title: Fluorescence-guided bone resection by using Visually Enhanced Lesion Scope in diffuse chronic sclerosingosteomyelitis of the mandible: Clinical and pathological evaluation.
abstract: Diffuse chronic sclerosingosteomyelitis (DCSO) is a refractory disease, becausethe etiology and pathogenesis remain poorly understood and to determine the border betweenunhealthy boneandhealthybone is difficult. However, progressive inflammation, clinical symptoms and a high recurrence rate of DCSO were the reasons for surgical treatment. We report a case of a 66-year old woman with DCSO of the right side of mandible who was treated with hemimandibulectomy and simultaneous reconstruction by vascularized free fibula flap. After preoperative administration of minocycline for 1 month, the bone fluorescence was successfully monitored by using a Visually Enhanced Lesion Scope (VELscope®). Intraoperatively, we could determine the resection boundaries. We investigated the clinical and histopathological findings. The fluorescence findings were well correlated with histopathological findings. Using a VELscope®was handy and useful to determine the border between DCSO lesion andhealthybone.The free fibula flap under the minocycline-derived bone fluorescence by using a VELscope®offered a good quality of mandibular bone and the successful management of an advanced and refractory DCSO.
  
  
  BACKGROUND
  Fluorescence-guided bone resection, fibular free flap, osteomyelitis of the mandible, diffuse chronicosteomyelitis, VELscope®.
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Yoshiga
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sasaguri
authors.affiliation: Department of Health Promotion, Division of Oral Pathology, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Kou
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Oto-Rhino-Laryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Sei
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Habu
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Haraguchi
authors.affiliation: Department of Science of Physical Function, Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Tatsurou
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Science of Physical Function, Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Morimoto
authors.affiliation: Department of Science of Physical Function, Division of Oral Medicine, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Yoshioka
authors.affiliation: Department of Science of Physical Function, Division of Maxillofacial Surgery, Kyushu Dental University, Fukuoka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tominaga