하악골 측두하악관절의 이연골을 이용한 악관절원판 재건술에 관한 연구

Autogenous auricular cartilage graft for repair of temporomatndibular joint disk

Thirty two joints in twenty one patients, who had fibrous or fibroosseous ankylosis and severe degenerative changes of the joint with/without history of alloplastic implant and a history of multiple operations rather than in patients immediately after diskectomy, were operated by autogenous auricular cartilage graft for repair of temporomandibualr joint. Subjects were pre and postoperatively evaluated the clinical signs and symptoms and radiological findings by the two visual analog scales(VAS) and surgeon s examination. Sixteen patients(84%) about the pain and seventeen patients(89%) about the function felt the good or better improvement compared with preoperative condition. Improvement rate of pain and function based on all patients self assessment(VAS) was 49% and 36% and increase rate of maximum interincisal opening(MIO) was 129%. Improvement rate of pain and function of arthritides was more than those of ankylosis. Rates of fibrous ankylosis was more than those of osseous ankylosis. Single operated joint had higher improvement rate of pain and function than multiple operated joint. Improvement of pain and function of non implanted joint was higher than those of allografted joint. Patients with stable occlusion also was higher than patients with unstable occlusion. We could suggest, as appears from our results, that autogenous auricular cartilage graft is slightmarkedly useful operation method in patients who has fibrous or fibroosseous ankylosis and severe degenerative changes of the joint.