打哈欠變落下頦 慣患別張嘴太大太久

打哈欠變落下頦 慣患別張嘴太大太久 – 中時電子報

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打哈欠變落下頦 慣患別張嘴太大太久

2015年06月22日 04:10
中國時報 林宜慧/台北報導

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醫師建議,曾有下巴脫臼問題的民眾,打哈欠時最好用手輕托下巴,並避免過度張嘴。圖中人物與此病症無關。(本報資料照)

卡通中常出現主角笑到「落下頦」,現實世界裡也時常上演類似的情節。31歲竹科工程師藍先生某次在工作時只是打了個哈欠,竟然下巴脫臼無法言語,當下急奔醫院急診,當到院開口準備說:「我要掛急診」時,下巴卻自行復位了;事隔兩年,某次與女友約會時又發生了同樣窘境,還好有經驗的他立即以手推回下巴,沒讓美事泡湯。台北醫學大學附設醫院口腔顏面外科主治醫師黃暘凱表示,下巴脫臼主要是因為患者顳骨的「關節隆突」前斜坡太陡,下巴「好出不好進」,一旦過度運動、下顎張太開或太久,就會導致韌帶過鬆,讓下顎滑出「關節隆突」斜坡而回不來。

打哈欠變落下頦 慣患別張嘴太大太久 - 中時電子報

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打哈欠變落下頦 慣患別張嘴太大太久

2015年06月22日 04:10
中國時報 林宜慧/台北報導

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醫師建議,曾有下巴脫臼問題的民眾,打哈欠時最好用手輕托下巴,並避免過度張嘴。圖中人物與此病症無關。(本報資料照)

卡通中常出現主角笑到「落下頦」,現實世界裡也時常上演類似的情節。31歲竹科工程師藍先生某次在工作時只是打了個哈欠,竟然下巴脫臼無法言語,當下急奔醫院急診,當到院開口準備說:「我要掛急診」時,下巴卻自行復位了;事隔兩年,某次與女友約會時又發生了同樣窘境,還好有經驗的他立即以手推回下巴,沒讓美事泡湯。台北醫學大學附設醫院口腔顏面外科主治醫師黃暘凱表示,下巴脫臼主要是因為患者顳骨的「關節隆突」前斜坡太陡,下巴「好出不好進」,一旦過度運動、下顎張太開或太久,就會導致韌帶過鬆,讓下顎滑出「關節隆突」斜坡而回不來。

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黃暘凱指出,下巴脫臼常見於接受口腔治療、需長時間開口的患者,也曾遇過患者因打哈欠、演唱會太high尖叫過久而造成,男女老幼都有,一般人並不需特別預防,但曾發生過下巴脫臼的人,最好在打哈欠時用手輕托下巴,平時也要避免過久張嘴,及嘴部過度運動。治療上,黃暘凱指出,一般情形可用手把下巴推回(下顎骨復位),通常剛推回時韌帶會有點鬆,容易再發生脫臼,若下巴掉下時間較久,可在復位後固定上下顎,復位兩天內嘴巴別張太開。若復位困難的患者,醫師會打肌肉鬆弛劑、麻醉劑,主要是讓患者肌肉放鬆、睡著後不易反抗,也較容易推回;而習慣性脫臼患者可接受手術治療,手術方式多種,目前國外文獻較有效的方法是「關節隆突切除術」,將關節隆突斜坡修緩,讓下顎「好出也好進」。台北國泰醫院口腔顎面外科主任林宏政提醒,下巴脫臼與「顳顎關節障礙」不同,前者是嘴巴合不起來,後者是張不開,正常人張口約3至4個手指頭大小,顳顎關節障礙則約2個手指頭,主因包括吃太硬、壓力大、下巴撞到,常見於壓力大的學生和上班族,大多會反覆發作。林宏政建議這類患者多吃軟質食物、練習減少壓力、牙齒放鬆,在家可自行以40~50℃溼毛巾熱敷20~30分鐘,間隔休息後可再敷數次,就醫則可服用肌肉鬆弛、止痛藥物以減緩不適。(中國時報),

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