Mandibular distraction in temporomandibular joint ankylosis

被引:46
作者
Dean, A [1 ]
Alamillos, F [1 ]
机构
[1] Hosp Univ Reina Sofia, Serv Cirugia Oral & Maxilofacial, Cordoba 14004, Spain
关键词
D O I
10.1097/00006534-199912000-00012
中图分类号
R61 [外科手术学];
学科分类号
摘要
Condylar damage during childhood can produce ankylosis and alteration of the mandibular growth. In case of unilateral ankylosis occurring in early childhood, a mandibular hypoplasia of the affected side may develop. The patients have limitation of mouth opening, facial asymmetry, and chin deviation toward the affected side. The aims of this study are to show the use of distraction osteogenesis in mandibular hypoplasia associated with ankylosis and to present our experience with a new therapeutic option for the treatment of mandibular hypoplasia with unilateral ankylosis in the childhood consisting of the association of arthroplasty to treat the ankylosis and mandibular distraction to correct the facial asymmetry, both accomplished in the same surgical procedure. From November of 1996 to November of 1997, three male patients aged 2, 7, and 13 years with mandibular hypoplasia and ankylosis were treated by distraction osteogenesis. An arthro plasty consisting of the resection of the ankylotic block and interposition of a temporalis muscle flap, plus coronoidectomy was done in two of them and mandibular distraction was done in all three patients. Articular functional rehabilitation began on the first postoperative day. Mandibular distraction began on the fifth postoperative day with a rate of 1 mm per day, ending when the facial symmetry was achieved. From the first postoperative day, an increase in the mouth opening was achieved; this increase continued until ending the distraction. The average duration of distraction was 22 days. Average duration of consolidation was 6 weeks. Oral opening increased from 10 mm to 35 mm in the 7-year-old patient, from 9 mm to 27 mm in the 2-year-old patient, and from 14 mm to 38 mm in the 13-year-old patient. To date, oral opening and facial symmetry persist. Osseous mandibular distraction together with arthroplasty offers an excellent new alternative for treatment of patients with mandibular hypoplasia and associated ankylosis, with minimal morbidity and complications.
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页码:2021 / 2031
页数:11
相关论文
共 37 条
[1]  
Bradley P, 1994, ROWE WILLIAMS MAXILL, P405
[2]   THE TEMPORALIS MUSCLE FLAP IN TEMPORO-MANDIBULAR JOINT SURGERY [J].
BRUSATI, R ;
RAFFAINI, M ;
SESENNA, E ;
BOZZETTI, A .
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 1990, 18 (08) :352-358
[3]  
CARLOTTI AE, 1992, MODERN PRACTICE ORTH, V3, P1996
[4]   DISTRACTION OSTEOGENESIS OF THE HUMAN CRANIOFACIAL SKELETON - INITIAL EXPERIENCE WITH A NEW DISTRACTION SYSTEM [J].
COHEN, SR ;
RUTRICK, RE ;
BURSTEIN, FD .
JOURNAL OF CRANIOFACIAL SURGERY, 1995, 6 (05) :368-374
[5]   Intraoral distraction for mandibular lengthening: A technical innovation [J].
Diner, PA ;
Kollar, EM ;
Martinez, H ;
Vazquez, MP .
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 1996, 24 (02) :92-95
[6]   Submerged intraoral device for mandibular lengthening [J].
Diner, PA ;
Kollar, E ;
Martinez, H ;
Vazquez, MP .
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 1997, 25 (03) :116-123
[7]   Bird face deformity secondary to bilateral temporomandibular joint ankylosis [J].
ElSheikh, MM ;
Medra, AM ;
Warda, MH .
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 1996, 24 (02) :96-103
[8]   Management of unilateral temporomandibular ankylosis associated with facial asymmetry [J].
ElSheikh, MM ;
Medra, AM .
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 1997, 25 (03) :109-115
[9]  
ENLOW DH, 1996, ESSENTIALS FACIAL GR, P4
[10]  
FEINBERG SE, 1992, MODERN PRACTICE ORTH, V1, P717