外傷による頬骨弓内側ガラス片埋入症例

概要

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The patient came to our hospital with a chief complaint of trismus due to glass chips embedded in the face from hitting the car winshield during a traffic accident.<BR>The patient was a 29-year-old man, who came to our department of oral surgery for posttraumatic trismus 23 days after a traffic accident. Open mouth range was 18 mm and dyskinesia of the right mandibular process was observed. Roentogenographic diagnosis revealed non-permeable images involking glass chips in the anterior, posterior and temporal cavities of the right mandibular process. Because of the trismus, general anesthesia was transnasally performed by inducing the tube with a soft fiberscope. Skin incision was carrier out from the right anterior auricular region by means of the buccal cicatrix, and glass chips in the external, internal, anterior and temporal cavities of the right mandibular process were observed and isolated. Simultaneously, seeing that there was cicatricial contraction of the tanporal muscles, the mandibular process was resected, resulting in an open mouth range of 40 mm. Ten days after operation salivary fistula was formed, which, however, disappeared by compression. Facial paralysis led to the start of functional training from the 18th postoperative day, and 3 months postoperatively the nerve paralysis showed improvement.