2000
DOI: 10.1097/00005537-200006000-00018
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A Retrospective Analysis of Temporomandibular Joint Reconstruction With Free Fibula Microvascular Flap

Abstract: Objectives:The temporomandibular joint is occasionally encountered in extirpative surgery of the head and neck. It presents a difficult management issue. Little has been reported on functional outcomes after resection and reconstruction of the temporomandibular joint. Design: A retrospective analysis consisting of chart reviews and phone interviews was performed on 17 patients who underwent fibular free flap reconstruction of the temporomandibular joint from 1993 to 1998. Results: Mean follow-up in surviving p… Show more

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Cited by 88 publications
(70 citation statements)
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“…Iliac grafts can be used to reconstruct condyle, so iliac grafts can be a viable option in selected cases for condylar reconstruction 37 . reported placement of the distal portion of the flap directly into the glenoid fossa for condylar reconstruction 93 . The fibula is tubular in shape and is densely cortical.…”
Section: Iliac Crestmentioning
confidence: 99%
See 1 more Smart Citation
“…Iliac grafts can be used to reconstruct condyle, so iliac grafts can be a viable option in selected cases for condylar reconstruction 37 . reported placement of the distal portion of the flap directly into the glenoid fossa for condylar reconstruction 93 . The fibula is tubular in shape and is densely cortical.…”
Section: Iliac Crestmentioning
confidence: 99%
“…It currently represents the best treatment option in paediatric patients with large mandibular defects 56 . The fibular osseocutaneous free-flap is nowadays considered the workhorse donor site for mandibular reconstruction, as large segments of bone can be harvested from the fibula with robust axial blood supply, permitting multiple osteotomies 25,26,93,94 . TMJ reconstruction can effectively and successfully be performed by direct transposition of fibula into the fossa.…”
Section: Iliac Crestmentioning
confidence: 99%
“…Options for articular surface replacement are free cartilage grafts from the rib, a condylar replacement prosthesis, pedicled vascularized auricular cartilage flaps, and free vascularized second metatarsal flaps. [1][2][3] The unpredictable survival of free cartilage grafts and the wear and tear of metal against the glenoid fossa make the use of vascularized autogenous tissue in the TMJ more attractive. Experience with the vascularized second metatarsal flap in TMJ repair in cases of joint ankylosis and hemifacial microsomia has shown promising outcomes.…”
Section: Commentmentioning
confidence: 99%
“…Various adjunctive techniques to interface the reconstructed mandible with the glenoid fossa have been described and include the use of alloplasts, costochondral grafts, softtissue interposition grafts, and suture suspension. [1][2][3] However, trismus following mandibular condyle reconstruction is common and can significantly limit the degree of oral intake. We describe the novel use of the vascularized scapular tip flap for the reconstitution of the TMJ in an extended mandibulectomy defect, with excellent functional outcome.…”
mentioning
confidence: 99%
“…No reconstruction (gap arthroplasty) B. Alloplastic reconstruction C. Autologous reconstruction a. Soft tissue graft interposition (fascia, fibula perisoteum) [52] between glenoid fossa and fibula b. Constochondral graft attached to the bone flap [53] If the condyle is excised unnecessarily, it may be fixed to the neomandible and replaced in the glenoid fossa [54]. Alloplastic reconstruction of the temporomandibular joint has a high incidence of serious complications over time.…”
Section: Temporomandibular Jointmentioning
confidence: 99%