Follow-up study on the prognosis of the costochondral graft for TMJ reconstruction

This is to review the longterm prognosis and fate of costochondral graft for temporo-mandibular joint reconstruction. The subjects were 12 patients who had been treated with costochondral graft for TMJ reconstruction rendered and followed-up from 1996 to 2011 at Ewha Univ Medical Center. Three patients were growing children under age of 16 years old, nine patients were over 18 years old. 3 male and 9 female patients were followed up to 12 y 3 m (mean 6 y 2 m). 8 unilateral and 4 bilateral reconstructions were given due to TMJ ankylosis (10), ameloblastoma extended to condyle (1), and far advanced DJD (1). The radiologic changes and clinical examinations including maximum mouth opening, mandibular protrusive movement, lateral movement, TMJ function & symptoms, complications such as infection and overgrowth of graft were evaluated periodically.

As a result, Maximal mouth opening was increased from 16.2 ± 7.0 mm to 38.6 ± 6.7 mm after costo-chodral graft. The change of graft length was 0.75–1.06 mm. All of 10 adult patients showed good function without any evidence of infection or nonunion, but the growing children presented with recurred ankylosis or disclosed cap-like overgrowing surrounded the graft. The fate and prognosis of costochondral graft in adults were successful, but the growing children who had no TMJ disks due to previous surgery resulted in reankylosis and unsatisfactory joint functions. Therefore, TMJ reconstruction with costo-chondral graft can be a good option for adult osteoarthritis, but uncertain in growing children who had no TMJ discs.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Follow-up study on the prognosis of the costochondral graft for TMJ reconstruction
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