Pedicled tragal chondral flap for irreparable temporomandibular joint disc
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Fecha
2019
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Publicado en
Journal of oral and maxillofacial surgery, 0278-2391, Vol 77, Num 6, 2019, pag 1143–1146
Publicado por
Elsevier
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Abstract
Despite the plentiful number of publications regarding
temporomandibular joint (TMJ) disorders, their etiology is still unclear. Disc perforation is one of the
most frequent findings associated with the late stages
of TMJ disorders. It may be caused by an abnormal relationship of the intra-articular disc to the condyle and
temporal bone that produces dynamic and physiological alterations.1 When the damage is extensive, techniques such as discoplasty,2 discoplasty with
replacement,3 discectomy,4,5 and discectomy with
replacement6,7 have been proposed as treatment
options. It has been widely described in the
literature that the use of alloplastic materials for
discal replacement causes a foreign-body giant cell reaction, lymphadenopathy, and severe osteoarthritis,
among other complications.8 In some cases, minimally
invasive surgery for disc repair or removal using
arthroscopy can be performed, but this is technically
difficult and sometimes not indicated for extensive
procedures.
We propose an open method that minimizes the
surgical approach and uses local tissues for the
reconstruction. This novel technique uses a pedicled
tragal chondral flap for closure of disc perforations—
or total replacement of the disc in irreparable
cases—without causing esthetic or functional consequences for the donor site
Palabras clave
Keywords
Temáticas
Colgajo
Articulaciones
Mandíbula
Articulaciones
Mandíbula