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両側陳旧性顎関節脱臼に対し関節隆起切除術と関節包周囲の癒着剥離術を行い整復した1例
Title: | 両側陳旧性顎関節脱臼に対し関節隆起切除術と関節包周囲の癒着剥離術を行い整復した1例 |
Other Titles: | Open reduction with eminectomy and adhesiolysis for chronic long-standing bilateral temporomandibular joint dislocation : a case report |
Authors: | 格口, 渉1 Browse this author →KAKEN DB | 中道, 祥之2 Browse this author | 笠原, 和恵3 Browse this author →KAKEN DB | 堀川, 雅昭4 Browse this author | 長, 太一5 Browse this author | 松下, 和裕6 Browse this author →KAKEN DB | 大廣, 洋一7 Browse this author →KAKEN DB |
Authors(alt): | KAKUGUCHI, Wataru1 | NAKAMICHI, Yoshiyuki2 | KASAHARA, Kazue3 | HORIKAWA, Masaaki4 | CHO, Taichi5 | MATSUSHITA, Kazuhiro6 | OHIRO, Yoichi7 |
Keywords: | 顎関節脱臼 | 陳旧性顎関節脱臼 | 観血的整復術 | 関節隆起切除術 | temporomandibular joint dislocation | chronic long-standing | open reduction | eminectomy |
Issue Date: | 15-Sep-2023 |
Publisher: | 北海道歯学会 |
Journal Title: | 北海道歯学雑誌 |
Volume: | 44 |
Start Page: | 96 |
End Page: | 100 |
Abstract: | 顎関節脱臼が陳旧化した場合,観血的整復術が必要となることが多い.症例は,84歳女性で,アルツハイマー型認知症の既往があった.他院手術での経口挿管時に脱臼し,整復されないまま2か月経過後に,北海道中央労災病院口腔外科・顎顔面外科を受診した.局所麻酔下では徒手整復できず,観血的に整復する方針とした.脱臼から約3か月経過後,全身麻酔下に顎関節を開放し,加えて関節隆起切除術を試行したが整復できず,関節包周囲の癒着組織剥離術を追加することで,整復し得た.術後,わずかな臼歯部開咬がみられたが,術後5日目には義歯を装着し咬頭嵌合位が得られた.術後12か月経過後も再脱臼なく,咬合状態は良好である.整復が困難な陳旧性顎関節脱臼症例においては,関節隆起切除術に加え,関節包周囲の癒着組織剥離術を施行することが必要と思われた. | Open reduction is performed frequently for chronic long-standing dislocation of the temporomandibular joint (TMJ) owing to difficulty with closed reduction. This case report presents a case of an 84-year-old woman with a medical history of Alzheimer’s disease who was referred to our hospital for treatment of TMJ dislocation attributed to tracheal intubation upon general anesthesia 2 months ago. Closed reduction with local anesthesia was unsuccessful; thus, open reduction with general anesthesia was performed 3 months later. Reduction was successful upon performing eminectomy and adhesiolysis around the articular capsule. Open bite was observed until 5 days after the surgery. No recurrence of the dislocation was observed at 1 year following her surgery. Thus, eminectomy and adhesiolysis around the articular capsule could be considered for challenging cases of chronic TMJ dislocation. |
Type: | article |
URI: | http://hdl.handle.net/2115/90521 |
Appears in Collections: | 北海道歯学雑誌 > 第44巻
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