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Systemic air embolism, a very rare clinical condition, has many causes. We report a case of multiple air embolisms following laryngopharyngoesophagectomy salvage surgery for hypopharyngeal residual cancer after concurrent chemoradiotherapy. Cervical infection arose from a fistula caused by postoperative suture failure in which the 56-year-old man suddenly lost consciousness and went into shock. A few days post operation, an air embolism happened and caused in the brain, pulmonary, myocardiac and cerebral infarction. The man died two months after initial occurrence. We suspect that air entered through the ruptured left internal jugular vein via infection due to aspiration at the injury site. Air embolisms are associated with different medical maneuvers, and it is necessary to recognize that they may become a serious perioperative complication.

We report a 47-year-old woman with polyostotic fibrous dysplasia. She complained of a painless swelling of the left cheek since she was two years old. A craniofacial CT examination showed sclerotic changes of the left maxilla, sphenoid and temporal bone. Bone scintigraphy showed high uptakes at not only these craniofacial bones but also thoracic vertebrae, rib, left humerus and pelvis. A biopsy of the left maxilla bone was performed, and a histopathological examination showed fibrous dysplasia. Therefore, we diagnosed her as having polyostotic fibrous dysplasia. At present, the left maxillary tumor has not progressed. We are continuing careful follow-up.

中咽頭癌において上側壁が切除された場合，術後にしばしば鼻呼吸，嚥下，構音障害をきたす。著者らはこのような欠損における再建にGehanno法を用い，術直後より良好な術後機能を得ている。今回Gehanno法の長期的成績について評価をおこない，同法の有用性につき検討をおこなった。1997年より現在までに33例に対しGehanno法を施行し，今回8例に対して，術後機能評価を行うことができた。それらの症例については概ね順調に術後機能の維持ができていると思われるが，前腕皮弁使用例の一部において，術後徐々に機能が悪化してくる症例があった。元来前腕皮弁は柔軟性に優れており，中咽頭のような複雑な形態の再建に適しているとされていたが，Gehanno法による再建材料としては，周囲組織の瘢痕による形態的変化を受けやすい可能性が示唆され，皮弁の第一選択としては腹直筋皮弁が推奨されると思われた。