Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 650-655
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.650
Application of computer-assisted navigation in treating congenital maxillomandibular syngnathia: A case report
Li-Qin Lin, Shan-Shan Bai, Min Wei
Li-Qin Lin, Shan-Shan Bai, Min Wei, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
Author contributions: Lin LQ and Bai SS are co-first authors and contributed equally to this work; all authors contributed to this work.
Supported by Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine "Multi-Disciplinary Team" Clinical Research Project, No. 201701011.
Informed consent statement: The relatives of the individual in this manuscript have provided informed written consent to publish this case.
Conflict-of-interest statement: The authors have no conflicts of interest to declare. None of the authors have received funding from any organization with a real or potential interest in the subject matter, materials, equipment, software, or devices discussed.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Min Wei, MD, PhD, Doctor, Full Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China. drwm1010@sina.com
Telephone: +86-137-01671615
Received: November 9, 2018
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
Processing time: 117 Days and 15.9 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Application of computer-assisted navigation can significantly improve accuracy, effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.

Keywords: Craniofacial abnormalities; Mandibular diseases; Maxilla; Computer-assisted navigation; Case report

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.