J Korean Assoc Oral Maxillofac Surg.  2014 Apr;40(2):83-86. 10.5125/jkaoms.2014.40.2.83.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

• Jang HW
• Kim NK
• Lee WS
• Kim HJ
• Cha IH
• Nam W

• KMID: 1960959
• DOI: http://doi.org/10.5125/jkaoms.2014.40.2.83

Abstract

There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

Keyword

Reconstructive surgical procedures; Free tissue flaps; Temporomandibular joint; Bone transplantation

MeSH Terms

Bone Resorption
Bone Transplantation
Cerebrospinal Fluid
Follow-Up Studies
Free Tissue Flaps
Humans
Mandible
Mandibular Condyle*
Mandibular Osteotomy
Reconstructive Surgical Procedures
Ribs
Skull
Temporomandibular Joint
Transplants*

Figure

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  Fig. 1 Computed tomography and magnetic resonance imaging (T2 enhanced) shows a tumorous lesion (arrows) on the right external auditory canal that invades into the cranial base. There is no invasion on the right mandibular condyle.

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  Fig. 2 Vascularized calvarial bone was harvested.

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  Fig. 3 Ipsilateral fourth rib was harvested.

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  Fig. 4 Ten months after surgery demonstrated stable occlusion and no remarkable bone resorption.

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