. Surgical procedures were utilized to perform orthodontic treatment. Before the orthognathic surgery, crowding and the narrow dental arch were eliminated with orthodontic treatment involving surgically assisted rapid palatal expansion. Segmental osteotomy and gradual distraction osteogenesis of the lower anterior teeth were performed to change the severe lingual inclination of the symphysis. After alignment of the upper and lower dental arches, sagittal split ramus osteotomies were undergone to correct the mandibular prognathism and skeletal open bite. In the post-operative period, detailing and completing teeth alignment were performed, and suitable occlusion was finally achieved. This case shows that changing the inclination of the symphysis by distraction osteogenesis is effective for patients with a thin symphysis.

This clinical study was performed in order to investigate the spectrum of dentofacial deformities, management, surgical outcomes and the living area of orthognathic patients treated at Kushiro Red Cross Hospital in the eastern part of Hokkaido. Fifty-three patients were treated for dentofacial deformities in our hospital from April 1989 to December 2004. These patients have increased in recent years. There were 13 male and 40 female patients. According to clinical diagnosis and operation procedure, mandibular prognathism was the most predominant diagnosis and only sagittal split ramus osteotomy was performed in most cases. The patients lived over a wide area of eastern Hokkaido. As Kushiro Red Cross Hospital cooperats with Hokkaido University Hospital and nearby dental clinics, patients could receive the greater part of orthognathic treatments in Kushiro Red Cross Hospital. However, most patients had to go to Hokkaido University Hospital a few times. Patients could benefit from developing orthognathic management at Kushiro Red thus Cross Hospital as well as at Hokkaido University Hospital.

A case of unilateral tongue atrophy caused by idiopathic hypoglossal nerve palsy is presented.A 38-year-old woman noticed atrophy in the left side of the tongue and visited Hokkaido University Dental Hospital. The face was symmetrical, and there was neither facial nerve weakness nor muscle atrophy. The movement of the neck and brachium was not restricted. She had fasciculation and atrophy in the left side of the tongue. When the tongue protruded, it deviated towards the left. The shape and movement of the soft palate were normal. MRI examination revealed atrophy in the left side of the internal muscles of the tongue. The cranial nerves other than the twelfth nerve were normal, and there were no signs of systemic neurological abnormalities. Unilateral tongue atrophy caused by idiopathic hypoglossal nerve palsy was diagnosed.

A case of spindle cell lipoma of the tongue is presented. The patient, a 71-year-old man, had a painless swelling of the tongue. Physical examination revealed two discrete, tender masses in the left ridge of the tongue. These masses were removed surgically. Histopathologically, they consisted of small groups of mature lipocytes separated by spindle cells and of stroma to composed of bundles of collagen fibers and mucinous materials. The spindle cells had a single fusiform nucleus. The histopathological diagnosis was spindle cell lipoma. Spindle cell lipoma commonly arises in the posterior neck, upper back, and shoulders and is extremely rare in the oral cavity. Only nine cases have been reported in the literature.