TMJ Condyle Replacement to a patient with metastatic tumor in the right mandibular ramus

Reconstructions

TMJ Condyle Replacement to a patient with metastatic tumor in the right mandibular ramus

Prof. Imad Abu el-Naaj D.M.D, Head, Department of Oral & Maxillofacial Surgery, The Baruch Padeh medical center & Dr. Avi Toeg, Oral & Maxillofacial senior staff specialist, The Baruch Padeh medical center.
A 64-year-old patient with metastatic tumor to his right mandibular ramus. Resection of the tumor required removal of the condyle, resulting in loss of the Temporomandibular Joint. The joint disc was intact.
The tumor was resected with the help of a 3D Template surgical guide, which enabled cutting the mandible at exactly the planned position.
The custom implant was placed using specific screws. The surgery was completed in 2 hours, which was far less than anticipated and less than the conventional treatment with much better recovery. Post op CT showed good position of the condyle in the eminence fossa.
The patient was able to chew 2 days after the surgery, good mouth opening, excellent function with no pain on chewing.
After more than one year follow up the patient is functioning with the TMJ prosthesis with no complications.

A.

3D Planning

B.

3D Printed stereolitic model after Virtual Removal of Tumor, and Titanium Laser Sintered Implant

C.

3D Image Post-Op

D.

The Surgical Procedure: Surgical guide for jaw resection

E.

Condyle Removal

F.

Location of Implant in TMJ

G.

Anterior View of Implant with Fixation Screws

H.

Lateral View of Implant

I.

Panoramic view of Post-Op CT