急性化膿性顎関節炎の1例鏡視所見および二重造影CT像の検討

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In recent years, acute suppurative temporomandibular joint arthritis has rarely been encountered and is thus not well documented. Recently, we encountered a case of such joint inflammation and presented mainly clinical signs and symptoms, Ga schintigram findings, and double-contrast computed tomograms, arthroscopic findings, and arthroscopic surgical procedures of the temporomandibular joint. The patient, a 46-year-old man, visited our hospital with the chief complaint of pain in the right face, left-directed mandibular deviation, and malocclusion in April, 1988. Mouth opening was limited to 12 mm. X-ray revealed that the mandibular head and moved in front of the fossa mandibulars, despite the fact that the mouth was closed. Antiinflammatory therapy was instituted. This was followed by intra-articular joint puncture; 5 ml of pus was aspirated. Concurrently performed double-contrast CT of the joint revealed joint cavity enlargement and abscess cavity formation. Ga scintigram revealed pronounced accumulation in the right temporomandibular joint. Subsequent management included temporomandibular joint arthroscopy and arthroscopic biopsy (histopathological diagnosis: synovial tissue calcification and fibrillation) and intra-articular washing with an antibiotic. Post-curative rehabilitation by means of mouth-opening training was perfomed. The double-contrast CT of the current time after a lapse of 28 months revealed joint cavity disappearance, but the clinical course has been good and mouth-opening range is 43 mm. Thus, such rehabilitation as mouthopening training and others are important in curing high-grade inflammation manifesting in a joint accompanied by intra-articular organic change.
社団法人日本口腔外科学会の論文

急性化膿性顎関節炎の1例鏡視所見および二重造影CT像の検討

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急性化膿性顎関節炎の1例 鏡視所見および二重造影CT像の検討

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急性化膿性顎関節炎の1例鏡視所見および二重造影CT像の検討