習慣性顎関節脱臼に対する外科療法

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タイトル別名
  • Surgical treatments for habitual dislocation of the temporomandibular joint
  • シュウカンセイ ガク カンセツ ダッキュウ ニ タイスル ゲカ リョウホウ

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<p>Recently, the number of patients of habitual dislocation of the temporomandibular joint is increasing, along with an increasing number of elderly people with systemic diseases such as cerebral infarction and dementia. Although invasive treatment is often performed when noninvasive treatment is ineffective for habitual dislocation of the temporomandibular joint, the criteria on which surgical methods should be chosen is not clear. In addition, since the patient’s general condition is often poor, minimally invasive surgery that can be performed with local anesthesia is desirable.</p><p>　We investigated treatment methods for habitual dislocation of the temporomandibular joint in our department and their problems. Forty-two patients were enrolled in this study. Their mean age was 79 ± 14 years, with a range of 36 − 95 years. All patients had an underlying disease such as cerebral infarction, dementia, and Parkinson’s disease. The Buckley-Terry method or eminectomy were performed under local anesthesia in 26 joints of 16 patients and 44 joints of 26 patients, respectively. Recurrence occurred in 5 of 16 patients (6/26 joints; 23.1%) after the Buckley-Terry method, and 2 of 26 patients (2/44 joints; 4.5%) after eminectomy (p = 0.045). The causes of recurrence after the Buckley-Terry method was the deformation of titanium plates. Temporarily peripheral facial nerve palsy developed in 3 of 16 patients (3/26 joints; 11.5%) treated by the Buckley-Terry method, but not in any patient treated by eminectomy (p = 0.048).</p><p>　Our results suggested that eminectomy is a more useful treatment than the Buckley-Terry method for habitual dislocation of the temporomandibular joint, especially in elderly patients with underlying diseases. However, since we found a few recurrent cases after eminectomy, there are still many problems to be considered, such as the criteria for adaptation and the approach to these cases.</p>

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