[Application of computer assisted navigation in the treatment of temporomandibular joint ankylosis].

PURPOSE

The aim of this study is to evaluate the effect of image-guided navigation on gap arthroplasty in the treatment of temporomandibular joint (TMJ) ankylosis.

METHODS

Four patients with unilateral TMJ ankylosis underwent gap arthroplasty with the guide of computer-assisted navigation. With preoperative planning and 3-dimensional simulation, normal anatomical structures of the TMJ were created by superimposing and comparing the unaffected and the affected side. The amount and range of ankylotic bone was determined and displayed. All patients were treated by TMJ gap arthroplasty under the guide of navigation system.

RESULTS

Through registration, an accurate match between the intraoperative anatomy and the CT images had been achieved. With the guide of the navigation, anatomy structures and the position of surgical instruments were shown real-time on the screen. No complications occurred in all patients and the systematic error was within 1 mm. The use of image-guided navigation resulted in the promotion of safe surgical excision of the ankylosed skull base tissue.

CONCLUSIONS

Navigation-guided resection of the ankylotic bone in the TMJ gap arthroplasty is a valuable and safe technique in this potentially complicated procedure. Supported by National Natural Science Foundation of China (Grant No.30471897), Research Fund of Medicine and Engineering of Shanghai Jiao Tong University(Grant No.YG2007ZD09) and Shanghai Leading Academic Discipline Project(Grant No.Y0203).