耳下腺部に膿瘍を形成した下顎頭部骨髄炎の一例 A case of osteomyelitis of the mandibular condyle accompanied by abscess formation in the parotid region
A rare case of osteomyelitis of the mandibular condyle is reported. A 35-year-old woman presented with pain in the right parotid region. A dull pain had developed in the right parotid region the previous month, and swelling and pain gradually increased. At presentation, the interincisal distance was 12 mm. Radiographs revealed no obvious findings of inflammation. We doubted that her clinical symptoms were caused by parotitis and administered cefditoren pivoxil, but her symptoms worsened. The parotid gland was normal on sialography. However, osteomyelitis of the right condylar head of the mandible was found on CT, MM, and bone scintigraphy. An abscess was noted in the right parotid region. We therefore performedbacterial examinations by centesis.<BR>Microbiological examination showed an abscess associated with a mixed infection involving Gram-negative bacteria, with a dominance of<I>Actinobacillus actinomycetemcomitans</I>.Antibiotic treatment was switched to levofloxacin totreat this organism. Inflammation subsided and after 7 days. The interincisal distance returned to 30mm. There was no inflammatory recurrence for 12 months. A CT scan obtained after 5 months showed signs of remineralization in the condylar head of the mandible. In this patient, a blood-borne or local infection in the mandible appasently caused a bacterially induced form of periodontal disease.
日本口腔外科学会雑誌 52(2), 69-72, 2006-02-20
Japanese Society of Oral and Maxillofacial Surgeons