Triad of temporomandibular joint ankylosis, micrognathia, and obstructive sleep apnoea: a systematic review of surgical management.

Autor: Yew TF; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia., Kiong CT; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia., Sng TJH; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Singapore., Hariri F; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: firdaushariri@um.edu.my.
Jazyk: angličtina
Zdroj: The British journal of oral & maxillofacial surgery [Br J Oral Maxillofac Surg] 2024 Nov; Vol. 62 (9), pp. 857-865. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1016/j.bjoms.2024.08.003
Abstrakt: Complex functional issues arising from temporomandibular joint (TMJ) ankylosis are associated with abnormal mandibular growth secondary to the condylar-glenoid fossa and its surrounding structures. These include severe limited mouth opening, micrognathia, mandibular asymmetry, and obstructive sleep apnoea (OSA), which necessitate effective treatment to allow optimum functional rehabilitation. This article aims to present a comprehensive systematic review of the surgical strategy for patients who present with a triad of TMJ ankylosis, micrognathia and OSA via a literature search of PubMed, Google Scholar, and Scopus following PRISMA guidelines. The outcomes of interest were difference in maximum mouth opening, incidence of reankylosis, amount of mandibular advancement, posterior airway space, preoperative and postoperative apnoea/hypopnoea index, and arterial oxygen saturation, as well as changes in other cephalometric or polysomnographic variables. Thirty four studies involving 360 patients were included. Surgical interventions included distraction osteogenesis (DO), release of TMJ ankylosis and mandibular advancement, simultaneous arthroplasty and DO, pre-athroplasty DO, and post-arthroplasty DO. Most studies reported functional post-intervention mouth opening, with reankylosis reported in four. Mandibular advancement was between 6 mm and 34 mm. All studies reported improvement in the various polysomnographic variables measured. In conclusion, the systematic review was conducted based on a low level of literature evidence. Even though various surgical strategies were reported, effective case-specific management of TMJ ankylosis with micrognathia and OSA requires comprehensive assessment and careful consideration of surgical options that promote mandibular advancement and airway improvement.
(Copyright © 2024 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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