Page 278 - Demo

Chapter 10276The results of the FACE-Q questionnaire are presented in Tables 1 and 2. While one patient reported a lower Rasch score (59/100), all other patients evaluated their satisfaction with the implant between 87/100 and 100/100, representing excellent results. The mean Rasch score was 89.2/100.Table 1: FACE-Q Satisfaction with outcome VeryDissatisfiedSomewhatDissatisfiedSomewhatSatisfiedVerySatisfiedI am pleased with the result. 0 0 1 4The result turned out great. 0 0 1 4The result was just as I expected. 0 0 1 4I am surprised at how good I look in the mirror.0 0 1 4The result is fantastic. 0 0 1 4The result is miraculous. 0 0 2 3DiscussionDuring eTMJR surgery, we encountered a number of obstacles. Adjustment at both sides of the implant was the most frequent (Cases #1, #4, and #5). Neuromuscular deficiency of the pterygomasseteric sling was likely the reason for the occlusal deviation observed in case #1.(Fig. 3) Lack of manual control over the vertical position of the condyle in the fossa before the screw fixation was likely the reason in case #2.(Fig. 4) The difficulty in retrieving the proper position at the symphysis, necessitating modification of the contact surfaces, probably contributed to the slight malpositioning as well. Both of these patients also had facial paresis on the affected side, but that was probably a coincidence. The solution could involve suture suspension of the prosthetic condyle to the prosthetic fossa and proper fixation of the pterygomasseteric sling through holes in the gonial region.(5)(Fig. 8) Case #3 had a diminutive and mostly cortical area on the contralateral osteotomy side, with rotation of the segments in three planes; there was considerable space between the segments but no space for bicortical screw osteosynthesis. Delayed union was also observed after revision surgery, involving extensive osteosynthesis plus addition of a cancellous bone block and particulate cancellous bone between the repositioned segments.(Fig. 5)Nikolas de Meurechy NW.indd 276 05-06-2024 10:15