Clinical Treatment Of Adult Patients With Temporomandibular Joint Ankylosis And Mandibular Dysplasia

ObjectiveBy comparing and analyzing some indicators,which were collected before and after the surgeries,the aim is to explore the clinical effect of innovative use of interpositional arthroplasty by temporalis fascia flap and galea aponeurotica combined with distraction osteogenesis in treatment of adult patients with temporomandibular joint ankylosis,and to provide the reference for the clinical treatment for temoromandibular joint ankylosis.MethodsClinical dates of unilateral temporomandibular joint ankylosis with mandibular dysplasia were collected in Peking union medical college affiliated plastic surgery hospital from 2010 to 2014.The temporalis fascia flap and part of adjacent galea aponeurotica were filled the space after surgical release.Mouth-opening exercises started immediately post-IPA.Distraction osteogenesis was performed 6 months after IPA and had a 4-month consolidation.The maximum interincisal distance at preoperative,immediately post-IPA and latest follow-up were recored,as was distraction length.The body mass index was measured at each patient’s postoperative visit.ResultsAll patients had obvious improvements in facial shapees,degree of open mouth,and occlusion.No major complication or recurrence was observed at 3 to 4 years’follow-up.The mean maximum interincisal distance was 4.83±2.79mm preoperative and 35.67±3.39mm at the latest follow-up.The mean distraction was 16.17±5.98mm.The body mass index improved from 17.33±0.64kg/m2 preoperative to 18.75±0.60kg/m2 before DO.ConclusionsTemporalis fascia flap and adjacent galea aponeuratica as new graft materials are recommended for IPA.The modified staged treatment proved to be reliable and effective to prevent recurence,improve length of mandibualr and final occlusion,which is worth promoted.