5/10/2023 0 Comments Plaza lama santiago![]() ![]() It also reduces dietary limitations and significantly improves life functions such as chewing, speech and swallowing ( Wolford et al., 2003 Mercuri, 2012 Burgess et al., 2014 Mehra et al. This is essential to autogenous reconstruction, improves mouth opening and the quality of life. Furthermore, it is an effective way to treat distorted and mutilated joint anatomies, without depending on the vascularization of periarticular tissues. It also eliminates the need for a second surgical site, associated morbidity, reduces time in the operating room, minimizes the effects on connective tissue/autoimmune disease and other pathologies, that can cause the destruction of autogenous tissues used to reconstruct the TMJ. The customized joint prostheses adapts appropriately to the anatomical structures to achieve stability, functional compatibility and mechanical strength to resist chewing forces that offers long-term predictability. This implied a complete condylectomy and immediate joint reconstruction using an extraoral approach, because the anatomical location of the tumor makes access difficult, making it impossible to use other approaches such as endoscopy. In this case, the mandibular condyle could not be preserved, because the tumor extended to the condylar neck, thus radical resection was necessary. The resection is usually curative and no recurrence or malignant transformation has been reported, so the recurrence may be due to incomplete removal (Kitsoulis et al.). ![]() The surgical treatment of mandibular osteochondromas involves resection of the tumor and generally the condyle, which must be reconstructed because it is essential to maintain TMJ's function (Mehra et al.). The fat autograft obtained from the suprapubic region is placed around the joint surfaces of both components to avoid formation of heterotopic bone. The component for the glenoid fossa is fixed to the lateral portion of the zygomatic arch and the condylar mandibular component is fixed to the remaining bone tissue, according to planning. Two fragments of irregular bone tissue corresponding to the mandibular condyle and the resected specimen was obtained ( Fig. The mandibular ramus and condyle osteotomy was performed removing the tumor lesion with a safety margin. Subsequently, the discectomy and removal of the tissues of the joint capsule is carried out. A modified guide was used at the level of the mandibular angle for tumor resection and condylectomy. The surgical team decided a resection of the tumor and reconstruction with a customized alloplastic joint prosthesis (Artfix, Sao Paulo, Brazil). 1 Maxillofacial CT: Axial CT shows the tumor located on the medial side of the left mandibular ramus, in front of the styloid apophysis, occupying the parapharyngeal space without displacing muscular structures. PALABRAS CLAVE: osteocondroma prótesis articular personalizada aloplástica reemplazo total de la articulación tumor osteogénico benignoįig. La reconstrucción inmediata después de la resección es una buena alternativa para evitar una segunda operación, y la planificación virtual prequirúrgica garantiza la eliminación completa de la lesión utilizando guías de corte y cubriendo todo el defecto con una prótesis articular aloplástica personalizada. Después de la cirugía, el paciente permanece asintomático y recupera los intervalos de apertura y cierre, la fonación y la función masticatoria. En este caso, un osteocondroma localizado en la rama mandibular y el cuello del cóndilo fue reseccionado y reconstruido simultáneamente a través de un reemplazo articular total. ![]() Los osteocondromas son tumores osteogénicos benignos que pueden alcanzar grandes tamaños, los cuales requieren de resección quirúrgica y generalmente de algún tratamiento adicional para restaurar la forma y la función mandibular.
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