Back again for another round

January 9, 2004

Hi all!

I haven't been here in awhile, been too busy working a lot of hours

to make up for the two months I'll be off post-op. I hope all of you

post-oppers are doing well and wish lots of luck and smooth

recoveries to those of you with upcoming surgeries.

I'll be going through surgery #4 on January 14. To make a long story

short, I've had TMJ problems almost all my life because of a small

mandible. I had surgery to correct a severe overbite and open bite.

The surgery was done in two stages to minimize stress on my already

arthritic TMJ's. First the lower jaw was advanced 17 mm using

distraction and then my upper jaw was moved 5 mm. My bite was then

perfect but unfortunately instead of making the TMJ better, it got

much worse. The joints deteriorated rapidly and six months later, my

lower jaw was deviated 7 mm to the left and the overbite was coming

back. I then had a temporalis muscle graft placed in the left joint

and arthroscopic surgery on the right. For a few months, everything

went well and then the problems started again. I still have a very

limited opening (about 15 mm) and a lot of pain. I've been on a

liquid/ mushy diet since my first surgery in Sept 2002.

My lower jaw has noticeably regressed again and once again, I have

an open and overbite. The left condyle is pretty much gone and the

right condyle has avascular necrosis and the joint is ankylosed

(fused). This time, the surgeon is going to remove what is left of

the condyles and coronoids and put a muscle graft into the right

joint to replace the missing cartilage. We are going to regrow the

condyles using distraction osteogenesis again. He is going to place

distractors in the healthy bone in the back of the mandible and make

a cut through the bone. Twice daily for 10-15 days my husband will

have to turn the screws to lengthen the bone. The screws will come

out through my cheeks near my earlobes. Rebuilding the condyles will

advance my lower jaw again and close the bite. After everything has

healed, I'll have another minor procedure to remove the distractors

and have plates put in to reinforce everything.

The only other option was to use prosthetic joints but they

typically don't last as long. Hopefully since we are using my own

healthy native bone, the new condyles should last a lifetime.

I hope I haven't scared anyone. My case was very unusual and most

people do have relief from the TMJ symptoms from the orthognathic

surgery. good luck to everyone going through surgery soon.

Any January 14 surgery buddies?

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