Early Rehabilitation of Temporomandibular Joint Ankylosis after Interpositional Arthroplasty

顳頜關節僵直病人於內置式關節整形術術後早期的復健治療

賴宇亮(Yu-Liang Lai) ； 周立偉(Li-Wei Chou) ； 吳貞儀(Chen-Yi Wu) ； 柯政全(Edward C Ko) ； 劉郁君(Yu-Chun Liu) ； 高木榮(Mu-Jung Kao)

《北市醫學雜誌》 7卷3期 (2010/09) Pp. 278-283

https://doi.org/10.6200/TCMJ.2010.7.3.09

摘要

高張性痙攣是上運動神經元病變的一種表現，且是腦血管病變後常見的後遺症。雖然透過一些已知的手術方法，可以使得顳頜關節僵直病人其張口程度獲得改善，但是關於新的賴氏內置式關節整形術(Lai's interpositional arthroplasty operation)術後立即的復健與成效研究資料尚仍缺如。我們報告一例腦幹中風後病患，因高張性痙攣導致牙關緊閉，於賴氏內置式關節整形術術後立即的復健治療後，成功地治癒顳頜關節僵直。在六個月的追蹤治療後，測量到38毫米的最大張口距離。而且，於一年的追蹤治療後，完全成功地治癒顳頜關節僵直。賴氏內置式關節整形術術後早期立即的復健治療，在顳頜關節僵直治療上證實可以獲得良好的療效。

關鍵字

復健 ； 語言治療 ； 中風 ； 顳頜關節僵直

並列摘要

Spastic hypertonia, which is often a component of an upper motor neuron lesion, is a not uncommon sequela after cerebrovascular accident (CVA). Though satisfactory mouth opening in patients with temporomandibular joint ankylosis can be achieved by some surgery methods, data on rehabilitation immediately after the Lai's interpositional arthroplasty operation is still not available. We report a case of spastic hypertonia leading to severe trismus after brain stem stroke that was successfully treated by early rehabilitation of the temporomandibular joint ankylosis immediately after Lai's interpositional arthroplasty. The maximal dimension of mouth opening was found to be 38mm at the 6 months follow-up. Furthermore, the ankylosis had disappeared after one year of follow-up. Thus early active rehabilitation was able to achieve a good functional outcome.

並列關鍵字

rehabilitation ； speech therapy ； stroke ； temporomandibular joint ankylosis