颞下颌椎间盘切除术后用于椎间盘置换的颞肌深层皮瓣的前方梗阻术

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2023-10-06 DOI:10.1016/j.ajoms.2023.10.005

Osamu Sakaguchi , Izumi Yoshioka , Daigo Yoshiga , Manabu Habu , Kazuhiro Tominaga

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引用次数: 0

摘要

目的在颞下颌关节（TMJ）重建术中，颞肌前方梗阻性肌皮瓣具有功能上的优势。然而，椎间盘切除术后用于椎间盘置换的皮瓣厚度较大，可能会引起包括咬合不正在内的多种术后并发症。颞肌可分为较薄的浅层和较厚的深层，两者之间由较薄的脂肪层隔开。因此，我们利用颞肌深层开发了改良的颞肌前路梗阻肌皮瓣，其大小适合颞下颌关节间隙切除术后的颞下颌关节间隙，且不失功能优势。结果所有患者均未出现明显的术后并发症。此外，所有患者术后下颌功能均恢复正常，无咬合不正。

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Anteriorly pedicled deep layer of temporalis muscle flap for disc replacement after temporomandibular discectomy

Objective

An anteriorly pedicled temporalis muscle flap has a functional advantage for temporomandibular (TMJ) joint reconstruction. However, the greater thickness of the flap for disc replacement after discectomy might cause several postoperative complications including malocclusion. The temporalis muscle can be split into the thin superficial and thick deep layers; they are separated by a thin fatty layer. Therefore, we developed the modified anteriorly pedicled temporalis muscle flap using the deep layer of the temporalis muscle, which has a suitable size for the TMJ space after discectomy without losing the functional advantage.

Methods

The procedure was applied to three patients who underwent discectomy for the treatment of synovial osteochondromatosis. They were followed up from preoperatively to more than 1 year postoperatively.

Results

No significant postoperative complication were observed in all patients. Additionally, all patients obtained normal jaw function without malocclusion from immediately after the surgery.