Use of costochondral graft in distraction of mandible to correct facial asymmetry and restore function in peadiatric TMJ ankylosis

Introduction: Craniomandibular ankylosis is characterized by the formation of a bony mass which replaces normal temporomandibular joint articulation. Aetiology of ankylosis is multifactorial with trauma being the predominant factor. The destruction of the growing joint affects mandible directly and have secondary effects on the maxilla and surrounding tissues. This result in sever functional limitations and apparent facial asymmetry which subsequently adds to breathing difficulties and psychological issues.

Aims and objective: The objective of this study is as follows:

  • 1.

    To remove the ankylotic mass.

  • 2.

    To restore the function.

  • 3.

    To correct the facial deformity reestablishing the growth centre and joint-ramus assembly in growing patients.

  • 4.

    Use of autogenous grafting material to ensure distraction and continued growth.

Methods and materials: A total number of 24 patients of temporomandibular ankylosis from 2002 to 2007 were seen .Age ranged from 3 to 15 years. There were 16 males and 8 females with 5 subjects having bilateral ankylosis and the rest unilateral. Trauma attributed for 19, birth trauma 3 and firm arm injury 2 patients. Minimum time elasped from time of injury to presentation was 4 years resulting in both unilateral and bilateral facial deformity. Preoperative mouth opening was 2–12 mm. Patients were treated for TMJ ankylosis, distraction for correction of facial profile and restoration of function done by appropriate size and angulation of costochondral grafting at the same operation. Postoperative mouth opening ranged from 24 to 41 mm. One developed reankylosis, 2 costochondral overgrowth and 4 had triensent facial nerve weaknes. Satisfactory results both in terms of function and facial profile were achieved by using costochondral graft.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Use of costochondral graft in distraction of mandible to correct facial asymmetry and restore function in peadiatric TMJ ankylosis
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