Résumé
A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.
Sujets)
Animaux , Nerf facial , Cornes , Os hyoïde , Lèvre , Mandibule , Bouche , Cou , Ostéotomie , Cuir chevelu , Peau , Os zygomatiqueRésumé
The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and high incidence of recurrence. TMJ ankylosis has been treated by excision and total joint reconstruction with alloplastic, allogeneic, autogenous materials as interpositional materials. The temporalis myofascial flap had been considered to be a successful interpositional material, due to its anatomical, topographical, and functional properties. This study evaluated the efficacy of the temporalis myofascial flap for nine TMJs (five patients) through the preauricular approach and coronoidectomy. Radiographic and physiologic long term result was investigated in this study. The result reveals that the temporalis myofascial flap is a good autogenous tissue satisfying the criteria of an ideal interpositional material, which offers a material that fulfills the physiological function of the disc. In spite of favorable functional outcome, mild postoperative openbite tendency remains another challenge.