Gap arthroplasty of temporomandibular joint ankylosis by transoral access: a case series

Rajan, Ritesh; Reddy, N.V.V.; Potturi, Abhinand; Jhawar, D.; Muralidhar, P.V.; Reddy, B.V. Bhaskara

doi:10.1016/j.ijom.2014.08.010

Cited by 11 publications

(12 citation statements)

References 21 publications

(20 reference statements)

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“…2,6,11,12,[19][20][21] The postoperative recurrence is associated with the inability to remove extensive areas of affected tissue owing to its proximity to vital structures such as the base of the skull and the maxillary neurovascular bundle. 2,11,[19][20][21] While the segmental mandibulectomy between the fourth premolar and first molar teeth had previously been proposed as a possible treatment for unilateral TMJA, 22,23 veterinary practitioners have raised questions regarding which area of the mandible should be addressed and how much bony tissue must be removed. To the best of our knowledge, the specific area of the mandible and amount of bony tissue that must be excised during a segmental mandibulectomy in cats affected by unilateral TMJA has not been established.…”

Section: Introductionmentioning

confidence: 99%

“…Among these complications are excessive or uncontrollable intraoperative bleeding, facial paralysis and TMJA recurrence. 2,6,11,12,19–21 The postoperative recurrence is associated with the inability to remove extensive areas of affected tissue owing to its proximity to vital structures such as the base of the skull and the maxillary neurovascular bundle. 2,11,19–21…”

Section: Introductionmentioning

confidence: 99%

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Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study

Villamizar-Martinez

Chia

Robertson

et al. 2020

Journal of Feline Medicine and Surgery

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Objectives Temporomandibular joint ankylosis (TMJA) is the partial or complete inability to open the mouth due to intra- or extra-articular fibrous, bony or fibro-osseous tissue proliferation. Surgical procedures such as gap arthroplasty, condylectomy or wide extra-articular osteotomy have been recommended to treat this condition; these techniques are challenging, time-consuming and have been occasionally associated with postoperative recurrence, severe periarticular neurovascular iatrogenic trauma and death. Segmental mandibulectomy had previously been recommended as an alternative option for unilateral TMJA, but the location of mandibulectomy and extent of bone removal from the mandible region have not been mentioned in the literature. This study aimed to validate the area of the mandibular body (rostral, middle or caudal) and amount of bony tissue that should be osteotomized during a segmental mandibulectomy for treatment of unilateral TMJA in cats. Methods In this block study, 30 cadaver heads of domestic shorthair cats were randomly divided into three groups of 10 specimens each based on the mandibular region that would undergo segmental mandibulectomy (rostral, middle and caudal). The size of the removed mandibular segment and pre- and postoperative vertical range of mandibular motion were compared for statistical purposes. Results A significant statistical difference was observed between the pre- and postoperative vertical range of mandibular motion between the rostral, middle and caudal segmental mandibulectomies ( P <0.001). The mean postoperative recovered range of mandibular motion for the rostral, middle and caudal segmental mandibulectomies was 50.4%, 81.9% and 90.4%, respectively. Conclusions and relevance The caudal segmental mandibulectomy showed the highest postoperative vertical range of mandibular motion. The removal of a minimum of 1.2 cm of the caudal mandibular body was required to achieve nearly full recovery of presurgical mouth opening in the specimens of this study. The caudal segmental mandibulectomy may eliminate the risk of iatrogenic periarticular neurovascular damage inherent to more invasive surgeries performed at the temporomandibular joint area. When performed unilaterally, the caudal segmental mandibulectomy is a viable surgical alternative that may show a similar outcome to other surgical techniques.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study

Villamizar-Martinez

Chia

Robertson

et al. 2020

Journal of Feline Medicine and Surgery

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“…Because the TMJ area is a complex region, the risk of complications after TMJ surgery is high; complications include facial scars, facial nerve palsy, gustatory sweating, perforation of the middle cranial fossa, and damage of the maxillary artery. 16 19 Our patient had pain and a facial scar immediately after surgery, but no other complications. The vertical dimension was newly established during the full-mouth rehabilitation period.…”

Section: Discussionmentioning

confidence: 66%

Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

et al. 2015

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Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

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“…The treatment of TMJ ankylosis through creating an adequate gap is of paramount importance in preventing any future recurrence and this can be achieved only when good access is gained to this complex anatomical joint [15,17].…”

Section: Discussionmentioning

confidence: 99%

“…Most reported causes of reankylosis are inadequate removal of ankylotic mass [5,17] also, lack of compliance to post-operative exercises [18]. Anterior open bite occurred in patients treated with gap arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

True bony TMJ ankylosis in children: Case report

Al-Rawee¹,

Al-Khayat

Saeed³

2019

International Journal of Surgery Case Reports

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Highlights Ankylosis in children can affect growth, function, esthetic. Un observed or missed facial trauma in children can end with serious complication. Re-ankylosis is convoluted bothersome complication should kept in mind. Mouth opening should be at maximum range by the end of surgery. Patient follow up is mandatory for a period of time.

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Gap arthroplasty of temporomandibular joint ankylosis by transoral access: a case series

Cited by 11 publications

References 21 publications

Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study

Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study

Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

True bony TMJ ankylosis in children: Case report

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