Mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer

Objectives: The aim of the present study was to evaluate the success rate and postoperative complication rate following surgical treatment of patients with severe temporomandibular joint chronic arthritis and ankylosis using mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer.

Methods: A total of 24 patients (5 male and 19 female) with mean age of 47 (range 22–72) diagnosed with temporomandibular joint chronic arthritis and ankylosis were treated with resection of the condyle with osteoarthrectomy and interposition with a temporalis muscle flap. Mean follow-up period was 21 (12–54 months). All patients were prospectively evaluated. Investigated subjective outcome parametres before surgery and at follow-up were pain during mandibular movements (VAS, 1–10) and impaired mandibular function such as chewing and biting off (VAS, 1-10). Objective criteria evaluated was maximum interincisal opening measured with a ruler.

Results: Pain was successfully alleviated in 83% ( n = 20), mandibular function improved in 88% ( n = 21) and opening capacity improved in 96% ( n = 23) of the patients. Success rate with all criteria fulfilled was 79% ( n = 19). Two patients reankylosed. 13 patients displayed postsurgical malocclusion. In about half of the patients the malocclusion was mild either requiring no treatment ( n = 1) or minor equilibration ( n = 6). Five patients required postsurgical prosthetic therapy and in one individual orthognatic surgery was performed. No intraoperative complications occurred. One patient, operated for the third time, had a partial permanent injury to the temporal branch of the facial nerve, demanding no further action.

Conclusion: In patients with severe temporomandibular joint chronic arthritis and ankylosis, were conventional treatment in terms of arthroscopic surgery or gap osteoectomy either had previously failed or could not be regarded as a reasonable treatment option, mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer seems to be a safe and good treatment option.

Key words: temporomandibular joint chronic arthritis; ankylosis; mandibular condylectomy; temporalis muscle transfer

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer
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