- 期刊
下顎人工關節髁頭異位至中顱窩－病例報告
Middle Cranial Fossa Displacement of Artificial Mandibular Condyle-A Case Report
摘要
顳顎關節重建是一個特殊的領域，不僅因為顳顎關節在功能上的獨特性，也因為它是一個二級生長中心。一旦有缺損時，重建顳顎關節是相當地複雜，至今仍沒有單一種方法可以解決。目前有多種移植方式，包括自體肋軟骨，甚至人工材料的重建已廣泛被使用。然而，因材料的選擇、磨耗、外型設計等等的因素，衍生出眾多合併症，包括常見的骨板外露和張口受限、疼痛和髁頭移位等。而下顎關節窩的侵蝕甚至髁頭異位至中顱窩是很罕見的。本病例為一48歲男性因左側頰癌實行下顎骨半切除術，並以重建骨板合併人工顳顎關節髁頭重建下顎與顳顎關節，術後輔以同步放化療後，發生人工關節髁頭異位至中顱窩；後因治療次發性腫瘤，患者延至2年後方進行手術移除人工骨板與髁頭，術後傷口癒合，現無其他腦神經方面併發症，因案例稀少故提出報告。
並列摘要
Not only the unique function but also a secondary growth center makes the temporomandibular joint reconstruction a special field. Multiple reconstructive materials were used, including autologous and alloplatic materials. However, TMJ reconstruction still has some complications, such as bone plate exposure, open mouth limitation, pain and dislocation of the TMJ. The artificial condyle superior displacement into middle cranial fossa was rare. A 48 year-old male who was a victim of left buccal cancer received hemimandibulectomy and reconstruction by plate and titanium condyle. CCRT was also performed due to advanced tumor size. However, the artificial condyle entrapped into middle cranial fossa but no specific neurological symptoms and signs. Unfortunately, 2nd primary maxillary cancer was diagnosed so we removed the plate 2 years later after the underline diseases were stable. Because of its rarity, we report it.