Xu Xin, Ma Hailong, Jin Shufang
Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang.
Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
J Craniofac Surg. 2018 May;29(3):636-639. doi: 10.1097/SCS.0000000000004097.
To introduce the surgical techniques and evaluate the effect of alloplastic total temporomandibular joint (TMJ) replacement aided by digital templates in giant condylar osteoma.
Three patients with giant condylar osteoma were enrolled in this study. The maximal mouth opening was 1.9 cm on average. All the patients were underwent the computed tomography scan (slice thickness 1 mm) and the data were imported to Proplan 1.3 software for 3-dimensional bony segmentation and reconstruction. Osteotomy line and digital template according the 3-dimensional measurement were designed. All the joints were replaced with Biomet standard prosthesis under general anesthesia.
All the operations were successfully performed. The follow-up period was from 6 to 18 months (average, 12 months). Pain relief of the joint and mouth-opening improvement were significant in 3 patients. No infection or loosening the prostheses was occurred. The occlusal relationship kept stable in all patients.
Total TMJ replacement with standard prosthesis is a good strategy for TMJ reconstruction after giant condylar osteoma excision. The joint pain and the mouth-opening limitation resulted from giant condylar osteoma were markedly improved. Long-term effect remains to be evaluated based on a long-term follow-up.
介绍手术技术,并评估数字模板辅助下的异体全颞下颌关节(TMJ)置换术治疗巨大髁突骨瘤的效果。
本研究纳入3例巨大髁突骨瘤患者。平均最大开口度为1.9厘米。所有患者均接受计算机断层扫描(层厚1毫米),并将数据导入Proplan 1.3软件进行三维骨分割和重建。根据三维测量结果设计截骨线和数字模板。所有关节均在全身麻醉下采用Biomet标准假体进行置换。
所有手术均成功完成。随访时间为6至18个月(平均12个月)。3例患者关节疼痛缓解和开口度改善明显。未发生感染或假体松动。所有患者的咬合关系保持稳定。
采用标准假体进行全颞下颌关节置换是巨大髁突骨瘤切除术后颞下颌关节重建的良好策略。巨大髁突骨瘤所致的关节疼痛和开口受限明显改善。长期效果有待基于长期随访进行评估。