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Application of temporalis myofascial flap combined with coronoid process graft in the treatment of temporomandibular joint ankylosis

XUE Guo-chu,XU Ping-ping,AI Wei-jian,ZHOU Hui-xi,LIU Shu-guang,ZHAO Jian-jiang,ZHENG Jun-fa,ZENG Shu-guang.(Department of Oral and Maxillofacial Surgery,Guangdong Provincial Stomatological Hospital.Guangzhou 510280,Guangdong Province,China)  
PURPOSE:To determine the efficacy of interpositional temporalis myofascial flap and coronoid process graft in the treatment of temporomandibular joint ankylosis.METHODS:A retrospective clinical study of 6 cases of TMJ ankylosis surgically treated was performed.Our operative protocol for TMJ ankylosis entailed resection of ankylotic mass,arthroplasty,interpositional tissue transfer to the TMJ with temporalis superficial fascial flap and autogenous coronoid process graft for lengthening the ramus,and early postoperative initial exercise.Clinical examination,radiographs,and photographs were used postsurgically to evaluate the grafts,condylar function,and facial appearance.RESULTS:Very satisfactory postsurgical results were obtained in terms of function of the TMJ and aesthetics during the follow-up period of 4 to 28 months.The postoperative mean maximal incisal opening was 35 mm,ranged from 31 to 38 mm.CONCLUSION:The temporalis superficial facial flap combined with coronoid process are autogenous grafts that have the advantages of close proximity to the TMJ,minimal surgical morbidity,and successful clinical results.It was found to be a valuable option for TMJ ankylosis reconstruction.
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