Release of extra-articular ankylosis by coronoidectomy and insertion of a free abdominal flap: case report

Introduction: It is generally agreed that an effective treatment for extra-articular ankylosis mag be coronoidectomy and excision of scar tissue. But these conventional procedures have shown a high rate of recurrence of ankylosis due to heterotopic bone and fibrous tissue formation. Objective and Patient: We report a case in whom a coronoid osteotomy and insertion of a free abdominal flap was used to treat ankylosis of the mandible following radiotherapy for maxillary cancer. Results: This procedure prevented recurrence of ankylosis by heterotopic bone and fibrous tissue formation. in addition, this flap reduced the risk of postoperative infection and promoted primary healing. Conclusion: The procedure, coronoidectomy and insertion of a free flap, was successful because the well-vascularized musculocutaneous flap occupied the dead space, and replaced the shortage of oral mucosa consequently inhibiting the recurrence of extra-articular ankylosis. (C) 2000 European Association for Cranio-Maxillofacial Surgery.