ABSTRACT
Context: Surgery for the release of temporomandibular joint (TMJ) ankylosis is a commonly
performed procedure. Various interposition materials have been tried with varying
success rates. However, none of these procedures attempt to recreate the architecture
of the joint as the glenoid surface is usually left raw. Aims: We aimed to use a vascularised cartilage flap and to line the raw surface of the
bone to recreate the articular surface of the joint. Settings and Design: There is a rich blood supply in the region of the helical root, based on branches
from the Superficial Temporal Artery (STA), which enables the harvest of vascularised
cartilage from the helical root for use in the temporomandibular joint. Materials and Methods: Two cases, one adult and the other a child, of unilateral ankylosis were operated
upon using this additional technique. The adult patient had a bony segment excised
along with a vascularised cartilage flap for lining the glenoid. The child was managed
with an interposition graft of costochondral cartilage following the release of the
ankylosis, in addition to the vascularised cartilage flap for lining the glenoid.
Results: The postoperative mouth opening was good in both the cases with significant
reduction in pain. However, the long-term results of this procedure are yet to be
ascertained. Conclusions: The vascularised cartilage flap as an additional interposition
material in temporomandibular joint surgery enables early and painless mouth-opening
with good short-term results. The potential applicability of this flap in various
pathologies of the temporomandibular joint is enormous.
KEY WORDS
Temporomandibular joint ankylosis - vascularised cartilage flap
