Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.650
Peer-review started: November 13, 2018
First decision: December 29, 2018
Revised: January 28, 2019
Accepted: January 29, 2019
Article in press: January 30, 2019
Published online: March 6, 2019
Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion. However, surgical procedures for this disease are rarely reported.
Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour, the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.
Application of computer-assisted navigation can significantly improve accuracy, effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.
Core tip: Congenital maxillomandibular fusion is a rare anomaly of the craniofacial region. We report a 7-mo-old girl with bilateral maxillomandibular syngnathia. We performed bony isolation by computer-assisted navigation, a first-of-its-kind treatment approach for syngnathia. The operation time was minimized by at least one hour, and the patient's blood vessels, nerves, and tooth germs were well protected, and bleeding was minimized. There were major improvements in the patient's status. We concluded that application of computer-assisted navigation can significantly improve accuracy, effectiveness, and surgical safety in difficult-to-treat deformity.