The long-term effect of transport distraction in the management of temporomandibular joint ankylosis

Abstract

BACKGROUND: The purpose of this study was to investigate the long-term effect of condylar reconstruction by transport distraction of the mandibular ramus after the release of temporomandibular joint ankylosis. METHODS: Five patients presenting with unilateral temporomandibular joint ankylosis corrected by gap arthroplasty and transport distraction of the ascending mandibular ramus were recruited for this prospective cohort study. A clinical evaluation of each case was performed longitudinally before and during the operation, during the distraction consolidation period, and 1 to 2 years after removal of the distractor. The assessment criteria included temporomandibular joint mobility and patient satisfaction expressed with reference to a visual analogue scale. RESULTS: The mean preoperative mouth opening of the five patients was 14 mm. Coronoidectomies were performed concurrently to widen the mouth opening in all cases. Maxillomandibular osteotomies were performed in three cases to correct associated dentofacial deformities. The mean mouth opening achieved during the operations was 40.4 mm. At long-term follow-up, the mean mouth opening was 38 mm, and no sign or symptom of temporomandibular joint dysfunction was noted. The mean patient satisfaction score was 8.6 of 10. CONCLUSIONS: Transport distraction of the mandibular ramus is a good treatment modality for temporomandibular joint ankylosis, particularly for adults. It can achieve long-term, symptom-free, stable mouth opening. ©2007American Society of Plastic Surgeons.