Temporomandibular joint reconstruction with costochondral graft using modified approach.
12 patients presenting with long standing temporomandibular joint (TMJ) ankylosis were treated with a costochondral graft inserted through a modified approach. The age of the patients ranged from 5 to 17 years. A preauricular incision was made for resection of the ankylosed condyle. After release of the ankylosis the contralateral rib was harvested with costal cartilage. An intra-oral incision was made along the external oblique ridge to the mucobuccal fold and was used for resection of the coronoid process and insertion and fixation of the graft. The graft was fixed with a minimum of three titanium screws. The patients were instructed to start physiotherapy 1 week postoperatively and were followed up clinically and radiographically using 3D CT. Postoperative results were encouraging, the graft took well in all patients without postoperative infection or graft rejection. The graft was properly positioned in all cases. There were no visible scars as the preauricular scar is relatively hidden, no possibility of damaging the facial nerve or the marginal mandibular branch and shorter operating time.
El-Sayed
K M
KM
Department of Oral & Maxillofacial Surgery, College of Dentistry, King Saud University, P.O Box 5967, Riyadh 11432, Saudi Arabia. khelsayed60@yahoo.com
D000293:Adolescent; D000844:Ankylosis / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007431:Intraoperative Complications; D019248:Jaw Fixation Techniques; D017746:Joint Capsule / Q000601:surgery; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D012272:Ribs; D013704:Temporomandibular Joint / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods