Bone hook을 이용한 장기간 지속된 악관절 탈구의 치험 2례

Treatment of long standing T.M.J. dislocation with bone hook - report of 2 cases -

This is a report of 2 cases about 39-& 58-year-old female patients with chronic painful forward mandibular condylar dislocation, which is non amenable to hand manipulation. Chronic mandibular dislocation can became exquiitely painful for the patient and frustrating to both the patient and the doctor. Clinically the forward dislocation of the TMJ can be divided into 3 groups; a dislocation occuring only once, a recurrent dislocation and a prolonged dislocation. The prolonged or long-standing dislocation has its own special problems. Manual reposition is not possible anymore in most cases. As the time between onset of the dislocation and reposition increases, the prognosis diminishes. The methods of the treatment for the dislocated mandible mainly used are closed(manipulation or traction) or open(condylectomy, eminectomy and several types of osteotomy, etc.) reduction. In these cases, authors treated successfully 2 female patients of longstanding forward TMJ dislocation as below. Case Ⅰ : manipulation using bone hook under general andesthesia as a closed repositioning method. Case Ⅱ : high condylectomies via preauricular approach as a open reduction after the failure of the reduction with bone hook.