title: Vascularized bone graft reconstruction of the temporomandibular joint using the tunneled, anchored suture technique.
abstract: OBJECTIVE
  To describe a novel technique that provides a simple, flexible and safe method to approximate and secure the neo-condyle into the glenoid fossa in reconstruction of hemi-mandibulectomy defects.
  
  
  METHODS
  Retrospective chart review of a case series was performed.
  
  
  METHODS
  Three patients underwent composite resection of the hemi-mandible with condylectomy. A minimally invasive tunneled suture, anchored with a miniplate to the zygomatic root, was used to approximate the neo-condyle into the glenoid fossa. Postoperative outcomes were assessed with clinical and radiographic measures.
  
  
  RESULTS
  The median patient age was 64 years. Median follow-up was 19 months. All patients reported improved facial symmetry, jaw opening and acceptable dental occlusion. Post-operative CT imaging revealed sustained approximation within the TMJ without evidence of jaw drift.
  
  
  CONCLUSIONS
  The described approach introduces a simple, safe, flexible and effective technique for neo-condylar suspension and appropriate realignment during mandibular reconstruction.
authors.affiliation: Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Seth
authors.forename: Heather H
authors.initials: HH
authors.lastname: Waters
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Knott
mesh_terms: D001860:Bone Plates; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D053441:Suture Anchors; D013536:Suture Techniques; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015050:Zygoma / Q000601:surgery