顔面神経麻痺のみられた過長茎状突起症の1例

ELONGATED PROCESSUS STYLOIDEUS THAT CAUSED FACIAL PARESIS

　Ⅰ．緒言

　茎状突起は，第2鰐弓のReichert氏軟骨に起始を有するが^5）18），それが異常に長くなりそのため種々の症状を呈する場合がある^6）9）。著者らは，最近両側の過長茎状突起症で，その1側では文献上稀にみる過長茎状突起が舌骨との間に仮関節を作つており，さらに同側に顔神麻痺を伴つていた症例を経験したので若干の文献的知見をもあわせて報告する。

　The authors experienced a case of elongated processus styloideus, in a housewife, aged 58, who complained of right facial paresis, oppressive pain in the right submaxillary region, feeling of the swelling of the mouth and difficulty of swallowing. The facial paresis had been present since the patient was 2 years old.

　The examination showed the right processusstyloideus to be elongated touching the lesser cornu of the hyoid bone. The sheath of the processus styloideus measured over 1.6cm. The free-end of the process was connected to the lesser cornu of the hyoid bone by pseudoarthrosis. The removal of this elongated processus, which measured 8.4cm, was effected through external incision along the lower border of the mandible.

　Through this surgical removal the patient was relieved of all symptoms. The difficulty in swallowing and the rotation of the neck were both improved. Radiographically the movement of the hyoid bone was increased during deglutition.The cause of the facial paralysis evidently appeared to have been the result of undue pressure exerted on the facial nerve in its vertical course through the stylomastoid foramen.