頬骨弓骨折の治療経験—脳神経外科の立場から

Zygomatic Arch Fractures; A neurosurgical viewpoint

I．はじめに

　頬骨弓は頬骨の側頭突起と側頭骨頬骨突起よりなり，側頭部で隆起しているため，細く，折れ易い．そのため，頬骨弓骨折は重篤な外傷ではもちろんのこと，日常よくあるような顔面外傷でも発生する．それ故，救急医療の場において，頭部外傷に伴ってわれわれ脳神経外科医が経験する頬骨弓骨折は決して稀なものではない．

　過去4年間に10例の頬骨弓骨折整復術を経験したので，特に整復法，整復時期に注目し，脳神経外科の立場から報告する．

Depressed fractures of the zygomatic arch are often overlooked due to local swelling associated with the in-jury. However, such fractures are easily detected using roentgenography in superioinferior projection and/or hone image CT examinations of the zygomatic arch.

Ten patients with depressed fracture of the zygoma-tic arch were treated surgically. Nine underwent an op-eration by the Gillies method within 15 clays after the injury and showed good results. In the remaining pa-tient, the operation performed on the 27th day after the injury failed to reconstruct the zygomatic arch perfect-ly, even when the open procedure was used.

The most important point in these cases is the detec-tion and surgical treatment of the fracture at an early stage. Patients with trismus and depressed fracture of the zygomatic arch should be operated on within two weeks after injury. During this period, the surgical method reported by Gillies can be performed easily and also produces successful results.