Shivakotee Satyapriya, Menon Col Suresh, Sham M E, Kumar Veerendra, Archana S
Gangtok, India.
Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, India.
J Maxillofac Oral Surg. 2020 Dec;19(4):579-584. doi: 10.1007/s12663-019-01293-y. Epub 2019 Sep 30.
Temporomandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance and hygiene. Surgery of TMJ ankylosis needs careful evaluation and planning to yield predictable results. Temporomandibular joint ankylosis is very common among young children. The aim of treatment is not only to treat the movement of the joint but also to prevent relapse.
In this series, 18 cases of temporomandibular joint ankylosis were treated at our institute from January 2012 to January 2017 with osteoarthrectomy and interpositional arthroplasty. Patients were in the age range of 5-57 years, with 11 males and 7 females and including 8 unilateral and 10 bilateral cases. Duration of ankylosis ranged from less than 2 years to more than 6 years. Seven of the patients were secondarily taken up for correction of their deformities with either orthognathic surgery or distraction osteogenesis.
Good mouth opening was achieved in all the patients with a mean follow-up period of 12 months. The early post-operative mouth opening ranged from 24 to 37 mm. The late post-operative mouth opening ranged from 20 to 33 mm. There was a stress on aggressive physiotherapy for a minimum of 6 months in all our patients.
Interpositional arthroplasty using vascularized temporalis fascia flap is a very reliable method to prevent recurrence of ankylosis, and it also avoids the disadvantages of alloplastic materials as well as nonvascularized autogenous tissues.
颞下颌关节强直是一种极为致残的疾病，会导致咀嚼、消化、言语、外观和卫生等方面的问题。颞下颌关节强直手术需要仔细评估和规划，以获得可预测的结果。颞下颌关节强直在幼儿中非常常见。治疗的目的不仅是恢复关节活动，还在于预防复发。
在本系列研究中，2012年1月至2017年1月期间，我院对18例颞下颌关节强直患者进行了关节骨切除术和间置关节成形术治疗。患者年龄在5至57岁之间，男性11例，女性7例，包括8例单侧和10例双侧病例。关节强直持续时间从不到2年至超过6年不等。其中7例患者随后接受了正颌手术或牵引成骨术以矫正畸形。
所有患者均获得良好的开口度，平均随访期为12个月。术后早期开口度为24至37毫米。术后晚期开口度为20至33毫米。所有患者均至少接受了6个月的积极物理治疗。
采用带血管蒂颞肌筋膜瓣的间置关节成形术是预防关节强直复发的一种非常可靠的方法，同时也避免了异体材料和非血管化自体组织的缺点。
