Vascularized bone graft reconstruction of the temporomandibular joint using the tunneled, anchored suture technique

Laryngoscope. 2010:120 Suppl 4:S236. doi: 10.1002/lary.21703.

Abstract

Objective: To describe a novel technique that provides a simple, flexible and safe method to approximate and secure the neo-condyle into the glenoid fossa in reconstruction of hemi-mandibulectomy defects.

Study design: Retrospective chart review of a case series was performed.

Methods: Three patients underwent composite resection of the hemi-mandible with condylectomy. A minimally invasive tunneled suture, anchored with a miniplate to the zygomatic root, was used to approximate the neo-condyle into the glenoid fossa. Postoperative outcomes were assessed with clinical and radiographic measures.

Results: The median patient age was 64 years. Median follow-up was 19 months. All patients reported improved facial symmetry, jaw opening and acceptable dental occlusion. Post-operative CT imaging revealed sustained approximation within the TMJ without evidence of jaw drift.

Conclusion: The described approach introduces a simple, safe, flexible and effective technique for neo-condylar suspension and appropriate realignment during mandibular reconstruction.

MeSH terms

  • Bone Plates
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Retrospective Studies
  • Suture Anchors
  • Suture Techniques*
  • Temporomandibular Joint / diagnostic imaging
  • Temporomandibular Joint / injuries
  • Temporomandibular Joint / pathology
  • Temporomandibular Joint / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Zygoma / surgery