Computer Guided Resection of Temporomandibular Joint Ankylosis promotes safety in Skull Base Surgery

Objective: The surgical resection of the ankylotic mass remains the ultimate line of treatment for bony ankylosis. Resecting massive bone formations at the skull base in a distorted anatomic environment is difficult and runs the risks of life threatening complications. This complicates the uniform resection of the ankylotic mass and accordingly creating a uniform dimension gap. Computer-guided surgery (CGS) has not been a routine part of craniomaxillofacial surgery in bony ankylosis to date. 

Aim: This study investigates the use of Prefabricated computer guided cutting stent to promote the safe removal and uniform of ankylosed temporomandibular joint bone in the skull base. This study included 8 cases of temporomandibular ankylosis (7 unilateral and 1 bilateral). The patients underwent a surgical procedure of bony gap arthroplasty guided by a prefabricated cutting stent. It aided in a predetermined guiding the uniformity of the gap arthroplasty intraoperatively. 

Results:The results showed that computer guided surgery resulted in an accurate presurgical determined osteotomies with subsequent safe and uniform surgical excision of the ankylotic mass.

 Conclusions: We regard Computer guided release of an ankylosed temporomandibular joint as a valuable additional technique in creating a preplanned uniform gap yet the depth of resection still needs for studies to be made.

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