Condylar disarticulation; Analysis of 20 cases from a Nigerian Tertiary Centre

Abstract

Background:A disarticulation resection is a variant of mandibular segmental resection in which the condylar articulation is sacrificed. Indication varies from primary condylar lesions to jaw conditions involving the condyle.Aim:This retrospective analysis was carried out to highlight the pattern of disarticulation resections carried out in our centre over a five-year period.Materials and Methods:Cases of mandibular resection were identified from the operation book. The medical records of patients who had disarticulation resection were then retrieved and analyzed for demography, indications for disarticulations, methods of reconstruction and complications.Results:A total of 20 cases of disarticulation with complete records were obtained, this constituted 24.7% of total mandibular resections in the department. There were 9 males and 11 females with a male: female ratio of 1:1.2. The age ranged between 13 and 59 years with a mean of 30.4 years (std. 12.0). Sixteen patients received autogenous bone graft; two were stabilized using Steinman's pins and two with reconstruction plates. One bone graft and one reconstruction plate were removed because of infection and exteriorization respectively. Condyle was not replaced in any case. Outcomes were satisfactory but jaw deviation on opening was a common complaint in all cases.Conclusion:Condylar disarticulation accounts for a considerably high percentage of mandibular resection in our centre. Non vascularized immediate bone grafting without actual joint reconstruction was common. No disarticulation was carried out for traumatic reasons.