Three-dimensional morphological changes of the temporomandibular joint and functional effects after mandibulotomy
Tóm tắt
The midline and paramedian mandibulotomy are surgical procedures that divide the mandibular bone into two halves and disconnects the condylar heads of the TMJ from each other. This study aimed to prospectively evaluate the temporomandibular joint (TMJ) functional and morphological changes after mandibulotomy using a reconstructed 3D models of the TMJ. Sixteen adult patients diagnosed with oral and oropharyngeal tumors with planned surgical mandibulotomy (test group, 9 patients) or transoral (control group, seven patients) treatments were included in the study. MRI and CBCT images were obtained immediately preceeding surgery and 6–8 weeks after surgery. Using the MRI-CBCT registered images, TMJ tissues were segmented at the two occasions by the same operator and 3D models were reconstructed for morphological assessment. Changes across time were measured using the volume overlap and Hausdorff distance of the disc and condyle 3D models. Disc-condyle relationship was measured using point-based and color map analysis. To assess the early functional changes, the Jaw function limitation scale (JFLS) and the maximum mouth opening were measured. Two-sample Hotelling T2
t-test was performed to determine the significance of the morphological and clinical outcomes’ differences between the two groups. The two-sample Hotelling T2
t-test showed significant differences (T2 (df1,df2) = 0.97 (5,26), p <0.01) between the mean values of all outcomes among the 2 groups. The change in disc displacement was significantly different between the two groups (p <0.05). However, the condylar displacement was not significantly different between the two groups (p =0.3). The average of the JFLS score was five times larger after mandibulotomy, and was 2 times larger after transoral surgery (p < 0.01). Patients showed decrease in the average of the maximum interincisal mouth opening by 11 mm after mandibulotomy, and by 5.4 mm after transoral surgery. The quantitative assessment of the TMJ showed minimal changes of the condylar position and variable degrees of articular disc displacement associated with the paramedian split mandibulotomy. As well, limited jaw functions and vertical mouth opening were noticed more in the mandibultomy group compared to the transoral group in 6- weeks after surgery.
Tài liệu tham khảo
Uwiera T, Seikaly H, Rieger J, Chau J, Harris JR. Functional outcomes after hemiglossectomy and reconstruction with a bilobed radial forearm free flap. J Otolaryngol. 2004;33(6):356–9.
Butlin HT. Diseases of the tongue. London: Casell; 1885. p. 331.
Rattan V, Rai S, Sethi A. Midline mandibulotomy for reduction of long-standing temporomandibular joint dislocation. Craniomaxillofac Trauma Reconstr. 2013;6(2):127–32.
Alexander CD, Bloomquist DS, Wallen TR. Stability of mandibular constriction with a symphyseal osteotomy. Am J Orthod Dentofacial Orthop. 1993;103(1):15–23.
Hara S, Mitsugi M, Hirose H, Tatemoto Y. Combination of mandibular constriction and intraoral vertical ramus osteotomies for a transverse jaw discrepancy. Plast Reconstr Surg Glob Open. 2015;3(9):e521.
Joondeph DR, Bloomquist D. Mandibular midline osteotomy for constriction. Am J Orthod Dentofacial Orthop. 2004;126(3):268–70.
Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of eighteen major cancers in 1985. Int J Cancer. 1993;54(4):594–606.
Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer. 2001;94(2):153–6.
Kreeft AM, van der Molen L, Hilgers FJ, Balm AJ. Speech and swallowing after surgical treatment of advanced oral and oropharyngeal carcinoma: A systematic review of the literature. Eur Arch Otorhinolaryngol. 2009;266(11):1687–98.
Rogers SN, Ahad SA, Murphy AP. A structured review and theme analysis of papers published on ‘quality of life’ in head and neck cancer: 2000-2005. Oral Oncol. 2007;43(9):843–68.
Dziegielewski PT, O’Connell DA, Rieger J, Harris JR, Seikaly H. The lip-splitting mandibulotomy: Aesthetic and functional outcomes. Oral Oncol. 2010;46(8):612–7.
