temporomandibular arthroplasty

The temporomandibular joint ankylosis is difficult to open or open at all because of unilateral or bilateral joints or fibrous or bony adhesions within the joint. It can be divided into: Intra-articular rigidity: Most children who occur before the age of 15 are commonly caused by inflammation, which is caused by the spread of suppurative inflammation of adjacent organs. Among them, suppurative otitis media is the most common. Extra-articular rigidity: The common cause is damage, such as the open jaw fracture of the jaw nodule, the mandibular ascending branch or the firearm injury, which forms a scar of contracture between the upper jaw and the lower jaw. One of the common causes of extensive scarring of the cheek tissue after various physical and chemical third-degree burns on the face. Surgery for intra-articular ankylosis includes condylar resection and temporomandibular joint surgery. Treatment of diseases: temporomandibular joint, temporomandibular joint dislocation Indication The temporomandibular joint is stiff. Preoperative preparation X-ray of the temporomandibular joint. Surgical procedure 1, high surgery (early path) (1) Incision and exposure: same as the condylar resection. (2) osteotomy: should be below the plane of the joint concave, cut off the sigmoid notch level and remove the partially adhered lesion bone. During the operation, care should be taken to avoid injury to the deep blood vessels. After the bone removal, the two broken ends should maintain a gap of about 1 cm. (3) Treatment of the fracture end of the bone: In order to prevent recombination of the bone cross section, the medial periosteum should be cut or excised, and the rongeur should be used to bite the mandibular section. The bone between the trailing edge and the upper and lower sections makes an arc-shaped section to facilitate the movement of the mandible. Someone between the bone sections is recommended to fill the fascia, dermis, and silicone joint cap to prevent adhesion of the bone surface. (4) Stitching: The drainage strip can be placed or not. 2, low surgery (submandibular path) (1) Incision: Starting from 1 cm below the earlobe, bypassing the posterior margin of the mandibular branch and the mandibular angle, along the lower 2 cm below the lower edge of the mandible, the arcuate incision about 8-10 cm long in front of the masseter muscle. (2) Exposure of the mandibular branch: After cutting the skin, subcutaneous tissue, superficial fascia, and platysma, the external and external veins of the jaw are separated, ligated and cut. The masseter muscle adhesion and periosteum were cut along the mandibular angle and the lower edge of the mandible, and separated upward along the bone surface to reveal the lateral surface of the mandibular branch, reaching the condylar neck and the sigmoid notch plane. Pull up with a hook to reveal the lesion. (3) Osteotomy: generally under the lesion, the mandibular branch is cut above the plane of the mandibular hole. The osteotomy can be drilled first with an electric drill, then with a bone chisel, or with a wire saw. During the operation, be careful not to damage the inferior alveolar vessels and nerves on the inside of the mandibular branch. (4) Treatment of the broken end of the bone: the broken end should maintain a gap of about 1 cm. The anterior and posterior edges of the mandibular section and the inner and outer edges were trimmed with a rongeur to make a rounded shape, and if necessary, a tampon was implanted. (5) Stitching: Washing the wound, layering and suturing, generally should be placed on the drainage strip.