Management of Adult Unilateral TMJ Ankylosis with Temporalis Muscle and Fascia Flap: Review of 51 Cases

Abstract

ABSTRACTPurposeThis study is aimed to determine the efficacy of temporalis muscle and fascia flap in the treatment of unilateral temporomandibular joint (TMJ) ankylosis in adults. Treatment of TMJ ankylosis has been a topic of debate and the treatment options are multidimensional. Achieving good postoperative mouth opening and functional and cosmetic outcomes of surgery, depends on the method of reconstruction. The need of study is to give the best possible solutions with minimal morbidity to the underlying deformity.Materials and methodsA retrospective study was done on 51 patients to evaluate the postoperative results for unilateral TMJ ankylosis. Parameters such as etiology, postoperative mouth opening on 1st, 2nd, 6th week and 6 months and intraoperative and postoperative complications were recorded. The operative protocol for unilateral TMJ ankylosis entailed: (1) Resection of the ankylotic mass, (2) intraoral ipsilateral coronoidectomy, (3) contralateral coronoidectomy when necessary, (4) interpositional tissue transfer to the TMJ with temporalis muscle and fascia flap, (5) maxillomandibular fixation (MMF) and (6) early mobilization and aggressive physiotherapy.ResultsThe results were encouraging and functional results of interpositional arthroplasty were satisfying with minimal complications. Early postoperative initial aggressive exercise, physiotherapy, and strict follow-up play an important role in preventing postoperative adhesions.ConclusionThe findings of this study support the use of temporalis muscle and fascia flap in adult patients with unilateral TMJ ankylosis.How to cite this articleMishra S, Tripathy R, Sabhlok S, Roy R. Management of Adult Unilateral TMJ Ankylosis with Temporalis Muscle and Fascia Flap: Review of 51 Cases. Int J Head and Neck Surg 2012;3(3):133-136.