開口障害を主訴とし顎関節症と鑑別を要した炎症および腫瘍の2症例

概要

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A case having abscess formation in the pterygomandibular space and a case having malignant tumor (adenocarcinoma) in the same area, which had been difficult to be distinguished from temporomadibular disorders (TMD), are reported. These cases initially showed the symptoms similar to those of TMD, and few clinical signs of those diseases. No apparent abnormality in the routine radiographic examinations was shown in both cases. In the case of inflammation caused by marginal periodontitis of the left maxillary second molar, the symptoms of the inflammation was made unclear by prescription of non-steroidal anti-inflammatory drug for the initial diagnosis of TMD. Computerized scanning tomography (CT) was useful to establish the diagnosis. In the case of adenocarcinoma, nevertheless an advanced tumor involving the pterygomandibular space to the parapharyngeal space existed, the patient just complained pain and joint sound in the temporomandibular joint (TMJ) during jaw movement. The tumor was coincidentally detected by magnetic resonance imaging (MRI) for the TMJ. In both cases, the lesions mainly occupied the pterygomandibular space which is difficult to image by screening radiographic examination for TMD. CT and/or MRI were useful equipment for confirmation of the diagnosis for this kind of unusual cases.
九州歯科学会の論文
2003-10-25