新生児・乳児上顎骨骨髄炎症例—追跡調査例

Maxillary Osteomyelitis in New-born and Infants: Follow-up Studies

I．はじめに

　新生児・乳児上顎骨骨髄炎は抗生物質の発達により本疾患の典型例，あるいは重篤な症例は少なくなる傾向にある。しかしながらいったん発症すると犬歯窩や内嘴部に瘻孔を形成し，さらに上顎骨が腐骨化し高熱が持続する症例も認められる。また時に外切開法による治療後の顔面，頬部の醜形をきたす例をみる。

　すなわち成長期にある新生児，乳児の顔面骨に比較的大きな外科的侵襲を加えることは，顔面骨，上顎骨，歯牙などに及ぼす影響は少なくなく永続的障害を遺す懸念があり，したがって初期診療にあたっては本症の病態，経過について熟知しておく必要があると考える^1）。

Maxillary osteomyelitis in new-born and infants was followed and evaluated for 10 years.

1. Three out of 5 cases were suffered from the disease within one month after their birth.

2. Bacteriological examination disclosed that eti-ologic bacteria was Staphylococcus aureus resistant to antibiotics.

3. The patients who developed this disease one month after the birth needed more time to cease draining through the maxillary wound, probably due to special pathophysiology of a developing maxillary bone.

4. From the standpoint of view of "developing bone and sinus", growth of the maxillary sinus would be restained toward outside.

5. The appropriate perioral incision and drain-age including radical operation must be consider-ed as early as possible to obtain a short-term healing.