A retrospective study of the costochondral graft in TMJ reconstruction.

A retrospective review of 76 costochondral grafts (57 patients) was undertaken to determine outcome with respect to the extent of previous surgery (none, disc surgery or soft tissue graft, alloplastic disc, alloplastic joint, previous graft) and to initial and preoperative diagnosis. The minimum follow up period was 2 years and for each patient both subjective (pain and dietary interference scores) and objective (interincisal distance) data was recorded. Collectively there was improvement in pain (mean 6.7 to 3.5) and diet (mean 2.2 to 3.0) scores with a moderate increase in interincisal distance (mean 21 to 24mm). In patients with no previous surgery, arthritic disease or congenital deformity the costochondral graft performed well but in patients with previous alloplastic discs and/or total joints the results were less predictable. A preoperative diagnosis of ankylosis was associated with a high complication and further surgery rate suggesting caution in this group of patients.