title: [3D mandibular distraction planification in a case of severe temporomandibular ankylosis].
abstract: BACKGROUND
  When occurring in childhood, temporomandibular ankylosis joint is responsible for complex maxillofacial deformities, including mandibular growth deficiency. We present a case of temporomandibular joint ankylosis associated with severe mandibular asymmetry treated by mandibular bone distraction performed under computer assistance.
  
  
  METHODS
  A 27-year-old patient presented with a severe facial asymmetry consisting in hypoplasia of the left hemi-mandible and maxilla. Mouth opening was non-existent. The CT-scan showed a left temporomandibular ankylosis. A left mandibular distraction was decided. The distraction characteristics (choice and positioning of the distractor, axis and amount of distraction) were determined preoperatively on the 3D CT-scan. The planning has been transferred to a navigation console (Kolibri®, Brainlab®). A combined intraoral and cutaneous was performed. Navigation allowed for an appropriate placement of the osteotomy line and fixation of the distractor. Distraction was started at the 5th postoperative day at the rate of 1mm per day and lasted 25 days without complication.
  
  
  CONCLUSIONS
  3D planning allows for better indication setting, better preparation of the procedure, reducing complications and operative time. It may help as an educational tool for young surgeons and for a better understanding from the patient. Navigation is an accurate method for the transfer of the planning in the operation room.
authors.affiliation: Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France. Electronic address: eliseweber@hotmail.fr.
authors.forename: E
authors.initials: E
authors.lastname: Weber
authors.affiliation: Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (EA 4268, IFR 133), université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Ernoult
authors.affiliation: Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Chatelain
authors.affiliation: Service de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Laboratoire intervention, innovation, imagerie et ingénierie en santé (EA 4268, IFR 133), université de Franche-Comté, place Saint-Jacques, 25030 Besançon cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Benassarou
mesh_terms: D000328:Adult; D000844:Ankylosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005146:Facial Asymmetry / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D057909:Orthognathic Surgery / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000379:methods*; D057234:Preoperative Period; D012720:Severity of Illness Index; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000473:pathology / Q000601:surgery*
keywords: Ankylose temporo-mandibulaire; Chirurgie assistée par ordinateur; Computer assisted surgery; Navigation; Temporomandibular ankylosis