A number of actinomycotic infections of maxillofacial region as specific inflammation have been reported. However, recent development and application of antibiotics have sometimes caused difficulty in the differential diagnoses and early decision of treatment because of resulted difficult demonstration of ray fungus or sulfur granule in the pus.
Recently, the authors found a case of actinomycotic infection which showed pathological bone absorption from mandibular angle to notch region. We applied a combination therapy of antibiotics with radiation.
After sedative treatment, continuous mandible resection and ceramic bone transplantation were done. During operation, rami buccales of the facial nerve cannot help being amputated due to partial necrosis in masseter muscle.
Since many aesthetic and functional disturbances like Bell's syndrome and muscle paralysis of buccal and orbicularis oris had occured following the operation, a dynamic control operation was performed to prevent these sequelae as far as possible, and a rather satisfactory result was obtained.
