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One-stage microvascular mandible reconstruction and alloplastic TMJ prosthesis.
Landes, Constantin; Korzinskas, Tadas; Dehner, Jan-Friedrich; Santo, Gregor; Ghanaati, Shahram; Sader, Robert.
Afiliación
  • Landes C; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany. Electronic address: constantinlandes@googlemail.com.
  • Korzinskas T; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany.
  • Dehner JF; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany.
  • Santo G; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany.
  • Ghanaati S; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany.
  • Sader R; Cranio-Maxillofacial and Plastic Facial Surgery, (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Center, Frankfurt, Germany.
J Craniomaxillofac Surg ; 42(1): 28-34, 2014 Jan.
Article en En | MEDLINE | ID: mdl-23466124
Severely deformed or absent temporomandibular joints (TMJ) benefit from total alloplastic joint replacement and large mandibular defects from revascularized free tissue transfer for reconstruction. However no cases of their combined one-stage placement with outcomes can be found in the literature. We present two cases with different indications and reconstruction. The first patient required mandibular body and ascending ramus reconstruction after previous sarcoma resection. This was with a condyle-bearing reconstruction plate which resulted in significant dysfunction, leaving the patient unable to open her mouth. A one-stage vascularized iliac crest free flap and alloplastic TMJ prosthesis was used to reconstruct the mandible. Subsequently, metal removal, soft tissue augmentation by lipotransfer and dental implant placement were performed. At 63 months follow-up patient was pain-free, with mouth opening, protrusion and lateral excursion back to normal. The second patient required mandibular body, ascending ramus and joint reconstruction, performed by transoral vascularized fibula free flap with temporal vessel anastomosis. The traumatic deep bite and posterior facial height were corrected, additional submandibular scars avoided by transoral placement of the fibula transplant and a miniaturized TMJ prosthesis along with the vascularised free flap with 28 months follow-up. A miniaturized TMJ prosthesis may become placed transorally for reconstruction of the TMJ, together with a vascularized free flap for mandibular reconstruction and promises good long-term stability with normal function above all for protrusion and lateral excursion.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Articulación Temporomandibular / Artroplastia de Reemplazo / Reconstrucción Mandibular Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Female / Humans Idioma: En Revista: J Craniomaxillofac Surg Asunto de la revista: ODONTOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Articulación Temporomandibular / Artroplastia de Reemplazo / Reconstrucción Mandibular Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Female / Humans Idioma: En Revista: J Craniomaxillofac Surg Asunto de la revista: ODONTOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Reino Unido