Functional outcomes of temporomandibular joint reconstruction with vascularized tissue.
Publication/Presentation Date
1-1-2019
Abstract
OBJECTIVE: To determine how current temporomandibular joint (TMJ) reconstruction methods affect functional outcomes.
METHODS: Retrospective review from January 2006 to July 2017 at a single tertiary care center. All patients who underwent mandibulectomy with subsequent reconstruction with vascularized free tissue were included in the study. Condylar segments were reconstructed with vascularized free tissue flap in conjunction with autologous tissue or allograft in the joint space. Preoperative, 3 month, 1 year, and 2 year postoperative records were assessed for trismus, need for tube feeds, and Functional Oral Intake Scale (FOIS).
RESULTS: Joint space was reconstructed with autologous tissue (n = 10), allograft (n = 15) or both (n = 9). At three months, FOIS scores significantly decreased from 5.4 preoperatively to 4.8 post operatively (P = .024) and need for tube feeds significantly increased from 15.8% preoperatively to 35.1% (P ≤0.027). Trismus significantly decreased from 63.2% to 27% (P = .006). At one-year, there were no significant changes in functional status compared to pre-operative state. Patients who had previous RT had significantly worse FOIS scores preoperatively (p = .002), at three months (p < .001), one year (p < .001), and two years (p = .008). There was no significant difference in postoperative functional status of patients based on the method of TMJ reconstruction.
CONCLUSION: Reconstruction of the TMJ with vascularized free tissue is a viable option and yields acceptable long-term outcomes. While functional status may improve or worsen in the immediate postoperative period, long term results mirror preoperative function. Preoperative trismus will likely improve.
LEVEL OF EVIDENCE: Level 3; Retrospective Comparative Study.
Volume
40
Issue
5
First Page
691
Last Page
695
ISSN
1532-818X
Published In/Presented At
Hjelm, N., Ortlip, T. E., Topf, M., Luginbuhl, A., Curry, J., Krein, H., & Heffelfinger, R. (2019). Functional outcomes of temporomandibular joint reconstruction with vascularized tissue. American journal of otolaryngology, 40(5), 691–695. https://doi.org/10.1016/j.amjoto.2019.06.004
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
31227259
Department(s)
Administration and Leadership
Document Type
Article