The auricular cartilage graft used as interpositional material for disc replacement after failed TMJ operative arthroscopy

Abstract

ObjectivesThe aim of this study was to evaluate the preoperative and 2-years postoperative clinical and radiological findings in a group of patients after temporomandibular joint discectomy and interpositional autogenous auricular cartilage graft. Materials and MethodsThe technique involved a disc removal, condylar remodeling and fixation of the graft to the fossa-eminence region. Preoperative and 2-years postoperative clinical findings and magnetic resonance features were evaluated in a group of 13 patients (fourteen joints). ResultsIn this series, a significant decrease of pain level (p<0.0001) was observed from the first month postoperatively whereas maximal interincisal opening improved significantly (p<0.05) after three months follow-up. Radiographically, the magnetic resonance imaging two years after surgery showed an increase on the condylar features of sclerosis and flattening. ConclusionDiscectomy and auricular cartilage interposition graft is an acceptable method for cases of temporomandibular joint dysfunction refractory to the arthroscopic treatment but progressive degenerative changes can be observed after this technique. Although this technique is a surgical option for patients with non-reducing displaced TMJ articular discs, the high failure rate indicates that there may be better alternative surgical procedures to consider.