The Clinical Applications Of Multiple Tissue Flap Combined With Costochondral Graft By Temporomandibular Joint Reconstruction

Objective:To discuss the feasibility and usefulness of multiple tissue flap_——buccal fat pad and temporalis fascia flap,as an inter-positional graft combined with costochondral graft TMJ reconstruction in the treatment of temporomandibular joint?TMJ?ankylosis.Methods:A Prospective study of 20 patients in 27 sides with TMJankyloses was performed with pre-op panaroma,CT scanning and 3D reconstruction,convert in to MIMICS to evaluate the ankylosis and measure resection,8 patients 10 sides of experimental group transfer temporalis fascia flap as a first inter-positional graft,use BFP?Buccal fat pad?as secondary inter-positional graft to TMJ ankylosis region combined with costochondral graft to reconstruct the TMJ and comparing with 12 patients 17 sides control group are retrospective which transfer temporalis fascia flap as only one inter-positional graft with gap arthroplasty or CCG,follow-up of 3 months to 1 years.Results:In the present study,in experimental group patients had a maximum interincisal opening of 34 to 41 mm?mean,37.5mm?and30 to 35 mm?mean,32.5mm?at control group the latest follow-up,compared two groups significantly improved occlusion.No major occlusal changes were observed and all the patients had satisfactory occlusion at the follow-up periods.No facial paralysis of temporal and zygomatic branch of facial nerve was observed in any case.Panoramic radiographs showed well-maintained intra-articular space because of the interposed tissue,with no signs of relapse.Conclusion:The findings of this study showed the short-term successful management of TMJ reconstruction using buccal fat pad and temporalis fascia flap as a first and secondary inter-positional graft is feasible and effective surgical method for the treatment of TMJ ankylosis.