Dislocation of the Right Mandibular Condyle into the Middle Cranial Fossa-A Case Report

右下顎骨髁突脫位至中顱窩－病例報告

Pei-Yin Chen ； Chih-Yu Peng ； Cheng-Siu Chang ； Ming-Yi Lu

《臺灣口腔顎面外科學會雜誌》 26卷1期 (2015/03) Pp. 64-75

摘要

下顎骨髁突脫位至中顱窩非常罕見，因為缺乏其代表性的臨床症狀，所以常造成誤診。如何讓病人兔於不必要的治療，關鍵在於正確的診斷。本病例為一個十九歲男性，車禍後送至本院急診，理學檢查顯示為前牙開咬、右側單側咬合並且下顎無法進行側方運動，經影像檢查後診斷為下顎右側髁突脫位至中顱窩。治療過程，一開始先進行保守性治療，但未見成果，於是進行開放性骨復位術，修補破損的腦膜以及顱底，以徒手復位將髁突拉出中顱窩後進行顎間固定。病人術後咬合穩定無張口受限情形。因病例之少見特殊性而提出，並回顧相關文獻。希望能作為日後處理這類病人的參考。

關鍵字

下顎骨髁突 ； 中顱窩 ； 顳顎關節異位 ； 開放性骨復位術

並列摘要

Dislocation of the mandibular condyle into the middle cranial fossa is extremely rare, It is often misdiagnosed initially because of its rarity and nonspecific symptoms, Accurate diagnosis is the key to effective management which can also keep patient from unnecessary treatment The authors presented a case of a 19-year-old man with dislocated right condyle entering the middle cranial fossa, The mandible was ＂ankylosed＂ in an ipsilateral lateral excursion, and the diagnosis was confirmed by plain radiography and computed tomography, Conservative treatment was tried initially but failed, Therefore open reduction with manipulation followed by repair of dura and glenoid fossa was performed successfully without intracranial complications, The occlusion was stable and no limitation of opening mouth during postoperative follow-up, Due to its rarity, the etiology, diagnosis, possible treatment plan from closed reduction to open reduction were reviewed, and hopefully it could be a reference for future management.

並列關鍵字

Mandibular condyle ； Middle cranial fossa