ABSTRACT
Maxillofacial osteochondromas are considered benign neoplasms, and compared with their extracranial variant are relatively rare. When they involve the mandibular condyle they can induce significant facial deformity, malocclusion and various temporomandibular joint symptoms. Complete excision is considered the standard of care, but can lead to a reduction in the height of the ipsilateral mandible with resultant complications. In such cases, reconstruction is usually warranted and may be approached in various ways. This case report demonstrates a straightforward, accurate and reproducible approach to reconstructing the TMJ, facial profile and occlusion following resection of a large TMJ osteochondroma, without the need for concomitant orthodontics.
Subject(s)
Mandibular Neoplasms , Osteochondroma , Temporomandibular Joint Disorders , Facial Asymmetry/diagnostic imaging , Facial Asymmetry/etiology , Facial Asymmetry/surgery , Humans , Mandibular Condyle/diagnostic imaging , Mandibular Condyle/surgery , Mandibular Neoplasms/diagnostic imaging , Mandibular Neoplasms/surgery , Osteochondroma/complications , Osteochondroma/diagnostic imaging , Osteochondroma/surgery , Temporomandibular Joint , Temporomandibular Joint Disorders/diagnostic imaging , Temporomandibular Joint Disorders/etiology , Temporomandibular Joint Disorders/surgeryABSTRACT
To understand and reduce the impact of postoperative complications, we studied 568 patients who had had operations over 72 months in our hospital. Multivariate analysis indicated that factors indicative of coexisting conditions (including activated systemic inflammation) and the complexity of the operation are primary determinants of postoperative complications. The enhanced recovery after surgery (ERAS) care pathway did not have an effect on their occurrence or severity. Systematic study of patients' toleration of major head and neck operations is required, as optimal perioperative care pathways remain elusive.