Dziegielewski PT, Mlynarek AM, Dimitry J, Harris JR, Seikaly H. The mandibulotomy: Friend or foe? safety outcomes and literature review. Laryngoscope. 2009;119(12):2375.
Marchetta FC. Function and appearance following surgery for intraoral cancer. Clin Plast Surg. 1976;3(3):471–9.
Al-Saleh MA, Armijo-Olivo S, Thie N, et al. Morphologic and functional changes in the temporomandibular joint and stomatognathic system after transmandibular surgery in oral and oropharyngeal cancers: Systematic review. J Otolaryngol Head Neck Surg. 2012;41(5):345–60.
Komisar A, Shapiro BM. Complications of midline mandibulotomy. Ear Nose Throat J. 1988;67(7):521–3.
Hatcher DC, Blom RJ, Baker CG. Temporomandibular joint spatial relationships: Osseous and soft tissues. J Prosthet Dent. 1986;56(3):344–53.
Yuodelis RA. The morphogenesis of the human temporomandibular joint and its associated structures. J Dent Res. 1966;45(1):182–91.
Al-Saleh MA, Jaremko JL, Alsufyani N, Jibri Z, Lai H, Major PW. Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints. Dentomaxillofac Radiol. 2015;44(6):20140244.
Orsini MG, Kuboki T, Terada S, Matsuka Y, Yatani H, Yamashita A. Clinical predictability of temporomandibular joint disc displacement. J Dent Res. 1999;78(2):650–60.
Murguia M, Villasenor L. Estimating the effect of the similarity coefficient and the cluster algorithm on biogeographic classifications. Ann Bot Fenn. 2003;40:415–21.
Huttenlocher D, Klanderman G, Rucklidge W. Comparing images using hausdorff distance. IEEE Trans Pattern Anal Mach Intell. 1993;5(9):850–63.
Nebbe B, Brooks SL, Hatcher D, Hollender LG, Prasad NG, Major PW. Magnetic resonance imaging of the temporomandibular joint: Interobserver agreement in subjective classification of disk status. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(1):102–7.
Sugisaki M, Kino K, Yoshida N, Ishikawa T, Amagasa T, Haketa T. Development of a new questionnaire to assess pain-related limitations of daily functions in japanese patients with temporomandibular disorders. Community Dent Oral Epidemiol. 2005;33(5):384–95.
Olivo SA, Fuentes J, Major PW, Warren S, Thie NM, Magee DJ. The association between neck disability and jaw disability. J Oral Rehabil. 2010;37(9):670–9.
Gellrich N, Schimming R, Schramm A, Schmalohr D, Bremerich A, Kugler J. Pain, function, and psychologic outcome before, during, and after intraoral tumor resection. J Oral Maxillofac Surg. 2002;60(7):772–7.
Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69–71.
Al-Saleh MA, Jaremko JL, Saltaji H, Wolfaardt J, Major PW. MRI findings of radiation-induced changes of masticatory muscles: A systematic review. J Otolaryngol Head Neck Surg. 2013;42:26. 0216-42-26.
de Almeida JR, Byrd JK, Wu R, et al. A systematic review of transoral robotic surgery and radiotherapy for early oropharynx cancer: A systematic review. Laryngoscope. 2014;124(9):2096–102.
Vissink A, Jansma J, Spijkervet FKL, Burlage FR, Coppes RP. Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):199–212.
Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: A prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(3):365–73.
Mendenhall WM. Mandibular osteoradionecrosis. J Clin Oncol. 2004;22(24):4867.
Urken ML, Buchbinder D, Costantino PD, et al. Oromandibular reconstruction using microvascular composite flaps: Report of 210 cases. Arch Otolaryngol Head Neck Surg. 1998;124(1):46–55.
Riddle SA, Andersen PE, Everts EC, Cohen JI. Midline mandibular osteotomy: An analysis of functional outcomes. Laryngoscope. 1997;107(7):893–6.
