A case of gap arthroplasty with a temporalis muscle flap as interpositional grafting

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Generally, temporomandibular joint surgery has been performed with temporomandibular joint ankylosis to restore condylar movement, however, the possibility of post-operative recurrence has been highly indicated. Therefore, to reduce recurrence, a tissue grafted from a living body such as a skin flap, temporalis muscle flap, or auricular cartilage is used as an interpositional inset after the resection of an articular disc. In this case report, a five-year follow-up study was conducted with regard to temporomandibular joint ankylosis treated by gap arthroplasty and interpositional grafting with temporalis muscle flap. A 54-year-old female patient who complained of severe restricted mouth opening was diagnosed as having left temporomandibular joint ankylosis based on clinical and radiographic findings. The mouth-opening exercise showed no effect, so gap arthroplasty and interpositional grafting with temporalis muscle flap was performed. The maximum mouth opening distance improved to 30 mm after the surgery. Neither particular change of facial appearance nor facial nerve paralysis was detected after the surgery. CT images taken 1.5 years after the surgery showed no findings of recurrence. The postoperative course was uneventful, with a maximum mouth opening of 30 mm maintained and no esthetic or functional disturbance found for 5 years.
一般社団法人日本顎関節学会の論文