Component approach to the temporomandibular joint and coronoid process.
Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar.
Department of Plastic and Reconstructive Surgery, Yale University, New Haven, Connecticut.
Miles J
MJ
Pfaff
Department of Plastic and Reconstructive Surgery, Yale University, New Haven, Connecticut.
James
J
Clune
Department of Plastic and Reconstructive Surgery, Yale University, New Haven, Connecticut.
Derek
D
Steinbacher
posttragal incision; preauricular incision; rhytidectomy; superficial musculoaponeurotic system; temporomandibular joint