Bertrand J, Luc B, Philippe M, Philippe P. Anterior mandibular osteotomy for tumor extirpation: A critical evaluation. Head Neck. 2000;22(4):323–7.
Christopoulos E, Carrau R, Segas J, Johnson JT, Myers EN, Wagner RL. Transmandibular approaches to the oral cavity and oropharynx: A functional assessment. Arch Otolaryngol Head Neck Surg. 1992;118(11):1164–7.
Lee SY, Park YM, Byeon HK, Choi EC, Kim SH. Comparison of oncologic and functional outcomes after transoral robotic lateral oropharyngectomy versus conventional surgery for T1 to T3 tonsillar cancer. Head Neck. 2014;36(8):1138–45.
Al-Saleh MA, Punithakumar K, Jaremko JL, Alsufyani NA, Boulanger P, Major PW. Accuracy of magnetic resonance imaging-cone beam computed tomography rigid registration of the head: An in-vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;121(3):316–21.
Probert TC, Wiesenfeld D, Reade PC. Temporomandibular pain dysfunction disorder resulting from road traffic accidents--an australian study. Int J Oral Maxillofac Surg. 1994;23(6 Pt 1):338–41.
Guler N, Yatmaz PI, Ataoglu H, Emlik D, Uckan S. Temporomandibular internal derangement: Correlation of MRI findings with clinical symptoms of pain and joint sounds in patients with bruxing behaviour. Dentomaxillofac Radiol. 2003;32(5):304–10.
Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand. 2005;63(2):99–109.
Okeson JP. Critical commentary 1: Evaluation of the research diagnostic criteria for temporomandibular disorders for the recognition of an anterior disc displacement with reduction. J Orofac Pain. 2009;23(4):312–5. author rey 323-324.
Okeson J, editor. Management of temporomandibular disorders and occlusion. 6th ed. St. Louis: Mosby Inc.; 2008. No. 6.
Larheim TA, Abrahamsson AK, Kristensen M, Arvidsson LZ. Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol. 2015;44(1):20140235.
Harris WH, Heaney RP. Skeletal renewal and metabolic bone disease. N Engl J Med. 1969;280(6):303–11. concl.
Eisen MD, Weinstein GS, Chalian A, et al. Morbidity after midline mandibulotomy and radiation therapy. Am J Otolaryngol. 2000;21(5):312–7.
Dubner S, Spiro RH. Median mandibulotomy: a critical assessment. Head Neck. 1991;13(5):389–93.
Ohrbach R, Granger C, List T, Dworkin S. Preliminary development and validation of the jaw functional limitation scale. Community Dent Oral Epidemiol. 2008;36(3):228–36.
Ohrbach R, Larsson P, List T. The jaw functional limitation scale: Development, reliability, and validity of 8-item and 20-item versions. J Orofac Pain. 2008;22(3):219–30.
Urken ML, Buchbinder D, Weinberg H, et al. Functional evaluation following microvascular oromandibular reconstruction of the oral cancer patient: A comparative study of reconstructed and nonreconstructed patients. Laryngoscope. 1991;101(9):935–50.
Manfredini D, Tognini F, Zampa V, Bosco M. Predictive value of clinical findings for temporomandibular joint effusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):521–6.
Wahlund K, List T, Dworkin SF. Temporomandibular disorders in children and adolescents: Reliability of a questionnaire, clinical examination, and diagnosis. J Orofac Pain. 1998;12(1):42–51.
Dworkin SF, Huggins KH, LeResche L, et al. Epidemiology of signs and symptoms in temporomandibular disorders: Clinical signs in cases and controls. J Am Dent Assoc. 1990;120(3):273–81.
Al-Saleh MAQ, Punithakumar K, Lagravere M, Boulanger P, Jaremko JL, Major PW. Three-Dimensional Assessment of Temporomandibular Joint Using MRI-CBCT Image Registration. PLoS ONE. 2017;12(1):e0169555