Indication and appreciation of operative procedures for mandibular ankylosis

Mandibular ankylosis may be of various etiology. A number of operative procdures have been presented and criticized, but the most appropriate procedure for ankylosis is not universally accepted. During the past decade, 17 cases of mandibular ankylosis have been treated surgically in the Nagoya University Hospital. The etiology includes both temporomandibular ankylosis and extraarticular origin. Three different surgical procedures were used: (1) High operation, in which skin incision is made in the preauricular region. This method is applied for moderate arthrogenic cases. (2) Low operation, in which skin incision is made in the submandibular region. This is applied for severe arthrogic cases and extraarticular ossification cases. (3) Tubed pedicle skin grafting is applied for buccal contracture cases caused by noma etc. A long-term follow-up to 10 years has disclosed many interesting findings and made it possible to evaluate each operative procedure.