• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.14.1-14.10
• /
• 2019

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제29권3호
• /
• pp.233-240
• /
• 2007

Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권6호
• /
• pp.354-359
• /
• 2023

The temporomandibular joint is a unique structure composed of the joint capsule, articular disc, mandibular condyles, glenoid fossa of the temporal bone, surrounding ligaments, and associated muscles. The condyle is one of the major components of a functional temporomandibular joint. Reconstruction of large mandibular defects involving the condyle is a surgical challenge for oral and maxillofacial surgeons. To restore large mandibular defects, there are different options for free flap method such as fibula, scapula, and iliac crest. Currently, the vascularized fibula free flap is the gold standard for reconstruction of complex mandibular defects involving the condyle. In the present report, neocondyle regeneration after mandible reconstruction including the condyle head with fibula free flap was evaluated. In this report, two patients were evaluated periodically, and remodeling of the distal end of the free fibula was observed in both cases after condylectomy or mandibulectomy. With preservation of the articular disc, trapezoidal shaping of the neocondyle, and elastic guidance of occlusion, neocondyle bone regeneration occured without ankylosis. Preservation of the articular disc and maintenance of proper occlusion are critical factors in regeneration of the neocondyle after mandible reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제34권5호
• /
• pp.349-356
• /
• 2012

Osteochondroma is one of the most common benign tumors that occur in the bone, but in the head and neck region, osteochondroma appears rarely. Malocclusion, temporomandiublar disorders and facial asymmetry can occur in most cases with osteochondroma of the mandibular condyle. Most surgeons prefer massive removal of osteochondroma and reconstruction of condyle, simultaneously, to prevent various complications, such as a lateral open bite on the contralateral side. We report a surgical treatment and reconstruction of osteochondroma on a mandibular condyle through intraoral approach.

• 대한관절경학회:학술대회논문집
• /
• 대한관절경학회 제21차 추계 학술대회
• /
• pp.190-190
• /
• 2009

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.43-50
• /
• 1994

It is a generally known fact that the patient can experience mouth opening limitation, mandibular deviation and malocclusion as a result of injury of tissues around the articular disc and complications even after successful open reduction surgery for fractured mandibular condyle. We have experienced a rare case of reconstruction using metallic condylar prostheses for a patient with complications resulted by unsuccessful management of fractured mandibular condyle. The case strongly suggested to us that careful selection of treatment methods should be taken for patient with fractured mandibular condyle. Accordingly, we are presenting a case in conjunction with reviews of fractured mandibular condyle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제40권2호
• /
• pp.83-86
• /
• 2014

There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

• Archives of Reconstructive Microsurgery
• /
• 제7권2호
• /
• pp.157-164
• /
• 1998

It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권3호
• /
• pp.378-387
• /
• 1996

We performed costochondral grafting in mmandibular reconstruction including condyle replacement in 5 patients which have 4 cases of ameloblastoma, 1 case of resorption of left condyle due to osteomyelitis. We harvested the 6 th costochondral cartilage of unaffected side. No specific complications were appeared with unexpected fracture of costochondral junction and infection of operation site, These patients show 30-45mm at month opening, near normal of affected side, near normal or normal of unaffected side at lateral excursion. Postoperative coureses was uneventful with improved cosmetic and functional results. Our report is indicated that the costochondral graft is satisfactory to reconstruct mandibular defect including condyle replacement, especially in growing patients.

• 대한관절경학회지
• /
• 제2권1호
• /
• pp.80-84
• /
• 1998

The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.