Masatoshi Higuchi DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Akinori Moroi DDS, PhD, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Yuri Ishihara DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Megumi Sotobori DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Ran Iguchi DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Akihiko Kosaka DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Hiroumi Ikawa DDS, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Ryuichi Nakazawa , Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Kohei Marukawa DDS, PhD, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Koichiro Ueki DDS, PhD, Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School of Medicine and Engineering,University of Yamanashi, Chuo-city Yamanashi, Japan
Injury in the maxilla-facial region can cause trismus induced by movement restriction of various surrounding tissues such as bone, joint or muscle.
We report a case of trismus for 40 years after maxillofacial fracture that was improved by surgery.
The patient was a 63-years-old male who was injured in a traffic accident 40 years ago and diagnosed as maxillofacial fractures including right zygomatic bone and arch, but did not receive treatment. Although, he had suffered from trismus (maximum mouth opening 17 mm) caused by interference between a deformed zygomatic bone, arch and the coronoid process for 40 years, no improvement was needed. However, after 40 years since the injury, he noticed that dental treatment of a progressive periodontitis was necessary, and decided to undergo surgery to maximum his mouth opening capacity.
In October 2013, he underwent resection of the coronoid process and part of the temporal muscle under general anesthesia. To correct the collapse at the zygomatic arch, bone from the resected coronoid process was grafted and fixed by a titanium plate and screws in the zygomatic bone defect. As a result, maximum mouth opening improved from 17 mm pre-operative to 40 mm post-operative and the collapse at the zygomatic region was also corrected. Post-operative functional and esthetic relapse was not found and the patient was satisfied and had a good prognosis.
