Shimizu M, Kurita K, Matsuura H, Ishimaru J-I, Goss A N
The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
Int J Oral Maxillofac Surg. 2006 Sep;35(9):842-9. doi: 10.1016/j.ijom.2006.03.003. Epub 2006 May 26.
The temporalis muscle flap can be used as an inter-positional graft placed into a gap arthroplasty site in temporomandibular joint (TMJ) ankylosis. The purpose of this study was to investigate the role of the muscle graft in sheep. Five pure-bred adult Merino sheep were used and ankylosis was induced in all right TMJs. At 3 months, the ankylosis was released by gap arthroplasty and reconstructed with a masseter muscle graft, because the temporalis muscle is short and poorly vasculized in sheep. The sheep were killed at 3 months after muscle grafting. The maximal mouth opening was recorded before and after operation and at death. The joints were examined radiologically and histologically. In 4 sheep mouth opening remained at the pre-operative level. A clear radiolucent space remained between the smooth temporal and ramus stumps. Histologically, the muscle graft remained vital but with some fibrous tissue formation between the bone ends. One sheep developed an infection at the operative site following the muscle graft; this partly resolved with antibiotics, but the TMJ developed a fibrous reankylosis that was demonstrated clinically, radiologically and histologically. These results indicate that an uncomplicated temporalis muscle graft reconstruction with gap arthroplasty is a successful and stable procedure in human TMJ ankylosis.
颞肌瓣可作为植入物移植到颞下颌关节（TMJ）强直的间隙关节成形术部位。本研究的目的是探讨肌肉移植在绵羊中的作用。使用了5只纯种成年美利奴绵羊，所有右侧颞下颌关节均诱导形成强直。3个月时，通过间隙关节成形术松解强直，并用咬肌移植进行重建，因为绵羊的颞肌短且血管化不良。肌肉移植后3个月处死绵羊。记录术前、术后及处死时的最大开口度。对关节进行放射学和组织学检查。4只绵羊的开口度维持在术前水平。光滑的颞骨和下颌支残端之间仍有明显的透亮间隙。组织学上，肌肉移植存活，但骨端之间有一些纤维组织形成。1只绵羊在肌肉移植后手术部位发生感染；经抗生素治疗部分缓解，但颞下颌关节出现纤维性再强直，临床、放射学和组织学检查均证实。这些结果表明，在人类颞下颌关节强直中，间隙关节成形术联合无并发症的颞肌移植重建是一种成功且稳定的手术方法。
