Vascularized Bone Graft Reconstruction of the Temporomandibular Joint Using the Tunneled, Anchored Suture Technique

To describe a novel technique that provides a simple, flexible and safe method to approximate and secure the neocondyle into the glenoid fossa in reconstruction of hemi-mandibulectomy defects. METHODS: Three patients underwent composite resection of the hemi-mandible with condylectomy. A minimally invasive tunneled suture, anchored with a miniplate to the zygomatic root, was used to approximate the neo-condyle into the glenoid fossa. Postoperative outcomes were assessed with clinical and radiographic measures. CONCLUSION: The described approach introduces a simple, safe, flexible and effective technique for neocondylar suspension and appropriate realignment during mandibular reconstruction. The temporomandibular joint (TMJ) is a diarthroidial joint in which the mandibular condyle articulates into the glenoid fossa. Reconstruction of the TMJ may be required for tumor extirpation, trauma or osteonecrosis. Re-approximation of an osseous graft within the glenoid fossa is critical to reestablish occlusion and allow mastication. We describe a novel technique to promote and sustain this approximation.