Neu entwickeltes Kiefergelenkkopfimplantat zur temporären Kondylus-Rekonstruktion in der ablativen Tumorchirurgie

Retrospective study of absorbable gelatin sponge soaked in triamicinolone acetonide as interpositioning material in temporomandibular joint ankylosis in 350 patients

AIM

To evaluate the feasibility and usefulness of absorbable gelatin sponge soaked in triamcinolone acetonide as an interposition material in the treatment of temporomandibular joint (TMJ) ankylosis.

MATERIALS AND METHODS

This retrospective study was conducted in 350 patients of TMJ ankylosis who visited our outpatient department between 2000 and 2010, and were treated by the same surgeon. Patients were randomly divided into two groups, where in group 1, absorbable gelatin sponge soaked with triamcinolone acetonide was interposed in the surgical gap created after arthroplasty and in group 2, temporalis fascia was interposed. Preoperative assessment included history and physical examination, along with cause of ankylosis, Postoperative observation were undertaken for maximum mouth opening (MMO), facial nerve paralysis and recurrence.

RESULTS

At one year follow-up, in group 1 MMO ranged from 35 to 45 mm with no case of re-ankylosis while in the other group 25-43 mm, with re-ankylosis in 20 patients (13.69%).

CONCLUSION

The findings of this study showed successful management of TMJ ankylosis using absorbable gelatin sponge soaked in triamcinolone acetonide in cases which did not require condylar reconstruction.

Recurrent aneurysmal bone cyst of the mandibular condyle with soft tissue extension

The case of a 17- year-old female patient with a destructive aneurysmal bone cyst of the right mandibular condyle is presented. Surgery revealed an eggshell thin, partly perforated remaining condylar cortex with extension of the lesion into the surrounding soft tissues. Condylar resection with curettage of the adjacent soft tissues and recurrence prophylaxis with intranasal calcitonin for 1 week could not prevent recurrence after 6 months. In a second operation the ascending mandibular ramus was partly resected and immediately reconstructed with a newly developed alloplastic condylar head add-on system. This time the lesion was intraoperatively completely surrounded by solid cortical bone.