歯原性側頭下窩膿瘍例

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A case of infratemporal fossa abscess caused by upper molar infection in a 82-year-old male is reported. The patient presented with a pain in his right upper molar region, and had been seen by a dentist on December 25th 1996. A caries was found in the 7th tooth and treated by extraction, systemic administration of antibiotics, and analgesics. Despite treatment, the patient subsequently complained of progressive pain in his upper jaw and eventually trismus developed. He was then referred to our clinicon January 8th 1997. On examination, trismus and a diffuse swelling withonut fluctuation of the right temporal region and cheek were found. The patient's body temperature was 37°C and other vital signs were normal. The white blood cell count was 9,000/mm3 and the CRP was 16.5 mg/dl. Free blood sugar was 203 mg/dl and glycosuria was found. MRI revealed multilocular abscess in the right infratemporal fossa. Under local anesthesia, he underwent an incision in the right upper gingivo-buccal sulcus and drainage of the infratemporal fossa abscess. After the operation, intravenous clindamycin and fosfomycin were administered for 6 days with local lavage. Gradual improvement was noted, and disappearance of the abscess with moderate thickening of external pterygoid muscle was seen by MR study 24 days after the operation. In this case, aging and diabetes were considered to have exacerbated the inflammatory process.
耳鼻咽喉科臨床学会の論文