Congenital cheek teratoma with temporo-mandibular joint ankylosis managed with ultra-thin silicone sheet interpositional arthroplasty

Abstract

Primary cheek teratomas are rare with < 5 reported cases. None had associated temporo mandibular joint ankylosis (TMJA). The fundamental aim in the treatment of TMJA is the successful surgical resection of ankylotic bone, prevention of recurrence, and aesthetic improvement by ensuring functional occlusion. Early treatment is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of child. Inter-positional arthroplasty with ultra-thin silicone sheet was performed. Advantages include short operative time, less foreign material in the joint space leading to negligible foreign body reactions and least chances of implant extrusion. Instead of excising a large bony segment, a thin silicone sheet was interposed and then sutured ensuring preservation of mandibular height. Aggressive post-operative physiotherapy with custom made dynamic jaw exerciser was used to prevent recurrence.

Tarsal Coalitions: Preliminary Results After Operative Excision and Silicone Sheet Interposition in Children

“…However, we thought that the use of silicone sheeting could be an effective form of interposition. Silicone sheeting has been used for surgical repair of fractured orbital floors (46,47), surgical repair of urethral strictures (48), and temporomandibular joint reconstruction in a child (49). A Perthese Ò silicone sheet is composed of alloplastic materials and is made from silicone elastomer that consists of dimethyl and methyl vinyl siloxane copolymers.…”