Abstract：
The repair of hemimandibulectomy defects involving the temporomandibular joint (TMJ) is challenging. This study compared the functional outcomes and reconstruction accuracy using a deep circumflex iliac artery (DCIA) flap with and without a virtually planned stock TMJ prosthesis (TMJP) after hemimandibulectomy. Ten patients were assessed: five with a TMJP (TMJP group) and five without (control group). A three-dimensional comparison revealed a mean deviation of 0.11 ± 0.04 mm between the planned and actual DCIA flap with TMJP. The planned and actual TMJP positions differed by 0.56 ± 0.57 mm in height, 0.33 ± 0.24 mm ventrally/dorsally, and 1.18 ± 0.42 mm medially/laterally. Mouth opening, laterotrusion, and midline deviation were significantly greater in the control group than in the TMJP group (P = 0.024, P = 0.008, P = 0.024). The deviation in ventral to dorsal translation for the DCIA flap was slightly higher than reported values in the literature, while height deviation was comparable. Lower deviations in the literature were due to the DCIA flap being used where both TMJs were intact. The in-house virtually planned DCIA flap with stock TMJP yielded results comparable to more expensive patient-specific prostheses.
摘要：
涉及颞下颌关节（TMJ）的半关节切除术缺损的修复具有挑战性。这项研究比较了半动脉切除术后使用和不使用虚拟计划的TMJ假体（TMJP）的深回旋动脉（DCIA）皮瓣的功能结果和重建准确性。评估了10例患者：5例使用TMJP（TMJP组），5例没有（对照组）。三维比较显示，带有TMJP的计划和实际DCIA皮瓣之间的平均偏差为0.11±0.04mm。计划和实际TMJP位置的高度相差0.56±0.57mm，腹侧/背侧0.33±0.24mm，内侧/外侧为1.18±0.42mm。张口,laterotrusion,对照组和中线偏差明显大于TMJP组（P=0.024，P=0.008，P=0.024）。DCIA皮瓣的腹侧到背侧平移的偏差略高于文献中的报道值，而高度偏差具有可比性。文献中的偏差较低是由于在两个TMJ都完好无损的情况下使用了DCIA瓣。实际上，内部计划的带有库存TMJP的DCIA皮瓣产生的结果可与更昂贵的患者专用假体相媲美。
