Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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LONG-TERM ANALYSIS OF RECONSTRUCTED TEMPOROMANDIBULAR JOINT AND MANDIBLE USING FREE FIBULAR FLAP

비골 피판을 이용한 하악 및 하악과두 재건의 장기간 임상적 평가

  • Ahn, Kang-Min (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Chung, Hun-Jong (Dept. of Pediatrics, Chungju Medical Hospital, Konkuk University) ;
  • Ryom, Hak-Ryol (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Hang-Jin (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Yoon-Tae (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Hwang, Soon-Jung (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Myoung, Hoon (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Soung-Min (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Kangnung National University) ;
  • Jahng, Jeong-Won (Dept. of Pharmacology, BK21 for Medical Science, College of Medicine, Yonsei University) ;
  • Lee, Jong-Ho (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University)
  • 안강민 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 정헌종 (건국대학교 의과대학 소아과학교실) ;
  • 염학렬 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김항진 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김윤태 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 황순정 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 명훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김성민 (강릉대학교 치과대학 구강악안면외과학교실) ;
  • 장정원 (연세대학교 의과대학 약리학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실)
  • Published : 2005.10.30
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Abstract

Purpose of study: The temporomandibular joint (TMJ) occupies a key functional role in mastication and contributes to normal deglutition, speech as well as cosmesis. When a large amount of mandible including the condyle head is resected, it is very difficult to reconstruct it as a functional unit. In this retrospective study, we present the functional, radiographic and cosmetic results of reconstructed temporomandibular joint using free fibular flap. Patients and Methods: Total 12 patients (M:F = 6:6) who underwent condylar reconstruction with the fibular flap were interviewed and examined by radiographs and Bio-PAK$^{(R)}$. Mean follow up periods was $47.7{\pm}20.0$ months and the average age was $38.7{\pm}15.3$ years. Remodeling of condyle and function of TMJ were evaluated and facial contour was judged subjectively. Results: All flaps were viable and no immediate postoperative complication had happened. One patient showed decreased mouth opening, so interpositional gap arthroplasty was performed. The resorption rates of reconstructed fibular were minimal and the condyle heads were changed into domeshaped neocondyle after 2 years. All patients had normal diet and no speech difficulty was reported. Nine patients were satisfied with their facial contour but three patients complained about the depression of cheek. Conclusion: The reconstruction of TMJ with free fibular flap was reliable methods and very effective means of restoring mandibular function. The functional and morphologic results were excellent and showed little complications.

Keywords

References

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