Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

A CLINICAL STUDY ON TEMPORALIS MYOFASCIAL FLAP FOR ADULT TEMPOROMANDIBULAR JOINT ANKYLOSIS

측두근 근막 피판을 이용한 성인 악관절 강직증의 외과적 재건에 관한 임상적 연구

  • Park, Bong-Wook (Department of Dentistry, College of Medicine and Institute of Health Science, Gyeongsang National University) ;
  • Kim, Jong-Ryoul (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Byun, June-Ho (Department of Dentistry, College of Medicine and Institute of Health Science, Gyeongsang National University)
  • 박봉욱 (경상대학교 의과대학 치과학교실, 경상대학교 건강과학연구원) ;
  • 김종렬 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 변준호 (경상대학교 의과대학 치과학교실, 경상대학교 건강과학연구원)
  • Published : 2006.03.31
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Abstract

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

Keywords

References

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