下顎骨に発生した動静脈瘻の1例

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Vascular lesion in the jaws are rare diseases, but oral surgeons must mind the dangers that causes a sudden fatal bleeding. We have experienced a case of very rare arteriovenous fistula with a large quantity of bleeding.<BR>A 15-year-old boy was referred from a dentist. About a year ago, he was conscious of gingival swelling and a slight bleeding at the lower right molar region, so he had been treated by the dentist. On the first visit, he had a diffuse swelling at the right mandibular region and a diffuse swelling, redness and hot feeling at MP gingival region, without fluctuation nor pulsation. A panoramic radiograph showed a diffuse radiolucent area from 7 to 5 and the honeycomb shadow from 5 to 1 in the mandible. Severe hemorrhage occurred during diagnotic puncture, so this disease was clinically diagnosed as the aneurysmal bone cyst. The emergency operation was performed under general anesthesia. The operative procedure included partial resection of the mandible and reconstruction with the autogeneous bone graft using iliac crest. The histopathological diagnosis after the operation was an arteriovenous shunt.<BR>A year and three months after the initial operation, reconstructive operation was performed with a ceramic artificial bone. The recurrent sign of this disease, facial deformity and functional disorder had been noticed a year and four months after the final operation.