Lateral Pterygoid Muscle Ossification After Intraoral Condylectomy

J Craniofac Surg. 2022 Oct 1;33(7):2122-2127. doi: 10.1097/SCS.0000000000008666. Epub 2022 Jun 29.

Abstract

Purpose: Lateral pterygoid muscle ossification has not been reported in condylectomy patients. This study aimed to explore the incidence, risk factors, and imaging characteristics of 38 cases with lateral pterygoid muscle ossification among 54 patients after condylectomy via intraoral approach.

Methods: This retrospective study included 54 patients following simultaneous orthognathic surgery and condylectomy with coronoid process resection via intraoral approach. The authors evaluated the preoperative, 1 week, 6 months, and 1 year or more postoperative computed tomographic (CT) scans for the presence of lateral pterygoid muscle ossification and its characteristics. Sex, age at the time of surgery, disease course, affected side, preoperative alkaline phosphatase, pathology diagnosis, the height of the removed condyle, condylar shape, operator, preoperative temporomandibular joint movement, and clinical symptoms were assessed as risk factors for ossification.

Results: No incidence of lateral pterygoid muscle ossification was found on preoperative CT images. Various small-size osseous masses were observed in the lateral pterygoid muscles on postoperative 6 months CT images in 38/54 patients (70.37%) after condylectomy. But no apparent enlargement of the osseous masses was found. No patients complained of clinical discomfort or functional disorder during the follow-up period (23.11 ± 13.16 months). No significant risk factors for ossification were found.

Conclusions: Lateral pterygoid muscle ossification is relatively common in patients after condylectomy via intraoral approach. However, its enlargement is self-limited and remains stable 6 months after surgery. it has no adverse effects on the temporomandibular joint functional movement.

MeSH terms

  • Alkaline Phosphatase
  • Humans
  • Mandibular Condyle / surgery
  • Orthognathic Surgical Procedures* / adverse effects
  • Ossification, Heterotopic* / etiology
  • Pterygoid Muscles* / diagnostic imaging
  • Pterygoid Muscles* / pathology
  • Pterygoid Muscles* / surgery
  • Retrospective Studies
  • Temporomandibular Joint / diagnostic imaging
  • Temporomandibular Joint / physiology
  • Temporomandibular Joint / surgery

Substances

  • Alkaline Phosphatase