Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2009-8-18
pubmed:abstractText
Temporomandibular joint (TMJ) ankylosis in children is a challenging problem. Surgical correction is technically difficult and the incidence of recurrence after treatment is high. The purpose of the present report is to describe the protocol currently used at the Massachusetts General Hospital for the management of TMJ ankylosis in children. It has been our observation that the most common cause of treatment failure is inadequate resection of the ankylotic mass and failure to achieve adequate passive maximal opening in the operating room. The 7-step protocol consists of 1) aggressive excision of the fibrous and/or bony ankylotic mass, 2) coronoidectomy on the affected side, 3) coronoidectomy on the contralateral side, if steps 1 and 2 do not result in a maximal incisal opening greater than 35 mm or to the point of dislocation of the unaffected TMJ, 4) lining of the TMJ with a temporalis myofascial flap or the native disc, if it can be salvaged, 5) reconstruction of the ramus condyle unit with either distraction osteogenesis or costochondral graft and rigid fixation, and 6) early mobilization of the jaw. If distraction osteogenesis is used to reconstruct the ramus condyle unit, mobilization begins the day of the operation. In patients who undergo costochondral graft reconstruction, mobilization begins after 10 days of maxillomandibular fixation. Finally (step 7), all patients receive aggressive physiotherapy. A case series of children with ankylosis treated using this protocol is presented.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
1531-5053
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
67
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1966-78
pubmed:meshHeading
pubmed-meshheading:19686936-Adolescent, pubmed-meshheading:19686936-Ankylosis, pubmed-meshheading:19686936-Arthroplasty, pubmed-meshheading:19686936-Bone Transplantation, pubmed-meshheading:19686936-Child, pubmed-meshheading:19686936-Clinical Protocols, pubmed-meshheading:19686936-Female, pubmed-meshheading:19686936-Humans, pubmed-meshheading:19686936-Mandible, pubmed-meshheading:19686936-Oral Surgical Procedures, pubmed-meshheading:19686936-Osteogenesis, Distraction, pubmed-meshheading:19686936-Physical Therapy Modalities, pubmed-meshheading:19686936-Range of Motion, Articular, pubmed-meshheading:19686936-Surgical Flaps, pubmed-meshheading:19686936-Temporal Bone, pubmed-meshheading:19686936-Temporal Muscle, pubmed-meshheading:19686936-Temporomandibular Joint, pubmed-meshheading:19686936-Temporomandibular Joint Disorders
pubmed:year
2009
pubmed:articleTitle
A protocol for management of temporomandibular joint ankylosis in children.
pubmed:affiliation
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA. lkaban@partners.org
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't