顎矯正手術後に末梢性顔面神経麻痺を発症したHemifacial microsomiaの1例

• Published in: 日本口腔外科学会雑誌 Vol. 66; no. 10; pp. 497 - 505
• Main Authors: 坂口, 修, 吉岡, 泉, 土生, 学, 郡司掛, 香織, 高橋, 理, 冨永, 和宏
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.10.2020
• Subjects: 片側小顔面症; 顎矯正手術; 顔面神経麻痺
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.66.497

We report a case of peripheral facial palsy after orthognathic surgery in a patient with hemifacial microsomia (HFM). The patient was a 20-year-old woman with right HFM. CT examination revealed hypoplasia of the right mandibular ramus, condyle, maxilla, temporal bone, muscles of mastication and parotid salivary gland. She underwent Le Fort Ⅰ osteotomy and bilateral sagittal split ramus osteotomy. Two days after the operation, right facial nerve palsy appeared. Three months after the operation, the palsy was completely resolved by conservative therapy including pharmacotherapy, stellate ganglion blocks and physiotherapy. Facial nerve palsy might have been caused by nerve ischemia and mechanical damage indirect or direct compression from the distal segment, surgical instruments, edema and hematoma. Furthermore, in this case, it is possible that an underlying cause of facial palsy is hypoplasia of the retromandibular region surrounding the facial nerve associated with HMF.