高度な骨性癒着をきたした顎関節強直症の1例  [in Japanese] A case of severe bony ankylosis of the temporomandibular joint  [in Japanese]

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Author(s)

    • 藤澤 健司 FUJISAWA Kenji
    • 徳島大学歯学部口腔外科第一講座 First Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Tokushima
    • 飛梅 悟 TOBIUME Satoru
    • 徳島大学歯学部口腔外科第一講座 First Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Tokushima
    • 鎌田 伸之 KAMATA Nobuyuki
    • 徳島大学歯学部口腔外科第一講座 First Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Tokushima
    • 長山 勝 NAGAYAMA Masaru
    • 徳島大学歯学部口腔外科第一講座 First Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Tokushima

Abstract

小下顎症を伴う高度な骨性癒着をきたした顎関節強直症の1例を報告する。<BR>患者は43歳の男性で, 開口障害を主訴に来院した。幼少期の関節突起骨折が原因で長期間開口障害を認めていた。初診時の開口域は11mmで, 側貌にてオトガイの後退を認めた。X線検査の結果, 両側下顎頭の変形と左側顎関節の著明な骨性癒着がみられた。全身麻酔下に右側は下顎頭切除術, 左側は骨関節切除術を施行し, 左側には遊離皮膚弁を中間挿入物として使用した。さらに小下顎症の改善を目的にオトガイ形成術, 腸骨移植術を施行した。術後開口域は30mmに増加し, 顔貌も改善され患者は満足している。

A case of severe bony ankylosis of the temporomandibular joint, which caused micrognathia, is reported. A 43-year-old man was referred to our clinic with the main problem of trismus. He had jaw movement limitation due to TMJ ankylosis, resulting from the fracture of bilateral condylar processes in his childhood. The maximum mouth opening was 11mm, and X-ray examination revealed deformity of the bilateral mandibular heads and severe bony ankylosis on the left mandibular head. We performed an osteoarthrotomy and inserted a free skin flap to the resected area on the left side. On the right side, a condylectomy was performed. After the operation, the maximum mouth opening increased to 30mm, but micrognathia remained. Therefore, we conducted genioplasty and an iliac bone graft, at 11 months after the initial operation. Since these operations, the patient has been satisfied with the result of improvement of mouth opening disturbance and facial appearance.

Journal

  • Journal of the Japanese Society for the Temporomandibular Joint

    Journal of the Japanese Society for the Temporomandibular Joint 14(2), 222-226, 2002-08-20

    The Japanese Society for Temporomandibular Joint

References:  7

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