Temporomandibular joint ankylosis: reconstruction with costochondral graft. Follow-up of two cases

Temporomandibular joint (TMJ) is a complex anatomical structure which it is involve with mastication, digestion, speech and head posture. The most frequent pathology of TMJ in children associated with facial trauma it is the Ankylosis ; although it can be related to local infection or systemic diseases. Prevention of the recurrence after arthroplasty or reconstruction is a real challenge for Oral and Maxillofacial Surgeons. The most common surgeries are the release of the ankylosis, insertion of interposing material or complete reconstruction of the joint.

To report two surgical treatment of ankylosis of TMJ in pediatric patients after facial trauma using costochondral graft. Evaluate the surgeries and literature review. History and physical examination as well as 3D CT Scan and Stereolithography allow us to determine the type of ankylosis. A 10 year old girl and a 3 year old boy patients were operated at Women & Children Ministry Federal Health Hospital under general anesthesia with fiber optic assisted naso-endotracheal intubation. The surgical technique was applied in both patients with preauricular approach. After surgery, early opening and closing lateral movements were mandatory. The mean maximum mouth-opening of both patients presurgical were of 7 mm and in the postsurgical period it was of 30 mm. The early diagnosis and the proper cautions in the management of the microtrauma is the key for the prevention of the ankylosis. We consider as standard of care; the early management postrauma, surgical treatment if is necessary as well as physical therapy before and after surgery.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Temporomandibular joint ankylosis: reconstruction with costochondral graft. Follow-up of two cases
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