下顎骨髁突骨瘤－病例報告及文獻回顧

Osteoma of the Mandibular Condyle-A Case Report and Literature Review

彭芷瑜(Chih-Yu Peng) ； 黃逸岳(I-Yueh Huang) ； 陳玉昆(Yuk-Kwan Chen)

《中華民國口腔顎面外科學會雜誌》 13卷2期 (2002/09) Pp. 149-162

https://doi.org/10.7104/CJOMS.200209.0149

摘要

骨瘤（Osteoma）是一種罕見而生長緩慢的良性腫瘤，約佔顎骨腫瘤的1%。發生部位以下顎骨角及下顎骨體舌側居多。發生在下顎骨髁突極為罕見。
本文報告一位27歲男性，因為在最近一兩年之間發現下巴有越來越偏斜的情形而到醫院求診。經臨床檢查，發現病人有張口受限及右側顳顎關節區域疼痛的問題，同時也有顏面不對稱，顏穴（Pogonion）偏在正中矢狀平面左邊10 mm，以及咬合不正（下顎齒列中線向左偏斜8 mm），X光檢查及電腦斷層攝影發現下顎骨右側髁突區有一個大小約3 cm × 2.6 cm × 1.8 cm的放射線不透性影像，疑似骨瘤。經下顎後切線（retromandibular incision）切除腫瘤及右側髁突，同時以肋骨及其軟骨移植重建下顎髁頭，以改善病人下顎骨偏斜及上下顎間關係；至於改善上下顎骨關係後的咬合不正問題則藉由齒列矯正治療改善。手術檢體經病理組織學檢查證實是骨瘤。這篇報告希望能對這種病變提供更多的研究資料。此外，本病例採用肋骨移植方式來改善顏面不對稱的情形，並獲得不錯的結果，應可作為髁突骨瘤治療的參考，此外，也將回顧七十五年間文獻報告的十四個病例作為比較。

關鍵字

骨瘤 ； 下顎骨髁突 ； 肋骨及其軟骨移植

並列摘要

Osteoma is a rare benign neoplasm that shows very slow growth. When the osteoma does develop in the mandible, the most frequent sites are the angle of the mandible and the medial side of the body of the mandible. Such case happens in mandibular condyle is extremely rare. According to literature reviewed, there was nothing but 12 cases written in English from 1927 to 1998. An osteoma involving the mandibular condyle can cause facial asymmetry, malocclusion and disorder of TMJ function. This case shows a 27 years old male had his chief complaints with a progressive shift in his chin. The tentative diagnosis was osteoma. The treatment suggested was condylectomy with a retromandibular incision approach. The condyle was reconstruction with costochondral graft immediately. Satisfactory occlusal, functional, and esthetic results were achieved. In addition to submitting further discussion for the diagnosis and treatment of the case by this report, it provides an overview and makes a reference to all related medical literature, too.

並列關鍵字

Osteoma ； mandibular condyle ； costochondral graft