Abdelrahman Tarek Ftohy, Takahashi Katsu, Bessho Kazuhisa
Department of Oral and Maxillofacial Surgery, Kyoto University, Kyoto 606-8507, Japan.
J Craniofac Surg. 2010 Jul;21(4):1301-4. doi: 10.1097/SCS.0b013e3181e1e69a.
Ankylosis of the temporomandibular joint (TMJ) is a severe disorder that leads to jaw function impairment and restricted mouth opening. Management of TMJ ankylosis poses a challenge to surgeons concerned because of the high rate of recurrence. The surgical approach to TMJ ankylosis can be performed according to different techniques and modalities. This report presents a case of a bilateral posttraumatic TMJ ankylosis that showed limited mouth opening (27 mm) along with dental occlusion abnormalities, and both TMJs showed severe fibro-osseous ankylosis. Bilateral gap arthroplasty was performed, and passive interincisal mouth opening of at least 47 mm was achieved after 15 days of physiotherapy. Eight months later, bilateral split ramus osteotomy was performed to correct the residual retrognathia and malocclusion. The outcome of the patient's treatment was satisfactory. Wide gap arthroplasty if followed by vigorous physiotherapy may be sufficient in treating TMJ ankylosis and prevent recurrence in adults.
颞下颌关节强直是一种严重的疾病，可导致颌功能受损和张口受限。由于复发率高，颞下颌关节强直的治疗对外科医生来说是一项挑战。颞下颌关节强直的手术方法可根据不同的技术和方式进行。本报告介绍了一例双侧创伤后颞下颌关节强直病例，该病例表现为张口受限（27毫米）以及牙合异常，且双侧颞下颌关节均表现为严重的纤维骨性强直。进行了双侧间隙关节成形术，物理治疗15天后，被动切牙间开口度至少达到了47毫米。八个月后，进行了双侧下颌升支劈开截骨术以纠正残留的下颌后缩和错牙合。患者的治疗结果令人满意。对于成人颞下颌关节强直，若在广泛间隙关节成形术后进行积极的物理治疗，可能足以治疗该疾病并预防复发。
