China Journal of Oral and Maxillofacial Surgery ›› 2020, Vol. 18 ›› Issue (5): 412-416.doi: 10.19438/j.cjoms.2020.05.006

• Original Articles • Previous Articles     Next Articles

Application of pedicled deep temporal fascial fat flap in temporomandibular joint reconstruction: clinical analysis of 135 consecutive cases

CHEN Guang-can, CHEN Min-jie, YANG Chi, WEI Wen-bin, WANG Yi-wen, LIU Zhi-yang   

  1. Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai200011, China
  • Received:2019-11-29 Revised:2020-03-19 Online:2020-09-20 Published:2020-10-28

Abstract: PURPOSE: To review the data of application of deep temporal fascial flap pedicled with middle temporal artery in temporomandibular joint reconstruction. METHODS: One hundred and thirty-five patients with various temporomandibular joint diseases from January, 2012 to December, 2017 were included in this study. All patients were treated surgically and a deep temporal fascial flap pedicled with middle temporal artery was harvested during surgery with different purposes. The patients were followed up regularly for at least one year, and classified with diagnosis and surgical methods. Radiological examinations were taken regularly to evaluate the position and long-term stability of the flap. RESULTS: Among 135 cases, eight underwent disc replacement with the pedicled deep temporal fascial flap due to terminal stage of internal derangement or osteoarthropathy. Twenty-eight underwent interposition with the flap due to temporomandibular joint ankylosis, while 31 underwent interposition due to space occupying disease of the temporomandibular joint - skull base region. Sixty-eight underwent joint replacement with autologous bone grafts and aforementioned flap interposition. Postoperative radiological examinations showed that the condyle or bone graft and the glenoid fossa were separated completely by a mixed-signal material. No severe complications such as flap necrosis, infection, alopecia or temporal hollowing were found during the follow-up period ranging from 20 months to 86 months. CONCLUSIONS: Pedicled deep temporal fascial flap can be widely used in reconstruction of temporomandibular joint.

Key words: Temporomandibular joint, Deep temporal fascial flap, Middle temporal artery, Middle temporal vein

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