Use of the suture anchor in interpositional arthroplasty  of temporomandibular joint ankylosis

Use of the suture anchor in interpositional arthroplasty of temporomandibular joint ankylosis

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Heleia Nestal-Zibo & Edvitar Leibur & Ülle Voog-Oras & Tiia Tamme
  • چاپ و سال / کشور: 2011

Description

Background The purpose of this article is to demonstrate the use of a mini suture anchor to attach the temporal myofascial flap to the head of the mandibular condyle in interpositional arthroplasty for the treatment of temporomandibular joint (TMJ) ankylosis. Case report A 29-year-old patient, with unilateral posttraumatic temporomandibular joint osseous ankylosis and preoperativemaximal interincisal distance of 9mm, was treated by the interpositional gap arthroplasty using the temporal myofascial flap. After rotation, the flap and the TMJ capsule were attached to the lateral pole of the condyle by a non-absorbable mini suture anchor. The surgery was uneventful. On the first post-operative day, the range of motion was considerably improved, with a maximal interincisal distance of 26 mm, a mandibular protrusion of 1 mm and a lateral mandibular excursion of 4 mmto the left and7mm to the right.On the 20th post-operative day, the maximal interincisal distance was 30 mm, protrusion 4 mm, the lateral excursion to the right 7 mm and to the left 5 mm. On the third post-operative month, the maximal interincisal distance reached 40 mm. Discussion The mini suture anchor demonstrated to be a good tool for the fixation of the temporalis myofascial flap to the condyle, also allowing with the same suture to attach the capsular tissue to the lateral surface of the condyle. The boneanchored suture permits the restoration of a more physiologic TMJ anatomy. The treatment of TMJ ankylosis should be comprehensive; physiotherapy plays an important role in the rehabilitation period to restore the normal function.
Oral Maxillofac Surg DOI 10.1007/s10006-011-0283-8 Received: 27 March 2011 / Accepted: 12 June 2011
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