Agarwal Pawan, Singh M P, Tiwari Swati, Sharma Dhananjaya
Department of Surgery, NSCB Government Medical College, Madhya Pradesh, Jabalpur, 482003 India.
Maxillofacial Surgeon Aditiya Hospital, Madhya Pradesh, Jabalpur, 482001 India.
Indian J Otolaryngol Head Neck Surg. 2021 Mar;73(1):78-84. doi: 10.1007/s12070-020-02063-w. Epub 2020 Aug 24.
Temporo-mandibular joint (TMJ) ankylosis is characterized by a decreased mouth opening which affects mastication, speech, and facial aesthetic. Interpositional arthroplasty using autologous tissue is accepted treatment for TMJ Ankylosis; however, harvesting autologous tissue is associated with additional morbidity. In this article we report our results of silicon interpositional arthroplasty for TMJ ankylosis. 20 patients with TMJ ankylosis were included in the study. All patients underwent standard operative procedure using preauricular incision for release of TMJ ankylosis by excision of at least 1 cm of bony block and insertion of 2 cm thick silicon block in the joint space. Postoperatively early mobilization of TMJ was advised from 3rd day onwards. Post operative result was evaluated by assessing the mouth opening as inter incisor distance (IID). 20 patients (27 joints) of TMJ ankylosis were included in the study. There were 8 male and 12 female patients with age ranged from 3-35 years. According to Sawhney classification bony ankylosis was present as Type-IV ( = 13 joints), Type-III ( = 12 joints) and Type-II (2 joints). Preoperative mean IID was 7.15 mm and post operative mean IID was 43.5. There was no facial nerve paresis, malocclusion or recurrence but infection and extrusion of implant occurred in 1 case each. Silicon interpositional arthroplasty is an effective procedure for the treatment of TMJ Ankylosis; as it restores mouth opening and function, maintains the vertical ramus height, and prevents re-ankylosis without any donor site morbidity.
颞下颌关节(TMJ)强直的特点是开口度减小,这会影响咀嚼、言语和面部美观。使用自体组织的关节间置换成形术是治疗TMJ强直的公认方法;然而,获取自体组织会带来额外的发病率。在本文中,我们报告了硅关节间置换成形术治疗TMJ强直的结果。20例TMJ强直患者纳入本研究。所有患者均采用标准手术方法,经耳前切口切除至少1 cm骨块以松解TMJ强直,并在关节间隙置入2 cm厚的硅块。术后建议从第3天开始早期活动TMJ。通过测量切牙间距离(IID)评估术后结果。本研究纳入了20例(27个关节)TMJ强直患者。其中男性8例,女性12例,年龄3 - 35岁。根据Sawhney分类,骨性强直表现为IV型(13个关节)、III型(12个关节)和II型(2个关节)。术前平均IID为7.15 mm,术后平均IID为43.5 mm。未出现面神经麻痹、错牙合或复发情况,但各有1例发生感染和植入物脱出。硅关节间置换成形术是治疗TMJ强直的有效方法;因为它能恢复开口度和功能,维持升支高度,防止再次强直,且无任何供区并发症。