異所性衝撃下顎第三大臼歯の口腔外外科的摘出術．症例報告

Extraoral surgical removal of an ectopic impacted third molar of the mandible. Report of a case.

• Lampros Goutzanis
• Chara Chatzichalepli
• Dimitrios Avgoustidis
• Panagiotis Papadopoulos
• Catherine Donta

抄録

衝撃を受けた第三大臼歯の口腔内アプローチは、専門の臨床医にとっては一般的な外科的処置である。しかし、異所性第三大臼歯のような症例では、口腔外での抜歯が避けられない場合もある。本症例は56歳女性の下顎異所性第三大臼歯と嚢胞性病変を顎下アプローチで外科的に切除した症例である。術後の経過は問題なく、顔面神経麻痺の徴候は認められなかった。このような症例では、X線画像や臨床検査を十分に検討した上で、適切な術前計画を立てなければならない。隣接する解剖学的構造物のリスクを最小限に抑えられるような、より保存的な術式を選択すべきである。異所性第三大臼歯、下顎、嚢胞、口腔外アプローチ。

Intraoral approach for the removal of impacted third molars represents a common surgical procedure for the specialized clinician. However, in some cases such as ectopic third molars, extraoral surgical removal seems to be inevitable. We present a step by step case of a 56 year old woman with an ectopic third molar of the lower jaw along with a cystic lesion, which were surgically removed by a submandibular approach. Postoperative clinical course was uneventful and there were no signs of facial nerve paresis. In such cases, appropriate preoperative planning must be made based on careful study of radiographic imaging and clinical examination. The more conservative technique that would minimize adjacent anatomic structures risk should be the surgical technique of choice. Ectopic third molar, mandible, cyst, extraoral approach.

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