頁籤選單縮合
題名 | Coronoid Process Hyperplasia Existed with Cyst-like Lesion in the Ramus--Five Years Follow up and Surgical Intervention=喙狀突增生合併下顎枝囊腫樣病灶--手術介入與五年追蹤觀察報告 |
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作者姓名(中文) | 黃婷愉; 陳文和; | 書刊名 | 臺灣口腔顎面外科學會雜誌 |
卷期 | 26:2 2015.06[民104.06] |
頁次 | 頁156-165 |
分類號 | 416.95 |
關鍵詞 | 喙狀突增生; 下顎骨病灶; Coronoid process hyperplasia; Bony lesion in ramus; |
語文 | 英文(English) |
中文摘要 | 一位47歲男性,因為反覆發生開口受限及張口疼痛的問題,於2007年求診。從環口放射線影像中,發現其右側喙狀突異常肥大,且右側下顎枝中有一囊腫樣病灶。當時建議病人接受手術治療,但遭拒絕。因此改以追蹤的方式觀察病灶變化,並將治療目標設定在改善其張口受限的問題。當時發現此一問題與右側翼間隙的感染有闕,因此施予一星期的抗生素治療,結果開口受限的問題便獲得改善。2012年患者回診,又發現其張口受限的問題與左側顯顎關節疾患相關,因此展開了非手術性的顯顎關節治療。使用咬合板治療八個月後,病人的症狀也漸漸獲得改善。但不久之後,因為突發性的開口受限與疼痛,病人終於願意接受手術治療。手術截斷患者右倒喙狀突並剜除下顎支囊腫樣病灶後,病人的顳顎關節障礙及其開口度使逐漸獲得改善,截至目前已經過了兩年半,沒有復發的現象。此一病例的重要性,在於長時間觀察喙狀突增生合併下顎支囊腫樣病灶的變化與影響。其一、造成患者開口受限原因,並不一定直接與喙狀突增生合併下顎支囊腫病灶且有關,因此給予相對應的治療方式,也能改善其開口受限的問題。其二、此病例的特殊性,在於其病理診斷的結果與原先臆測的診斷大不相同。 |
英文摘要 | There was a 47 years old male suffered from repeated mouth opening limitation and pain since 2007. The large size of right coronoid process of mandible and radiolucent shadow in right mandibular ramus were shown in the panoramic radiography. The patient refused surgical intervention at the beginning. As a result, close follow-up of the lesion was decided and the treatment goal was to gain a better mouth opening distance. At the first visit in 2007, he had mouth-opening limitation, and an infection involved right pterygomandibular space was found. The problem of opening mouth limitation was resolved after antibiotic treatment for one week. However, in 2012, a mouth-opening limitation associated with left temporomandibular joint problem was found. Bite plate treatment was applied and the symptoms and signs were gradually recovered during following eight months. The patient then received surgical removal of the cyst-like lesion in right mandibular coronoid process and coronoidectomy because of the sudden onset of pain and mouth-opening limitation. After operation, the problem of the temporomandibular joint and the mouth-opening limitation were gradually resolved. The importance of this case determined that long-term follow-up could observe the change and the effect of the coronoid process hyperplasia with a cyst-like lesion. Furthermore, the case revealed the value of conservative treatment and there might be different causes of mouth-opening limitation other than coronoid process hyperplasia. Besides, the unexpected pathologic diagnosis made this case unique. |
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