ドップラー血流計でモニターし顎関節手術を施行したもやもや病の1例 A case of moyamoya disease treated by temporomandibular joint surgery while monitoring blood flow with a microvascular Doppler
The microvascular Doppler (MD) is a doppler system specifically developed and produced for clinical applications involving microvessels. The MD can record hemodynamic variables from vessels as small as 0.2mm, and its high resolusion enables the depth of recording to be adjusted in steps of 0.1mm. We used an MD device to intraoperatively monitor blood flow velocity of the prepared superficial temporal artery during surgery to treat dislocation of the temporomandibular joint (TMJ).<BR>We describe our experience with a 33-year-old man with moyamoya disease who had previously undergone STA MCA anastomosis at 32 years of age. He was examined at the Department of Oral and Maxillofacial Surgery, Medical University Hospital on January, 2002because of disturbance of mouth closing. The clinical diagnosis was habitual temporomandibular dislocation. Conservative treatment was unsuccessful. On February 2002, mobilization of the TMJ was done under general anesthesia. The superficial temporal artery was exposed, and blood flow was managed with the MD. Neither hypertension nor tachycardia occurred, and no vasodilators were used during general anesthesia. We were able to perform mobilization for dislocation of the TMJ, with no complications. As of about 18 months after the operation, the status of moyamoya disease and the response to TMJ treatment have been good.
日本口腔外科学会雑誌 50(7), 446-449, 2004-07-20
Japanese Society of Oral and Maxillofacial Surgeons