PubMed · 14395213
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J A Lievre. 1955-07-02. [Ankylosing spondylitis].. https://pubmed.ncbi.nlm.nih.gov/14395213/
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INTRODUCTION: Temporo-mandibular joint ankylosis is a common cause of acquired deformity in children. PURPOSE: Surgical correction of the ankylosis only leaves the patient with an uncorrected mandibular deformity. This study was to evaluate the use of distraction osteogenesis for simultaneous correction of the mandibular deformity. MATERIAL: This study was done on six children with temporo-mandibular joint ankylosis and mandibular deformity. Uniaxial double pin distractors with Schanz pins were used in this study. METHODS: The patients underwent simultaneous gap arthroplasty and mandibular osteotomy (retromolar) with distractor insertion. Distraction was started on the fifth post-operative day. The patients were put on dynamic temporo-mandibular joint exercises on the first post-operative day. RESULTS: All patients had a satisfactory mouth opening on follow-up. Satisfactory cosmetic correction of the mandibular deformity was also achieved in all these patients. Some degree of malocclusion resulted from treatment due to which the patients were placed on orthodontic treatment. CONCLUSIONS: Distraction osteogenesis can be used simultaneously with gap arthroplasty in patients with temporo-mandibular ankylosis, for the correction of the mandibular deformity.
Temporalis myofascial flap holds great promise for the reconstruction of various defects of the maxillofacial region-either congenital or surgical. The dependable blood supply through the middle and deep temporal arteries, proximity to the maxillofacial region, possibility to mobilize it to the oral cavity through the under surface of zygomatic arch and its fanned out nature permits the surgeon to use this flap for the reconstruction of various maxillofacial defects and even as an interposing tissue. In this series of 30 cases, we have used the temporalis myofascial flap for the reconstruction of different types of maxillofacial defects and as an interposing material in TMJ surgeries. We found that this flap is very valuable in maxillofacial reconstruction.
Ankylosis of the temporomandibular joint (TMJ) can be a result of trauma, degenerative changes and infection or of a space-occupying lesion and, when occurring during early childhood, can result in severe functional disability and facial distortion. Septic arthritis of the TMJ is extremely rare in young infants. We report two children with TMJ ankylosis that is believed to have been a consequence of undiagnosed septic arthritis of the TMJ in the neonatal period.