Abstract
The aim of this study was to radiologically evaluate dermis-fat graft and temporalis muscle flap as replacements after TMJ discectomy. Patients and methods: fourteen female patients were categorized into two equal groups (seven patients on each group,) group (A) and group (B). Group A underwent TMJ discectomy followed by interpositional muscle flap. Group B underwent TMJ discectomy followed by interpositional dermis-fat graft. Pre-operative MRI (T1, T2 and proton density) were obtained in addition to 3 months and 12 months post-operative MRI for comparison and follow up of the graft. Results: Temporalis muscle flaps were diagnosed in all group (A) patients (12 joints). The dermis-fat graft was detected within the operated joints or surrounding the condyle in three patients of group B while mostly resorbed in the other four patients after one year follow up. Conclusion: Discectomy and dermis-fat graft appears to be a successful surgical option regarding to the clinical parameters. However, summed degenerative changes depending on surgical operation should be retained. Temporalis muscle flap still the gold standard after TMJ menesictomy.
Highlights
The aim of this study was to radiologically evaluate dermis-fat graft and temporalis muscle flap as replacements after temporomandibular joint (TMJ) discectomy
Dermis-fat graft has previously been reported for use as an interpositional material following gap arthroplasty in the management of TMJ ankylosis in many studies [6, 7]
It has long been used to fill the space after gap arthroplasty since it was described in 1872, Verneuil described its use following gap arthroplasty of the temporomandibular joint (TMJ) for ankylosis.(adopted from Edwards & Feinberg, 2003)(8)
Summary
The aim of this study was to radiologically evaluate dermis-fat graft and temporalis muscle flap as replacements after TMJ discectomy. Group A underwent TMJ discectomy followed by interpositional muscle flap. Group B underwent TMJ discectomy followed by interpositional dermis-fat graft. The dermis-fat graft was detected within the operated joints or surrounding the condyle in three patients of group B while mostly resorbed in the other four patients after one year follow up. Dermis-fat graft has previously been reported for use as an interpositional material following gap arthroplasty in the management of TMJ ankylosis in many studies [6, 7]. While the clinical outcomes appear favorable for the use of this material in the TMJ, the studies concerning fate of the dermis-fat graft within a functional joint space after discectomy are sparse. Its first use as replacements after discectomy was innovated by Feinberg and Larsen in 1989 [9]
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