著者

宮本 裟也 佐藤 仁 栗原 祐史 田中 元博 稲田 大佳暢 堅田 凌悟 守谷 崇 安田 有沙 代田 達夫

出版者

特定非営利活動法人 日本顎変形症学会

雑誌

日本顎変形症学会雑誌 (ISSN:09167048)

巻号頁・発行日

vol.31, no.4, pp.197-203, 2021 (Released:2021-12-22)

参考文献数

23

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Acromegaly is an endocrine disease caused by excessive secretion of growth hormone (GH) after the end of the growth period, due to a pituitary adenoma. Mandibular prognathism, tongue hypertrophy, and bulging of the eyebrow arch are observed in the maxillofacial region. We describe a case with acromegaly for which surgical orthodontic treatment was performed after excision of the pituitary adenoma. A 47-year-old woman who became aware of enlargement of the size of the hands and feet from 35 years old was diagnosed with acromegaly by the Department of Neurosurgery because of a high GH level and a pituitary tumor on MRI. In September 2014, chemotherapy was performed after tumor resection via the nasal cavity. In March 2016, she was referred to the Department of Orthodontics of our hospital for further examination and treatment of malocclusion. Overjet and overbite were −5.0mm and +2.5mm, respectively. The occlusal relationship of the molars was Angle class Ⅲ. Angular analysis of lateral cephalometric analysis showed SNA: 80.0°, SNB: 77.0°, ANB: 3.0°, and FMA: 37.9°. Mandibular prognathism was diagnosed based on a Wits appraisal of −7.1. Since there was no clinical activity of acromegaly and hypertrophy of the hard and soft tissues due to acromegaly had stopped, and serum insulin-like growth factor-1 was well controlled by chemotherapy, orthognathic treatment was started in April 2016 and bimaxillary surgery was performed in January 2019. The occlusal relationship was stable and there was no recurrence at 2 years after the surgery. Since acromegaly has various complications, it is necessary to create a treatment plan considering the complications, and to perform extended follow-up due to the potential for recurrence of the disease.

著者

栗原 祐史 勝田 秀行 山口 徹太郎 安田 有沙 塩竃 素直 佐藤 仁 斉藤 芳郎 鴨志田 慎之助 鎌谷 宇明 代田 達夫

出版者

特定非営利活動法人 日本顎変形症学会

雑誌

日本顎変形症学会雑誌 (ISSN:09167048)

巻号頁・発行日

vol.27, no.1, pp.17-23, 2017-04-15 (Released:2017-05-02)

参考文献数

9

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We report two cases of genioplasty performed using a navigation system. In recent years, virtual orthognathic surgeries have been performed using simulation software with data from preoperative computed tomography (CT), and the osteotomy design, direction and distance of bony segment movement have been established. Despite the accuracy of simulations using three-dimensional CT data, results obtained from simulations cannot be effectively applied to clinical practice unless comparisons can be made to actual surgery. We report our experience of performing genioplasty using simulation software with preoperative CT data, and established the osteotomy design as well as the direction and distance of bony segment movement. Simulation-guided navigation osteotomy was performed with reference to simulation results transferred to the navigation system. A reference antenna was attached to the head of the patient using a headband. Next, interfacing laser registration was performed. Osteotomy was then performed along the osteotomy line drawn on the chin bone surface using piezosurgery and a tracker, and the bone segment was mobilized by down-fracture using a bone saw. Using the image of the simulated repositioned bone segment shown on the navigation system screen, the bone segment was moved to the determined position and fixed. Our results suggest that use of a navigation system allows safer, more precise genioplasty.