2010 Annual Meeting Abstracts
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Long Term Results Of Mandibular Condyle Reconstruction With Costochondral Grafts
*David A Fenton1, *Norman Cavanagh2, *Charles Castiglione2, *Rhonda Agostonucci3
1University of Connecticut, New Britain, CT;2Hartford Hospital, Hartford, CT;3Valley Rehabilitation Center, Hartford, CT
Objective: Patients requiring resection of the mandibular condyle have multiple reconstructive options. The long term evaluation of adult patients' outcomes after autogenous costochondral reconstruction of the ramus/condyle unit is limited. This study demonstrates the utility and predictability of autogenous costochondral grafting with immediate function for reconstruction of the mandibular condyle and ramus unit
Design: 40 sequential adult patients from a single surgeon's practice were studied. The costochondral portions of ribs 5-7 were evaluated and one selected for harvest. The pathologic condyle was resected and the graft modified and fixated with lag screws to the ramus. Intermaxillary fixation was limited to intraoperative use alone. Immediate full function and physical therapy were institued on post operative day 3. The patients were evaluated for pre- and post-operative pain, range of motion, and radiographic, neurologic and occlusal examination. Intraoperative range of motion and occlusion was also recorded. The average follow up period was 16.5 years.
Setting: Private Practice Surgical office and Urban Hospital
Patients: 40 sequential adult patients from a single surgeon's practice
Interventions:The costochondral portions of ribs 5-7 were evaluated and one selected for harvest. Pathologic condyle resection and graft modification were followed by fixation with lag screws to the ramus.
Main Outcome measures: Data analysis includes direct value assessment and presentation.
Results: 40 patients who required reconstruction of the mandibular condyle were followed for an average of 16.5 years. Excellent early results, including symptom control, occlusal stability, normalized range of motion, were maintained throughout the two decade study period.
Conclusion: Autogenous costochondral reconstruction for adult mandibular condyle/ramus unit resection with immediate function and physical therapy allows rapid and persistent improvement in funtion and symptom control.
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