三叉神经带状疱疹罕见并发症颌骨坏死回顾分析

Retrospective analysis of the rare complication of osteonecrosis of the jaw associated with trigeminal herpes zoster

目的通过回顾分析,总结三叉神经带状疱疹罕见并发症颌骨坏死的发病特点及临床表现,以期为该病的正确诊治提供科学依据。方法收集上海交通大学医学院附属第九人民医院口腔外科在2011年5月至2016年12月间诊治的4例由三叉神经带状疱疹引发的颌骨坏死,结合52例以往文献报道的病例进行回顾分析。结果本病多发生于中老年患者,年龄范围6～86岁,平均年龄54岁;男性28例,女性19例;病变单独累及三叉神经第二支或第三支者23例,同时累及第二、三支者7例;合并HIV感染者6例,合并恶性肿瘤者8例。结论三叉神经带状疱疹合并颌骨坏死发病率较低,综合考虑其发病特点及临床表现有助于该病的诊治。对于面颊部带状疱疹患者宜尽早治疗,控制病情,同时检查是否存在全身性疾病,预防严重口腔并发症的发生。

Objective To summarize the pathogenesis features and clinical manifestations of osteonecrosis of the jaw associated with trigeminal herpes zoster and to provide scientific basis for the correct diagnosis and treatment through retrospective analysis.Methods Four cases were collected in the Department of Oral Surgery,Shanghai Ninth People's Hospital from 2011 to 2016 and 52 cases were collected from literatures.Then the retrospective analysis was conducted.Results The complication occurred mostly in middle-aged and elderly patients,with an age range of 6 to 86 and an average age of 54.These cases included 28 males and 19 females.The lesion could affect either the second(23 cases)or the third branch(23 cases)of the trigeminal nerve,or both(7 cases).6 cases were complicated by HIV,8 by malignant tumors.Conclusion Osteonecrosis of the jaw associated with trigeminal herpes zoster has a low incidence.Comprehensive consideration of its pathogenesis features and clinical manifestations can help to diagnose and treat it.For patients with cheek herpes zoster,it is advisable to treat them as soon as possible and to check for the presence of systemic diseases in order to prevent serious oral complications.