上顎洞手術後に見られた頭部破傷風症例

概要

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A rare case of 21 year-old male in which cephalic tetanus developed 4 days after maxillary sinuectomy was reported.The patient was at first considered as hysteric or under postoperative neurosis, because of his unnatural and theatrical behavior at his initial visit with chief complaints of lockjaw and difficulty in swallowing. However, symptoms giving rise to suspicion of cephalic tetanus such as trismus, nuchal rigidity, chvostek's phenomen and palsy of the cranial nerves increased in severity. Although cultures from the nasal discharge were not made, it was difficult to conceive of any organism other than Clostridium tetani that could have given rise to such symptoms. Assuming then this case to be cephalic tetanus, antitetanic serum was administered in combination with other symptomatic treatments and the patient made an uneventful recovery. A review of literature revealed 15 reported cases of tetanus resulting from nasal affeetion in Japan and occidental countries.
一般社団法人日本耳鼻咽喉科学会の論文