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

SummaryObjective: To describe the clinical features and results of treatment of true ankylosis and pseudoankylosis of the temporomandibular joint in dogs.Methods: This study was a retrospective case series. Ten client-owned dogs that were presented for inability to open the mouth or a severely decreased range of motion of the temporomandibular joint were included. Information on the surgical procedures performed and the perioperative complications were documented. Three-dimensional printing of the skull was performed in four dogs.Results: Two dogs were diagnosed with temporomandibular joint ankylosis and seven dogs with pseudoankylosis. One dog had evidence of combined temporomandibular joint ankylosis and pseudoankylosis. Of the seven dogs with pseudoankylosis, six had an osseous fusion involving the zygomatic arch and mandible. Surgical treatment was performed in nine dogs and a revision surgery was needed in one dog. Follow-up ranged from five months to eight years (mean: 48.6 months). Eight out of nine dogs that were treated surgically regained the ability to open their mouth, but six dogs never regained a fully normal temporomandibular joint range of motion.Clinical significance: Temporomandibular joint ankylosis and pseudoankylosis are uncommon in the dog. Surgical treatment for temporomandibular joint ankylosis or pseudoankylosis in dogs is a successful option and carries a prognosis dependent on patient-specific abnormalities. Computed tomography complemented with three- dimensional printing is valuable for understanding the extent of abnormalities and for preoperative planning.Supplementary material for this paper is available online at http://dx.doi.org/10.3415/VCOT-15-11-0189.

Download Full-text

Treatment of Temporomandibular Joint Ankylosis with Temporalis Superficial Fascia Flap, a case series

Galen Medical Journal ◽

10.31661/gmj.v2i4.92 ◽

2013 ◽

Vol 2 (4) ◽

pp. 183-186

Author(s):

Mehdi Sezavar ◽

Zahra Malekpour ◽

Maryam Sohrabi ◽

Mojtaba Salehi

Keyword(s):

Surgical Technique ◽

Facial Nerve ◽

Temporomandibular Joint ◽

Case Series ◽

Good Alternative ◽

Superficial Fascia ◽

Temporomandibular Joint Ankylosis ◽

Joint Ankylosis ◽

Fascia Flap

Background: Different interpositional materials have been used to prevent recurrence after gap arthroplasty in temporomandibular joint ankylosis. In this study, the temporalis superficial fascia flap was evaluated as an interpositional material after condylectomy. Materials and Methods: 9 Cases of unilateral or bilateral temporomandibular joint ankylosis were evaluated in this study with a follow-up of 12 months. The Al-khayat approach was used as the surgical technique with the inferiorly based temporalis superficial fascia flap. Results: 9 Patients (6 female and 3 male) had a preoperative maximal inter-incisal opening of 3 to 10 mm. During the last follow-up observation after surgery, patients had a maximum inter-incisal opening of 40 to 45 mm. Paresthesia or anesthesia of the temporal branch of facial nerve was absent in all cases. There were no signs of re-ankylosing in any of the patients. Conclusion: The findings of this study showed that the temporalis superficial fascia flap is a good alternative as an interpositional material in treatment of temporomandibular joint ankylosis.

Download Full-text

Gap Arthroplasty of Bilateral Temporomandibular Joint Ankylosis

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v29i2.425 ◽

2014 ◽

Vol 29 (2) ◽

pp. 28-31

Author(s):

Ferdinand Z. Guintu ◽

Alexander T. Laoag ◽

Joselito F. David

Keyword(s):

Temporomandibular Joint ◽

Mouth Opening ◽

Tmj Ankylosis ◽

Temporomandibular Joint Ankylosis ◽

Gap Arthroplasty ◽

Long Term Follow Up ◽

Preauricular Approach ◽

Temporal Bones ◽

Joint Ankylosis

Objective: To present a case of bilateral temporomandibular joint ankylosis that was managed successfully through gap arthroplasty. Methods: Design: Case report Setting: Tertiary Government Hospital Patient: One Results: A 25-year-old man presented with inability to open his mouth for 18 years after direct trauma to his chin. CT scan showed bilateral bony fusion of condyles to glenoid fossae, hypertrophic sclerosis and fusion of the condylar heads to the temporal bones. He underwent bilateral gap arthroplasty via preauricular approach with creation of a 15 mm space on the mandibular fossa. As of latest follow up, the patient maintained an inter-alveolar distance of 30 mm for 5 months postoperatively, through continuous aggressive mouth opening exercises. Conclusion: Gap arthroplasty may be an efficient procedure for temporomandibular joint ankylosis in achieving satisfactory post-operative inter-alveolar opening and articular function. Early and meticulous rehabilitation is required to prevent relapse. Long-term follow up is recommended to document possible recurrence. Keywords: temporomandibular joint ankylosis, gap arthroplasty, TMJ ankylosis, ankylosis

Download Full-text