Résumé
Temporomandibular joint ankylosis (TMA) is a highly distressing condition in which the temporomandibular joint (TMJ) is replaced by scar tissue. Most frequently reported complications after surgical treatment are limited mouth opening and re-ankylosis. Reankylosis happens due to inadequate bone removal, lack of sufficient interpositional material, fibrous tissue adhesions and elongation of coronoid process and regrowth of bone in the sigmoid notch area. In gap arthroplasty treatment chances to recurrence is 53% than interpositional arthroplasy. We treated a case of right sided TMJ reankylosis by interpositional arthroplasty with temporomyofacial flap and physiotherapy was started 3 days after surgery and maintained for 6 months. In 2 years follow-up, no signs of recurrence and maximum mouth opening 45 mm were observed. The success in preventing reankylosis after TMJ interpositional arthroplasty with temporomyofacial flap is relatively better than gap arthroplasty alone.
Sujets)
Ankylose/épidémiologie , Ankylose/chirurgie , Arthroplastie/méthodes , Enfant , Fascia/transplantation , Humains , Mâle , Techniques de physiothérapie , Lambeaux chirurgicaux/instrumentation , Lambeaux chirurgicaux/méthodes , Os temporal/chirurgie , Muscle temporal/transplantation , Articulation temporomandibulaire/chirurgie , Troubles de l'articulation temporomandibulaire/épidémiologie , Troubles de l'articulation temporomandibulaire/chirurgieRésumé
Management of temporomandibular joint (TMJ) ankylosis is challenging for the oral and maxillofacial surgeon because it involves the mouth opening, dentofacial deformity, diet problem, and quality of life. Although surgical techniques to treat TMJ ankylosis have improved, reankylosis is a persistent problem. The temporalis myofascial flap provides good material for interpositional arthroplasty, because of its good vascular supply, anatomic proximity, and adequate thickness. This case report examines the efficacy of submandibular anchorage to prevent reankylosis by inhibiting flap dislocation.