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    Efficacy of Deep Subfascial Approach to the Temporomandibular Joint
    (Lippincott Williams & Wilkins, 2012) Candirli, Celal; Celik, Salih
    Introduction: The aim of this study was to report the efficacy of the deep subfascial approach for the treatment of temporomandibular joint pathologies. The procedure set out below satisfies a wide-access approach for the prevention of facial nerve injury. Materials and Methods: The preauricular approach with the additional deep subfascial approach was applied to 18 patients who had various problems from ankylosis to internal derangement. All patients were assessed at the following postoperative times. Facial nerve functions were evaluated after surgery and 24 hours after surgery by the House-Brackmann facial nerve grading system. Results: Temporary facial nerve palsy was seen in a patient who had a residual keratocyst in the condylar neck region. Other patients tolerated the procedure well, and there were no other complications. Discussion: This procedure significantly decreased the risk of facial nerve injury. However, soft tissue traction at the condylar neck region or zygomatic arch where the facial nerve passes close by may increase the risk of nerve damage.
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    Evaluation of Discectomy and Dermis-Fat Grafting on the Contralateral Side
    (Lippincott Williams & Wilkins, 2012) Candirli, Celal; Esen, Alparslan; Taskesen, Fatih; Celik, Salih; Cakir, Banu
    Purpose: We investigated the effects of unilateral discectomy with an abdominal dermis-fat graft of the temporomandibular joint (TMJ) on the contralateral side. Patients and Methods: A total of 14 patients who underwent unilateral TMJ discectomy and dermis-fat grafting for severe internal derangement in 2009 and 2010 were included. Clinical parameters, such as maximum mouth opening and lateral movements of the mandible, were recorded preoperatively and at 1 year postoperatively. Preoperative and 1-year postoperative magnetic resonance imaging was conducted to determine the duration of the operated and unoperated TMJs. Results and Conclusions: All 14 patients showed improvement in the mandibular mobility and function. However, postsurgical disc displacement without reduction was observed on the unoperated TMJ in 1 patient. Another patient complained of crepitus on the operated TMJ. Primary occlusal contact on the operated side of occlusion was observed in 2 other patients. Maximum mouth opening and measured lateral movements had increased in all patients at 1 year after the operation.