How to Prevent a Limitation of Mouth Opening Following Fronto-temporal Craniotomy

前頭側頭開頭術は,側頭筋に対して侵襲的な開頭法であ るため側頭筋損傷に起因する合併症の可能性はいまだ高 く,それに対するさまざまな回避策が報告されている .しかしながら,その合併症とし てこれまでは側頭筋萎縮による皮膚陥凹といった美容的問 題に主に関心が向けられ,一方の開口制限や咬合機能低下 などといった顎運動障害,つまり側頭筋の機能的側面に着 目して開頭法を検討した報告はほとんどみられない.その 理由として前頭側頭開頭術後は顎運動が制限されるのは当 然のことであり咀嚼運動を繰り返すうちになんら後遺症な く自然治癒するものと一般的に認識されていることがあげ られる.しかし現状ではそれぞれの開頭法で開口量の経時 的変化や開口障害の発生頻度などを定量化して客観的に評 価,把握されているわけではない. 今回,われわれは機能的合併症を予防すべく開頭法に若 干の工夫を行い,顎運動の中でも開口制限に焦点を絞り開 前頭側頭開頭術後の開口制限を予防する工夫

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