Anchlia Sonal, Dhuvad Jigar, Shah Jay Chetan
Department of Oral and Maxillofacial Surgery, Govt. Dental College and Hospital, Ahmedabad, Gujarat India.
J Maxillofac Oral Surg. 2019 Jun;18(2):190-196. doi: 10.1007/s12663-018-1115-2. Epub 2018 Apr 25.
Various surgical techniques to release temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this paper is to report our Institution's experience regarding the post-surgical outcome of different surgical techniques for the release of ankylosis of the TMJ.
The records from our hospital of 386 patients (521 joints) treated for TMJ ankylosis were reviewed. Data analysis included the etiology of TMJ ankylosis, gender distribution, age group, distribution of ankylosis based on location, type, interincisal opening and complications in the perioperative period.
Out of 521 joints, 65.02% were unilateral and 73.89% had bony ankylosis. The mean maximal incisal opening preoperative was 5.4 mm (SD 3.63 mm) and at 1-year follow-up was 36.9 mm (SD 3.3 mm). There was no permanent facial nerve paralysis. However, transient facial nerve paresis was 14.78%. There was an overall recurrence rate of 8.82%.
We conclude that after TMJ ankylosis release with interpositional arthroplasty, reconstruction of the RCU with L ramus osteotomy is the most favorable. This procedure not only causes least complications, but also maintains height of ramus, facilitating surgeries for secondary asymmetry correction.
文献中已描述了多种用于松解颞下颌关节（TMJ）强直的手术技术。本文的目的是报告我们机构关于不同手术技术松解TMJ强直术后结果的经验。
回顾了我院386例（521个关节）接受TMJ强直治疗患者的记录。数据分析包括TMJ强直的病因、性别分布、年龄组、基于位置的强直分布、类型、切牙间开口度以及围手术期并发症。
在521个关节中，65.02%为单侧，73.89%为骨性强直。术前平均最大切牙间开口度为5.4毫米（标准差3.63毫米），1年随访时为36.9毫米（标准差3.3毫米）。无永久性面神经麻痹。然而，短暂性面神经麻痹发生率为14.78%。总体复发率为8.82%。
我们得出结论，在采用间置物关节成形术松解TMJ强直后，用L型升支截骨术重建喙突是最有利的。该手术不仅并发症最少，而且能保持升支高度，便于进行二期不对称矫正手术。
