Release of extra-articular ankylosis by coronoidectomy and insertion of a free abdominal flap: case report

Introduction: It is generally agreed that an effective treatment for extra- articular ankylosis mag be coronoidectomy and excision of scar tissue. But these conventional procedures have shown a high rate of recurrence of ankyl osis due to heterotopic bone and fibrous tissue formation. Objective and Pa tient: We report a case in whom a coronoid osteotomy and insertion of a fre e abdominal flap was used to treat ankylosis of the mandible following radi otherapy for maxillary cancer. Results: This procedure prevented recurrence of ankylosis by heterotopic bone and fibrous tissue formation. in addition , this flap reduced the risk of postoperative infection and promoted primar y healing. Conclusion: The procedure, coronoidectomy and insertion of a fre e flap, was successful because the well-vascularized musculocutaneous flap occupied the dead space, and replaced the shortage of oral mucosa consequen tly inhibiting the recurrence of extra-articular ankylosis. (C) 2000 Europe an Association for Cranio-Maxillofacial Surgery.