Feinberg S E, Larsen P E
Department of Oral and Maxillofacial Surgery, Ohio State University College of Dentistry, Columbus 43210.
J Oral Maxillofac Surg. 1989 Feb;47(2):142-6. doi: 10.1016/s0278-2391(89)80104-1.
Disc replacement in temporomandibular joint surgery has been troublesome. Problems such as migration, fragmentation, foreign body reactions, and unpredictable biodegradation have occurred. Autogenous tissue is presently the material of choice, but requires a second surgical site. In addition, it is a free graft, and thus its fate is unknown. A technique has been developed that uses a pedicled autogenous flap composed of a portion of the temporalis muscle and pericranium to act as an interpositional material in temporomandibular joint surgery. The flap, based on the deep temporal arteries, and pedicled off of the coronoid process, is rotated anterior to the articular eminence and then posteriorly into the temporomandibular joint where it is sutured to the retrodiscal tissue. This procedure allows maintenance of tissue viability and functional movement of the flap during mandibular excursions. The technique offers numerous advantages over the existing autogenous, allogeneic, and alloplastic materials presently used in temporomandibular joint surgery.
颞下颌关节手术中的椎间盘置换一直存在问题。出现了诸如移位、碎裂、异物反应和不可预测的生物降解等问题。自体组织目前是首选材料，但需要第二个手术部位。此外，它是一种游离移植组织，因此其转归尚不清楚。已开发出一种技术，该技术使用由颞肌和颅骨膜的一部分组成的带蒂自体皮瓣作为颞下颌关节手术中的插入材料。该皮瓣以颞深动脉为蒂，从冠状突处带蒂，向前旋转至关节结节前方，然后向后旋转至颞下颌关节，在此处缝合至盘后组织。该手术在下颌运动过程中可维持组织活力和皮瓣的功能运动。与目前颞下颌关节手术中使用的现有自体、异体和异种材料相比，该技术具有许多优势。
