Ishio Junichi, Nakahira Junko, Nakano Shoko, Sawai Toshiyuki, Minami Toshiaki
Masui. 2017 Feb;66(2):142-144.
We present a case of masticatory muscle tendon- aponeurosis hyperplasia in a patient who underwent general anesthesia for gynecologic surgery. The patient's square-shaped mandible was noticed during preoperative assessment by an anesthesiologist. Further investigation revealed masticatory muscle tendon- aponeurosis hyperplasia. Anesthetic induction agents were administered, and facemask ventilation was initi- ated easily. As the anesthesiologist had predicted, the patient's mouth opening was reduced after administration of muscle relaxants, and keeping her mouth open was more difficult than when she was conscious. Nasotracheal intubation was performed successfully using a bronchoscope. Patients with muscle tendon- aponeurosis hyperplasia do not generally have associated pain, and do not know that they have a limited mouth opening. They are therefore sometimes unaware that they have the condition. Anesthesiologists need to predict that airway intubation will be difficult when the patient has a limited mouth opening associated with a square-shaped mandible.
我们报告一例在接受妇科手术全身麻醉的患者中出现咀嚼肌肌腱 - 腱膜增生的病例。在术前评估时，麻醉医生注意到患者的方形下颌骨。进一步检查发现咀嚼肌肌腱 - 腱膜增生。给予麻醉诱导药物后，面罩通气很容易开始。正如麻醉医生所预测的，给予肌肉松弛剂后患者的张口度减小，保持其口腔张开比她清醒时更困难。使用支气管镜成功进行了经鼻气管插管。肌腱 - 腱膜增生的患者通常没有相关疼痛，并且不知道自己张口受限。因此，他们有时并未意识到自己患有这种疾病。当患者因方形下颌骨导致张口受限时，麻醉医生需要预测气道插管会有困难。
