Clinical effects of the combination of rhytidectomy and temporomandibular joint surgery on 23 patients with internal derangement of the temporomandibular joint and aging faces

doi:10.19438/j.cjoms.2022.06.006

Abstract

Abstract: PURPOSE: To investigate the clinical effects of the combination of rhytidectomy and temporomandibular joint (TMJ) disc repositioning surgery in internal derangement (ID) stage IV-V and facial aging patients. METHODS: Twenty-three middle-aged and elderly female patients with bilateral TMJ ID IV-V requiring surgical treatment and facial skin relaxation were enrolled in this study. All patients underwent TMJ surgery and facial rhytidectomy by the same surgeon. Preoperative and 6-month postoperative pain visual analog score(VAS), maximum mouth opening (MMO), CBCT and MRI imaging, postoperative wound healing, scar condition, complications, postoperative facial lift improvement and satisfaction were collected. SPSS 21.0 software package was used for statistical analysis. RESULTS: The VAS score of 23 patients was 6.13 points before operation, and decreased to 0.52 points 6 months after operation(P<0.05). The average MMO was 2.21 cm before operation and increased to 3.33 cm 6 months after operation(P<0.05). The wound healed well after operation, the scar before ear was not obvious, and there was no obvious complications such as hematoma, temporal skin numbness, infection, hair loss and severe facial nerve injury. Six months after operation, MRI showed that the position of TMJ disc had been stably restored above the condyle. CBCT showed that the anchoring screws were in place, and there was no destruction and absorption of condylar bone. Among them, 8 cases showed repair changes of condylar bone. Facial photos showed that the patient's soft tissue sagging and skin relaxation improved significantly. The average satisfaction of doctors, patients and third parties with younger facial appearance was 95.52%, 97.34% and 97.04%. CONCLUSIONS: For middle-aged and elderly female patients with TMJ ID IV-V who need surgical treatment and facial skin relaxation, due to the same incision of TMJ surgery and rhytidectomy,the combination of the two surgeries is an effective treatment method. It can improve the symptoms of TMJ disorder and reverse the destruction of condylar bone, improve the aging state of facial skin relaxation and soft tissue sagging, which is worthy of clinical promotion.

Key words: Temporomandibular joint internal derangement, Disc reduction of temporomandibular joint, Rhytidectomy

CLC Number:

R782.6

LEE Mui-lee, ZHU Yao-min, WANG Yu-meng, DAI Juan, ZHANG Dan-di, LIANG Xiao. Clinical effects of the combination of rhytidectomy and temporomandibular joint surgery on 23 patients with internal derangement of the temporomandibular joint and aging faces[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(6): 554-559.

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