下顎骨喙狀突增生―兩病例報告

下顎骨喙狀突增生是一種病因不明之罕見疾病，可能爲單側性或雙側性；臨床表徵爲緩慢但漸進性的張口受限，容易誤診爲其他張口受限疾病，確切的診斷端賴詳細的病史詢問、理學檢查、X光學檢查與鑑別診斷。本篇研究兩名主訴張口受限之年輕男性，經過傳統環口X光片以及電腦斷層的詳細檢查後確立爲雙側喙狀突增生；他們接受了口內法喙狀突切開術，並於術後第七天起進行張口練習運動，他們的張口度皆獲得了顯著改善。第一位患者有完整的追蹤紀錄，並且在術後一個月時接受了電腦斷層檢查，對於我們在了解喙狀突切開區域的變化及相關的影響有莫大的幫助。第二位患者在喙狀突切開之後張口度亦獲得大幅度改善（由19 mm增加到45 mm），但因個人因素在術後一個星期之後沒有再定期回診，無法得知其長期結果。從這兩名罕見病例的就診、診斷到接受手術以及治療結果，不但提醒我們臨床醫師不可忽略此一罕見疾病，同時我們也確信喙狀突切開術合併術後張口練習能有效改善喙狀突增生導致的張口受限問題。

關鍵字

喙狀突增生；喙狀突切開術

並列摘要

Mandibular coronoid hyperplasia is a rare disorder of unclear etiology that can occur in both unilateral and bilateral forms. It appears as a slow but progressive reduction in mouth opening. The definite diagnosis is established by the findings of detail history taking, physical examination, radiographic examination and differential diagnosis. The aim of this study is to evaluate the results of treatment by intraoral coronoidotomy with postoperative mouth opening exercise in two young males. They both had chief complaints of long term mouth opening limitation. The diagnoses were confirmed with the aid of panoramic radiography and 3-dimentional computerized tomography (3-D CT) scans. They both received bilateral coronoidotomy via intraoral approach under general anesthesia and started mouth opening exercise since postoperative 7(superscript th) day. Increase in mandibular interincisal distance was observed. The first patient had regular follow record and received CT scan one month after operation; which helped us much to know about the changes in operative area and the relative effect. Although the second patient had remarkable improvement immediate after surgery, he did not return for regular follow-up. Even so the present two cases remind us should keep coronoid hyperplasia in our differential diagnosis. The results indicate that intraoral coronoidotomy and postoperative physiotherapy gives satisfactory results in improving the range of mouth opening.

並列關鍵字

coronoid hyperplasia ； coronoidotomy

國際替代計量

下顎骨喙狀突增生―兩病例報告

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