Surgical management of the temporomandibular joint in resection of regional tumors.

The temporomandibular joint (TMJ) may require surgical violation or resection when involved in primary malignant or benign tumors of bone, regional tumors of the oral cavity adjacent to the mandible or with mandibular erosion, or in soft tissue tumors around the joint. The TMJ may require total resection with or without reconstruction, subtotal resection with preservation of the glenoid fossa and meniscus, resection of the capsule with dermal graft reconstruction, condylar resection with reconstruction, or subcondylar resection with mandibular reconstruction. TMJ anatomy is important in using joint structures as margins in resection of tumors, in preservation of uninvolved structures to obtain maximum joint function after surgery, and in reconstruction of ablated structures to reestablish joint function. Surgical cases are presented to illustrate surgical management and rehabilitation of the TMJ.