[Evaluation of patients' temporomandibular joint function after mandible reconstruction with free fibula flap].
OBJECTIVE
To evaluate the temporomandibular joint (TMJ) function after mandible reconstruction with free fibula flap and with different condyle treatment.


METHODS
Forty-one cases of mandible and condyle defects following benign tumor resection were reconstructed with fibula free flap, with the condyle being reconstructed by three methods: placement of the distal end of the fibula flap into the glenoid fossa, the fibula serving as the condyle (24 cases); attachment of the resected condyle as a nonvascularized transplant to the end of the fibula flap (5 cases); condyle preservation plus vascularized fibular reconstruction (12 cases). The postoperative TMJ function was evaluated by Fricton function index.


RESULTS
No TMJ ankylosis occurred in all patients. There were no significant differences in aesthetics, deglutition and speech function among the three groups; but there were significant differences in TMJ function index (DI, CMI) among different condyle treatments. Condylar preservation showed better TMJ function than fibula used as a substitute for condyle.


CONCLUSIONS
Preservation of condyle during free fibula mandibular reconstruction can improve patients' TMJ function. The location and shape of fibular condyle were important factors that could influence the outcome the condyle reconstruction.
Zhang
Tao
T
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Mao
Chi
C
Peng
Xin
X
Fu
Kai-yuan
KY
Yu
Guang-yan
GY
Guo
Chuan-bin
CB
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D005260:Female; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013704:Temporomandibular Joint / Q000503:physiopathology*; D055815:Young Adult