Open AccessOcclusion and Functional Outcomes after Complete Temporomandibular Joint Resection with Soft Tissue Reconstruction
Author(s) -
Lee Jake J.,
Lander Daniel P.,
Jackson Ryan S.,
Zenga Joseph,
Pipkorn Patrik
Publication year - 2020
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599819901144
Subject(s) - medicine , temporomandibular joint , occlusion , soft tissue , condyle , fossa , surgery , resection , dental occlusion , dentistry
Reconstructive outcomes after complete temporomandibular joint (TMJ) resection, including the condyle and glenoid fossa bone, are poorly defined in the literature. We described our technique and reviewed occlusion and functional outcomes of 6 consecutive patients undergoing complete TMJ resection and reconstruction with anterolateral thigh free tissue transfer and intermaxillary fixation with elastic bands for 6 to 8 weeks. At median follow‐up of 14 months, median Mandibular Function Impairment Questionnaire score was 32 (range, 4‐38), indicating mild to moderate impairment. Subjective occlusion was normal in 4 of 6 patients. Premature occlusal contact was seen in 2 of 6 patients. Maximal interincisor distance and horizontal mandibular shift with jaw abduction ranged from 29 to 40 mm and 5 to 8 mm, respectively. Four of 6 tolerated regular diets while 2 adhered to mechanical soft diets; no patients were feeding tube dependent. Soft tissue–only reconstruction after complete TMJ resection resulted in good subjective and objective occlusion in 4 of 6 patients and no cases of severe functional impairment.