人工顎関節置換術後の外側翼突筋の状態に関する研究

Study on the lateral pterygoid muscle status after artificial temporomandibular joint replacement.

抄録

本研究の目的は、人工顎関節置換術（TJR）における剥離後の外側翼状筋（LPM）の状態を探ることである。LPM剥離を伴う片側人工顎関節置換術の前後に、患者の臨床データとコンピュータ断層撮影の画像データを収集した。ProPlan CMF 3.0ソフトウェアを用いて、手術側と非手術側のLPMの体積を手術前と手術後（1、3、6、12ヶ月後）に測定した。両側のLPMの体積、患者の下顎運動、生活の質（QoL）、痛みと食事のスコア（視覚アナログスケール）を評価し、異なるフォローアップの段階で比較した。この研究には10名の患者が参加した。術後、手術したLPMの体積は3ヶ月で60.78%に有意に減少し（P=0.007）、徐々に安定し6ヶ月で51.58%、1年で54.68%となった（P=0.002）。未手術側では有意なLPM量の変化は見られなかった（P=0.67）。手術した関節の側方運動は有意に減少し（P=0.021）、手術剥離後のLPM体積変化と相関があった（P=0.042）。人工関節手術では、剥離後にLPMが縮小し、筋剥離が人工関節の動きに影響した。

The purpose of this study was to explore the status of the lateral pterygoid muscle (LPM) after detachment in artificial temporomandibular joint replacement (TJR) surgery. Patient clinical and computed tomography imaging data were collected before and after unilateral artificial TJR with LPM detachment. The volume of the LPM on the operated and unoperated sides was measured before and after surgery (at 1, 3, 6, 12 months) using ProPlan CMF 3.0 software. The volumes of the LPM on both sides, the patient's mandibular movements, quality of life (QoL), and pain and diet scores (visual analogue scales) were evaluated and compared at the different follow-up stages. Ten patients were included in the study. After surgery, the volume of the operated LPM was significantly reduced to 60.78% at 3 months (P=0.007), and gradually stabilized to 51.58% at 6 months (P=0.025) and 54.68% at 1 year postoperative (P=0.002). There were no significant LPM volume changes on the unoperated side (P=0.67). Lateral movement of the operated joint was significantly reduced (P=0.021) and correlated with the LPM volume change after surgical detachment (P=0.042). The LPM shrank after detachment in the artificial TJR surgery and the muscle detachment affected the movement of the replaced joint.