Figure 7 - uploaded by Tengku Aszraf Tengku Shaeran
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Sagittal view of CT scan. Preoperative view showing retrognathic mandible associated with a narrow retro-glossal airway space (A) and postoperative view showing an anterior displacement of the mandible producing a wider retro-glossal airway space (B).
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Context 1
... during sleep was eliminated and the Apnea-Hypopnea Index has improved from a preoperative score of 37.5 to 10.3 and CT scan image at six months post-operative does not show any foci of calcification in the left TMJ site ( Figure 6). Although resection of the ankylosed left TMJ has tremendously improved the mouth opening and at the same time able to produce a slight anterior displacement of the mandible, thus widening the posterior pharyngeal airway at the retro-glossal level, however the improvement in the AHI is still unsatisfactory (Figure 7). At this stage, a mandibular advancement appliance for sleep disordered breathing, which is able to protract the mandible forward, 5 may be recommended. ...
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Citations
... During surgery, bleeding may occur due to trauma to any of the vessels, such as the superficial temporal artery, transverse facial artery, inferior alveolar artery, internal maxillary artery, or pterygoid plexus. [14][15][16] The day after surgery all the five patients underwent physiotherapy to avoid re-ankylosis. There was a significant improvement in mouth opening at 3 months postoperatively. ...
Ankylosis of the temporomandibular joint (TMJ) is one of the most prevalent TMJ disorders in patients who have experienced trauma. Due to the high risk of recurrence, gap arthroplasty without interpositional material has been gradually discontinued as a treatment for TMJ ankylosis. After arthroplasty surgery, various interposition materials have been used to prevent a recurrence. Reporting on the effectiveness of TMJ bony ankylosis treatment using Mersilene mesh interpositional arthroplasty is the purpose of this study.This was a retrospective study carried out on five patients of TMJ ankylosis. All patients were treated through a Mersilene mesh interpositional arthroplasty procedure from January 2016 to April 2022 in Dr. Soetomo General Hospital and Universitas Airlangga General Hospital and evaluated 3 months postoperatively for the functional stability of TMJ. The result is preoperative mouth opening ranged between 0.7 and 13 mm. The patients achieved the interincisal opening between 27 and 40 mm postoperatively and had no complications for 3 months. In conclusion, Mersilene mesh interpositional arthroplasty is a very effective surgical treatment for TMJ bony ankylosis to achieve maximum mouth opening and avoid recurrences. The prevention of ankylosis recurrence necessitates thorough rehabilitation.
