Maxillomandibular Syngnathia: 3D Planning and Review of the Literature

Congenital Unilateral Zygomaticomaxillomandibular Fusion in a 4-year-old Girl

Congenital zygomaticomaxillomandibular (ZMM) fusion is an extremely rare and debilitating condition. Fusion of the jaws results in a severe limitation of the mouth opening accompanied by breathing and feeding difficulties. Mandibular fusions to the maxilla, palate, zygoma, and temporal bone are described in literature. We present the case of 4-year-old girl diagnosed with congenital unilateral ZMM fusion. She was treated surgically at 1 year and at 4 and a half years to release the fusion and to improve mouth opening. Second surgery was indicated due to recurrence. Management of young patients with congenital maxillomandibular fusion is challenging. The scarcity of cases makes formulating practice guidelines very difficult. If surgery is performed, the importance of postoperative physical therapy cannot be overstated. The goal of this article is to emphasize the risk of recurrence in ZMM fusion after surgical treatment and importance of regular follow-up.

Application of Computer-Assisted Preoperative Planning in Treating Congenital Bilateral Zygomatico-Maxillo-Mandibular Fusion: A Case Report and Literature Review

Congenital fusion of the jaws (syngnathia) is a rare facial malformation with an unknown etiology. This disease may vary in severity with adhesion of soft tissue and bony fusion. It can be anterior fusion, unilateral or bilateral fusion, and complete fusion. The main problem of these patients is the difficulty of airway maintenance and feeding, and the most common postoperative complication is the relapse of bony fusion. Here, we report a young male patient with bony syngnathia, involving bilateral fusion of the ascending ramus and body of the mandible with the maxillary complex. We performed bone isolation by computer-assisted preoperative planning and used an insertional temporalis flap to fix the wound surface to prevent refusion of bone.