Temporomandibular joint (TMJ) ankylosis in children is a challenging problem for the maxillofacial surgeon since the surgical technique is difficult and the recurrence rate is high. It is characterized by a hipomobility, breathing, eating problems,and facial asymmetry. There is a vertical and sagittal mandibular deficiency. Numerous treatment approaches have been proposed in the literature. The surgical excision of the ankylotic mass is mandatory; gap arthroplasty and interpositional flaps have been discussed. The reconstruction of the mandibular ramus and condyle with distraction osteogenesis and with autogenous costochondral has been reported. The purpose of this study is to describe the surgical management of TMJ ankylosis by arthroplasty and distraction osteogenesis at the same surgical time. Once the transport disc has contacted he skull base, the distraction is maintained to gain posterior vertical height. This elongation, allows the sagittal advancement of the inferior third of the face and to align the chin with the facial midline. The advantages of this technique, long term stability and results will be analyzed. This is a prospective study of eight children with unilateral TMJ ankylosis. All were treated with arthroplasty and distraction osteogenesis. The average of follow-up was 4 years.
Management of temporomandibular joint ankylosis in children with arthroplasty and distraction osteogenesis in the same surgical time
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