4年間の経過観察後に手術を行った下顎骨動静脈瘻の1例

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Vascular lesion of the jaws are rare but special consideration should be paid because of the potential for fatality. A case of arteriovenous fistula of the mandible was reported with its course and treatment.<BR>A ten year-old girl was admitted to our hospital as an emergency with a bleeding of the left gingiva of the mandible. Orthopantomography showed an irregular radiolucency extending from left canine region to mandibular ramus. Angiography proved arteriovenous fistula of the mandible, and the main vessels to the lesion appeared to be the left external carotid artery and the abnormal extension of right inferior alveolar artery.<BR>Operation was postponed because the patient was young and her lesion was very large, so brisk bleeding and danger to her life was predicted during operation. Her course was closely watched for about four years. During this early period, she came several times by ambulance because of gingival bleeding, but during the middle period no gingiva bleeding or radiographically decrease of the lesion were noticed. Although in the latter period, frequent gingival bleeding and lesion enlargement were observed again. She was operated on at age fifteen. The left external carotid artery, afferent and efferent vessels to the lesion were ligated and marginal resection of the left mandible and enucleation of the tumor were carried out. The postoperative course was entirely good and without com