Introduction: Temporomandibular joint ankylosis is a debilitating condition leading to problems in mastication, speech, digestion, oral hygiene and even facial appearance. The basic techniques for surgical correction of ankylosis include the gap arthroplasty, joint reconstruction or interpositional arthroplasty. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence.
Material and Methods: 21 patients of temporomandibular joint ankylosis admitted from 2015 to 2018 in the Department of Plastic Surgery, SMS Hospital, Jaipur. . Diagnosis was based on history and clinical assessment supplemented with orthopantomogram (OPG) and computer tomographic scans. Mouth opening is measured as interincisoral distance using a scale. Intraoperatively, silicon sheet is sutured with the distal part of flap using non absorbable suture in half overlapped fashion with an overlapped portion across the joint space. Preoperative photograph is taken in all patients and serial post operative photograph were taken during their regular follow up
Results: 21 patients were part of the study (14 males and 7 females). 16 of our patients were post traumatic. Their age ranged from 7 to 55 years. The disease was unilateral in 19 cases and bilateral in 2 cases. The pre-op interincisal mouth opening ranged from 0 to 9 mm. The intra-operative interincisal mouth opening ranged from 28 to 46 mm. There was no immediate complication and no incidence of facial nerve injury. One patient with bilateral congenital TMJ ankylosis had recurrence. Five patients were lost after the initial 1-year follow-up.
Conclusion: Use of combined temporoparietal fascia with thin silicon sheet as interpositional arthroplasty provides extra protection in cases of TMJ ankylosis and thereby decreasing the incidence of its recurrence
Keyword: Ankylosis, TMJ, Interpositional arthroplasty
Management of Temporomandibular Joint Ankylosis Using Temporoparietal Fascia Flap
