著者

吉田 和也 梶 龍兒 飯塚 忠彦

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.46, no.10, pp.563-571, 2000-10-20

参考文献数

26

被引用文献数

3 2

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Oromandibular dystonia is characterized by involuntary contraction of the masticatory and tongue muscles, causing difficulties in mastication or speech. Muscle afferent block (MAB) therapy by intramuscular injection of lidocaine and alcohol is aimed at reducing muscle spindle afferents. We treated 37 patients with oromandibular dystonia by intramuscularly injecting 5 to 10ml of 0.5% lidocaine with 0.5 to 1ml of 99.5% alcohol. The muscles for injection were chosen from among the masseter, the inferior head of the lateral pterygoid muscle, the anterior belly of the digastric muscle, the genioglossal muscle, the medical pterygoid muscle, the sternocleidomastoid muscle, and the trapezius muscle. The effect of therapy was assessed subjectively on a linear self-rating scale ranging from 0 (no improvement) to 100 points (complete cure). All patients showed clinical improvement with reduced EMG activity in the affected muscles. The mean number of injections was 10.1±5.8. The overall subjective improvement rate was 60.8±25.4%. Maximal mouth opening (26.0±7.7mm) in patients with restricted mouth opening increased significantly (<I>p</I><0.0001, <I>t</I> test) after treatment (37.1±7.6mm). Some patients had tenderness, stiffness, or swelling of the muscles after repeated injection. The discomfort disappeared spontaneously after discontinuing therapy. MAB therapy is an effective means of treating oromandibular dystonia that has no major side effects.

著者

西田 光男 飯塚 忠彦

出版者

日本頭頸部癌学会

雑誌

頭頸部腫瘍 (ISSN:09114335)

巻号頁・発行日

vol.24, no.3, pp.291-296, 1998

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Supraomohyoid Neck Dissection は口腔扁平上皮癌症例におき, 高頻度でリンパ節転移が認められるオトガイ下・顎下, および胸鎖乳突筋後縁より前方かつ肩甲舌骨筋より上方に位置する上中深頸部のリンパ節群のみを一塊切除する領域頸部郭清術である。胸鎖乳突筋, 副神経, 内頸静脈は温存する。一般的には選択的 (予防的) に適用されているが, 一部の症例では治療的にも実施されている。本術式は節外浸潤症例を除き, 頸部のリンパ組織が頸筋膜, 血管鞘により筋肉, 血管実質から隔絶されているという解剖により成立し, この fascia をリンパ組織とともに鋭的に切除すれば根治性を失わず, かつ筋肉, 神経, 血管の温存が可能で形態, 機能障害などの後遺症は最小限となる。しかし適応症例は厳選されねばならない。手術手技上, 上内深頸領域の郭清が難しく, 頭板状筋, 肩甲挙筋面から完全に郭清し, その郭清組織は同領域から副神経の下面を通して潜らせ前方へ運ばねばならない。

著者

横江 義彦 兵 行忠 広岡 康博 飯塚 忠彦 小野 尊睦

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.31, no.10, pp.2450-2456, 1985-10-20 (Released:2011-07-25)

参考文献数

24

被引用文献数

1

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Congenital aglossia is a rare tongue anomaly. There were 16 cases reported in Japan of which only one was an adult case.Recently we experienced a congenital aglossia case. The patient, a 20-year-old female, is the youngest of two children of unrelated parents, aged 32 (father) and 28 (mother). The patient's mother had a drugless normal pregnancy and normal delivery. The patient had sucking difficulty, but no treatment such as nasal feeding.Intraorally, a small extruded mass was recognized from the floor of the mouth. Both of the maxillary and the mandibular arches were very narrow, and three incisors of the mandible were congenitally missing. Radiographically, the existance of hyoid bone, submandibular, salivary gland and suprahyoid muscles were suggested by computed radiography and computed tornography. However, the patient had almost normal taste and clear pronunciation.