Vol.99 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 4 April 2006
A Case of External Dental Fistula
-The Protection of the Mandibular Branch of the Facial Nerve-
Masaaki Higashino, Ryo Kawata, Ayumi Hayashi,
Tetsuya Terada and Hiroshi Takenaka
(Osaka Medical College)
We experienced a case of external dental fistula that opened from a mandibular lesion. The patient was a 21-years-old woman. She noticed the tumor in a mandibular lesion she had had on her right side since childhood, and left it. It continued to increase in size and became more painful so she sought treatment. She was given treatment of antibiotics, but this was ineffective, so an operation of partial excision was done. However, pus continued to flow from the fistula of the mandibular lesion. So she was referred to our department. The pus disappeared by antibiotic treatment but the fistula remained. We decided to operate. Generally, to protect the facial nerve and avoid paralysis of it while operating on a tumor of the mandibular lesion, method not it confirming the nerve is more safe than the method to confirm it. But, with this case, we had to confirm the nerve to protect it, because the fistula existed near the running of the nerve. It is better to confirm the facial nerve at the top of the inner side of the lower jaw corner, because there is a part before the shared branch. The running and the branch of the nerve vary, so it is difficult to confirm the facial nerve before the operation. So, we need to thoroughly explain to the patient about the possibility of facial nerve damage before the operation of mandibular lesion, especially if inflammation is involved, as in this case.
Key words : external dental fistula, facial nerve, mandibular lesion