- 期刊
Regaining the Adequate Dimension of Mouth Opening for Pan-Oral Submucous Fibrosis with Surgical Intervention and Mouth Opening Exercise - A Case Report
以外科方法及張口練習來重獲理想開口度一病例報告
摘要
全口黏膜下織維化是一種慢性,疤痕性,真高危險性的癌前病灶,常見於嗜嚼食檳榔的南台灣。其伴隨的張口困難常會影響阻礙齒科治療及增加口腔衛照護的困難度。本院提供一全口黏膜下纖維化並嚴重張口困難之病酬報告 (張口度僅為十七點五毫米)。患者來院主訴為近年來張口困難並且無法忍受辛辣的食物。我們使用電刀將口內纖維組織切斷,衛中所得最大張口度為四十一 毫米,雙頰黏膜切除後裸露的區域以右大腿內側的皮膚植皮。術後患者每日皆依醫矚施行張口練習，術後九個月後追蹤所得最大張口度為五十二毫米。我們認為外科手術及術後病人合作配合張口練習都是治療全口黏膜下纖維化(併張口受限)不可或缺的要素。
並列摘要
Pan-oral submous fibrosis is a chronic, progressive, scarring, high-risk precancerous condition seen primarily in southern laiwan where betel quid chewing is popular. Accompanying symptom afld sign of trismus with oral submucous fibrosis (OSf) hinders the dental treatment and basic oral hygiene care. We present a case of pan-oral submucous fibrosis with severe trismus, 1 7.5 mm in maximal mouth opening (MMO). Patient went to our hospital with complaints of inability to open the mouth and discomfort with spicy food within recent years. Patient underwent surgical splitting o fibrous bands with diathermy blade. MMO was gained as 41mm during the surgery. Spilt-thickness skin graft harvested tram inner surface of the Rt thigh was to resurface bi\ateral lillded buccal mucosa. Buccal fat pad was for the repair of the right retromolar area. Forceful mouth opening exercise was done everyday following the surgery. 52 mm was the MMO nine months postoperatively. Both surgical scar bands relief and post-op forceful mouth opening exercise with good compliance play the important roles in treatment of the OSF with limited mouth opening.