Overgrowth of a costochondral graft in a case of temporomandibular joint ankylosis

Abstract

Ankylosis of the temporomandibular joint (TMJ) involves fusion of the mandibular condyle to the base of the skull. When it occurs in a child, it can have devastating effects on the future growth and development of the jaws and teeth. Furthermore, in many cases, it has a profoundly negative influence on the psychosocial development of the patient because of the obvious facial deformity. Reconstruction of the mandibular condyle with costochondral grafts(CCGs) in children may result in overgrowth at the reconstructed side of the mandible. The growth pattern of the CCG is extremely unpredictable, and mandibular overgrowth on the grafted site can actually be more troublesome than the lack of growth. We report the case of a 3-year-old boy with temporomandibular ankylosis, which was treated with a CCG. The mandibular condyles and coronoid were resected unilaterally and immediately reconstructed with autogenous CCGs. He required one further resection because the grafted tissue had overgrown 5 years later.