上顎智歯の冠状動脈アプローチによる抜歯。側頭窩への両側移動の症例について

[Removal through the coronal approach of the upper wisdom teeth. Apropos of a case of bilateral migration into the temporal fossa].

抄録

本報告は、上顎第三大臼歯の側頭骨窩への両側移動と冠状動脈アプローチによる抜歯の症例である。症例は15歳の男児で，大きな三咬症のため受診した．2ヶ月前に全身麻酔下で衝撃的上顎第三大臼歯の抜歯を行った。X線検査の結果、上顎第三大臼歯は左右ともに側頭窩に押し込まれ、取り残されていた。CT検査後、冠状動脈アプローチで抜歯した。これは顔面神経を温存し、抜歯の可能性を高めるための唯一の方法であった。手術は成功した。術後の経過は問題なかった。頬側開口は術後3ヵ月で正常化した。

This report presents a case of double migration of third maxillary molar in temporal fossa and their removal by a coronal approach. A 15 years of old boy, was seen for major trismus. 2 months before, he underwent under general anaesthesy impacted third maxillary molar removal. The radiologic examination showed that superior third molar has been pushed and left into the temporal fossa in both sides. After computed tomography examination, teeth were removed by a coronal approach. This was the only approach in order to preserve facial nerve and to allow with good chances to remove the teeth. Intervention was successful. Postoperative course was uneventful. The buccal apperture was normalized three months after surgery.