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Journal of Korean Cleft Palate-Craniofacial Association 2004;5(1):69-72.
Reconstruction of Lateral Capsular Ligament of Temporomandibular Joint with E-PTFE(Gore-tex(R)) Patch.
Sang Yoon Kang, Soo Sang Lee, Jun Park, Sang Hun Cho
1Department of Plastic and Reconstructive Surgery, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Kyonggi-do, Korea. shcho@cha.ac.kr
2Department of Plastic and Reconstructive Surgery, Kyunghee University College of Medicine, Seoul, Korea.
Abstract
The lateral capsular ligament of temporomandibular joint(TMJ) prevents mandibular condyle from lateral displacement in case of fractures related with condyle. When the condylar fracture with lateral extracapsular displacement occurs, open reduction and reconstruction of capsular ligament must be considered. However, many patients exhibit limitation of functional movements of the TMJ after such surgery. This may be a result of myositis, myospasm, fibrosis of bilaminar zone, adhesion of TMJ capsule. When the joint problem occurs, non surgical treatment must be attempted firstly. But if it fails, the surgical reconstruction must be considered. We reconstructed the lateral capsular ligament of TMJ with E- PTFE(Expanded Polytetrafluoroethylene, Gore-tex(R)) patch after removing scar tissues and adhesions. This surgical method showed improvements in movement as well as the pain of the joint. No side effect has detected from occlusion for about 2 years. There was no foreign body reaction or irritation to the capsule, since E-PTFE was biologically inert. We believe that the E-PTFE patch could be used as primary material of capsular ligament of TMJ reconstruction, insertion material in high tensioned capsule and reinforcement material in weakened capsule.
Keywords: Lateral capsular ligament; Temporomandibular joint; E-PTFE patch; Gore-tex(R)
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