Masaya Akashi1, Toshinori Sekitani2, Yumi Ohtsuki3, Yasumasa Kakei3, Junya Kusumoto3, Takumi Hasegawa3, Michinori Maeda4, Noriyuki Negi2, Kazunobu Hashikawa5, Yasuyuki Shibuya4, Satoru Takahashi2, Takahide Komori3. 1. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine (Chief: Prof. Komori Takahide), Kobe, Japan. Electronic address: akashim@med.kobe-u.ac.jp. 2. Department of Radiology, Kobe University Hospital (Chief: Prof. Satoru Takahashi), Kobe, Japan. 3. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine (Chief: Prof. Komori Takahide), Kobe, Japan. 4. Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences (Chief: Prof. Yasuyuki Shibuya), Nagoya, Japan. 5. Department of Plastic Surgery, Kobe University Graduate School of Medicine (Chief: Prof. Hiroto Terashi), Kobe, Japan.
Abstract
OBJECTIVE: Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction. METHODS: We enrolled seven healthy volunteers (median age 30 years, range 27-38 years) and seven patients (median age 65 years, range 52-80 years), who underwent mandibulectomy (segmental in five, hemi in one, marginal in one) and free flap reconstruction (using the fibula in six and the radial forearm in one). Six study subjects were instructed to masticate a cookie during the 4DCT scan (the seventh made chewing motions). The distance between the most anterior and posterior positions of the bilateral condyles on 4DCT (axial view) images was then measured and compared between controls and patients using the Mann-Whitney U-test. RESULTS: The crosswise difference in the distances of condylar protrusion was significantly greater in patients than in the controls. CONCLUSION: Axial 4DCT images can visualize a bilateral condylar protrusive path. Axial 4DCT images for patients who have undergone mandibulectomy and reconstruction may be useful for evaluation of functional movement of condyles.
OBJECTIVE: Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction. METHODS: We enrolled seven healthy volunteers (median age 30 years, range 27-38 years) and seven patients (median age 65 years, range 52-80 years), who underwent mandibulectomy (segmental in five, hemi in one, marginal in one) and free flap reconstruction (using the fibula in six and the radial forearm in one). Six study subjects were instructed to masticate a cookie during the 4DCT scan (the seventh made chewing motions). The distance between the most anterior and posterior positions of the bilateral condyles on 4DCT (axial view) images was then measured and compared between controls and patients using the Mann-Whitney U-test. RESULTS: The crosswise difference in the distances of condylar protrusion was significantly greater in patients than in the controls. CONCLUSION: Axial 4DCT images can visualize a bilateral condylar protrusive path. Axial 4DCT images for patients who have undergone mandibulectomy and reconstruction may be useful for evaluation of functional movement of condyles.