One-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft for temporomandibular diseases combined with dental-maxillofacial deformities.</p><p><b>METHODS</b>The preoperative measurement and model surgery was performed. The patients underwent arthroscope assisted condylar reconstruction with costochondral graft combined with bimaxillary surgery or mandibular surgery.</p><p><b>RESULTS</b>From Sept. 2003 to Dec. 2005, 15 cases were treated successfully with no bleeding, nerve injury and infection. The patients were followed up for 29 to 52 months (mean, 31.8 months). The appearance was markedly improved. TMJ function was good with no pain. The average maximum interincisal opening was 33.6 mm.</p><p><b>CONCLUSION</b>Compared with traditional operation, one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft has its advantages. Indication selection and preoperative design are very important.</p>

The clinical application of arthroscope-assisted reconstruction of the mandibular condyle with costochondral graft / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This is a preliminary study of the endoscopic technique on open surgery. The purpose of this study is to introduce the use of endoscopic technique for the reconstruction of the condyle with costochondral graft through a preauricular incision.</p><p><b>METHODS</b>33 patients of temporomandibular joint diseases (n=49) underwent reconstruction of mandibular condyle with costochondral graft. After preparation of the recipient site through a preauricular incision, maxillo-mandibular fixation, and preparation of the costochondral graft, the graft was fixed to the lateral side of the mandible ramus under the supervision of arthroscope.</p><p><b>RESULTS</b>All the patients had successful reconstruction of the condyle with costochondral graft without any severe bleeding or craniocerebral injury.</p><p><b>CONCLUSION</b>This case series demonstrates the feasibility of endoscopic technique for the reconstruction of the condyle through a preauricular incision. It has the advantage of high efficiency, minimal postoperative morbidity, great patient comfort, and little appearance impairment. The endoscopic technique has a promising future.</p>

Arthroscopic diagnosis for intraarticular adhesion of temporomandibular joint / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To demonstrate the incidence ratio of intraarticular adhesion (ID), arthroscopic findings of adhesions were evaluated by means of its shape, location and degree. To evaluate the correlation between intraarticular adhesion and the following index, including patients' age, locking duration and interincisal opening preoperatively.</p><p><b>METHODS</b>280 consecutive arthroscopically examined joints in 251 patients were evaluated. Two surgeons discussed and recorded the shape, location and degree of adhesion nine parts of the temporomandibular joint (TMJ) upper compartment on the chart. The adhesion ratio in different regions and the relation between different grades and ID stages of adhesions were calculated. The patients with ID stage III, IV, V were divided into two groups, one with adhesion, and the other without. Interincisal opening, locking duration and age were compared between two groups using t-test.</p><p><b>RESULTS</b>Of all 280 joints, 157 joints had adhesions, which accounted for 56.07%. The adhesion of grade 1 accounted for 44.59%, grade 2 for 32.48%, grade 3 for 7.64%, and grade 4 for 15.29%. The proportions of different grades in different stage were as follows. The joints with adhesion in Stage II accounted for 10.81%, Stage III for 48.76%, Stage IV for 75.61%, and Stage V for 77.78%. There were 223 patients who suffered from ID III - V. All of 223 patients were divided into the group with adhesion (136 patients) and the other group without adhesion (87 patients). The patients' age, interincisal opening and locking duration between two groups were statistically significant difference (P < 0.001).</p><p><b>CONCLUSION</b>Arthroscopic findings confirmed that the incidence ratio of adhesion was high, mainly occurred in the older patients with longer locking duration and less interincisal opening. With the higher stage of ID, the adhesion' grades rise.</p>