Internal Maxillary Artery Preoperative Embolization Using n-Butyl Cyanoacrylate and Pushable Coils for Temporomandibular Joint Ankylosis Surgery

Alderazi, Yazan J.; Shastri, Darshan; Wessel, John E.; Mathew, Melwin; Kass‐Hout, Tareq; Aziz, Shahid R.; Prestigiacomo, Charles J.; Gandhi, Chirag D.

doi:10.1016/j.wneu.2017.01.086

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…Hossameldin et al 6 reports 14 patients who underwent preoperative embolization of the IMAX artery with coils for TMJ ankylosis with no periprocedural complications as well. Alderazi et al 1 report two cases that underwent bilateral IMAX embolization using Vortex coils (Boston Scientific) distally followed by n-BCA (50% concentration) from the coil mass up to the proximal IMAX distal to the origin of the superficial temporal artery. In all of our cases, coils were used to achieve complete embolization of the target vessel.…”

Section: Discussionmentioning

confidence: 99%

“…In all of our cases, coils were used to achieve complete embolization of the target vessel. According to Alderazi et al, 1 pushable coils were used to define the distal end of the IMAX and to protect from inadvertent embolization of ethmoidal arteries and collaterals that could potentially occur with the use of n-BCA. We believe that avoiding liquid embolics allows for a safe embolization without the risk of inadvertent embolization into small branches of the proximal IMAX such as the MMA that has numerous anastomosis with branches of the internal carotid artery, often not visualized in a conventional diagnostic angiogram.…”

Section: Discussionmentioning

confidence: 99%

“…The mean volume loss reported in our case series from TMJ surgery was 246 cc per TMJ replacement surgery, which is similar to other reports. 1,4 Susarla et al 4 reports one case of bilateral TMJ disorder who had an estimated blood loss of 3750 cc after preoperative embolization of only one IMAX artery since the other IMAX artery was previously ligated and unable to be embolized due to retrograde flow. Hossameldin et al 6 reports a mean blood loss of 136 cc during surgery of 14 patients with preoperative embolization of the IMAX artery for TMJ ankylosis.…”

Section: Discussionmentioning

confidence: 99%

“…Temporomandibular joint (TMJ) replacement surgery is indicated for a variety of conditions that causes impairment in mastication, digestion, se. 1 This type of surgery can be associated with substantial blood loss with volumes as high as 3 L due to poor visualization and limited proximal access after iatrogenic arterial injury that might occur during surgery. [2][3][4][5] Preoperative endovascular embolization of the internal maxillary (IMAX) artery has been used as a means to reduce morbidity and mortality from large blood volume loss (BVL) that might occur during TMJ surgery.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular preoperative embolization for temporomandibular joint replacement surgery

et al. 2019

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Background and purpose This retrospective study evaluates the safety and effectiveness of preoperative endovascular embolization in patients who underwent temporomandibular joint (TMJ) replacement surgery. Material and methods We included all patients treated with preoperative embolization of the internal maxillary artery (IMAX) between June 2016 and January 2019. All patients were treated by the same surgeon using standard surgical approaches and procedures. Periprocedural adverse events, blood loss during surgery and clinical follow-up are reported. Results Fourteen patients (12 females, median age 32.5) were treated with 21 embolizations of the IMAX (bilateral embolizations in seven patients) prior to TMJ replacement surgery with prosthetic joints (TMJ Concepts prostheses). Seven patients presented with TMJ ankylosis/degenerative joint disease/post-trauma deformity, four patients with Idiopathic Condylar Resorption and resultant mandibular displacement/hypoplasia, two patients with rheumatoid arthritis-associated condylar degeneration and resultant loss of mandibular position, and 1 patient being re-reconstructed following management of a prosthetic joint infection. Seven patients underwent bilateral prosthetic joint replacement. Four patients underwent additional facial skeletal surgery as part of their treatment. The mean blood volume loss during TMJ surgery was approximately 370 cc (range 100–800 cc). Joint space-specific blood loss was not recorded, but, as per the surgical team, was significantly decreased when compared to non-embolized patients. There were no intra-procedural complications. The median clinical follow-up was 3.5 months (range 1–24 months). The modified Rankin scale (mRS) was 0 before the procedure and at last clinical follow-up in all patients. After TMJ surgery, three patients reported paresthesia of the trigeminal nerve likely related to the residual condyle resection and two patients had mild facial nerve weakness (Temporal and/or Marginal Mandibular branch) related to the surgical exposures. Conclusion Endovascular preoperative embolization of the IMAX is feasible, safe and likely effective in reducing blood volume loss in complex TMJ replacement surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endovascular preoperative embolization for temporomandibular joint replacement surgery

et al. 2019

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“…The present techniquewas planned also to avoid injury to the important vital structures located medial to the ankylosing bony mass. Creation of the conventional gap may endanger the common carotid artery at its entrance in the petrous part of temporal bone and the internal maxillary artery may also be jeopardized (17)(18)(19)(20) .…”

Section: Discussion:-mentioning

confidence: 99%

Semi-Sagittal Splitosteotomy of Ankylosingbony Mass for Release of Long Standingand Recurrent Temporomandibular Joint Bony Ankylosis.

Dehis¹,

Kamal²

2018

IJAR

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Temporomandibular joint bony ankylosis, Gap arthroplasty,major blood vessels related to ankylosis.Background:-Gap arthroplasty is a one of the techniques used to release TMJ bony ankylosis with reported many advantages and disadvantages. The aim of this study was to present and evaluate newsemi-sagittal split osteotomy of ankylosing bony massto release temporomandibular joint bonyankylosis. It was intended to minimize the disadvantage of gap arthroplasty. Patient and methods:-Twelve patients suffering from TMJ bony ankylosis were included in the present study. New semi-sagittal split osteotomy of ankylosing bony mass was implemented. This cut was extended from the most superior point of ankylosing bone mass laterally and directed downward and medially towards the most inferior point of the most constricted part just above the mandibular foramen.Pterygomasseteric sling release was performed.Six quantitative and qualitative calipers were used to assess the technique. Results:-Postoperative interincisal opening was increased significantly and the lower jaw displaced downward without shortening of the mandibular ramus.Only one case out of twelve (8.3%) represented postoperative anterior open bite. Conclusion:-Semi-sagittal split osteotomy of ankylosing bony mass was recommended to preserve the major vital structures at the base of the skull in long standing and recurrent temporomandibular joint bony ankylosis especially with bulbous bony mass.

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New Technologies and Reconstruction of the Temporomandibular Joint (TMJ)

Sánchez-Jaúregui

Vega

2021

Innovations and New Developments in Craniomaxillofacial Reconstruction

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Internal Maxillary Artery Preoperative Embolization Using n-Butyl Cyanoacrylate and Pushable Coils for Temporomandibular Joint Ankylosis Surgery

Cited by 9 publications

References 15 publications

Endovascular preoperative embolization for temporomandibular joint replacement surgery

Endovascular preoperative embolization for temporomandibular joint replacement surgery

Semi-Sagittal Splitosteotomy of Ankylosingbony Mass for Release of Long Standingand Recurrent Temporomandibular Joint Bony Ankylosis.

New Technologies and Reconstruction of the Temporomandibular Joint (TMJ)

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