TMJ Total Joint Prosthesis in Treacher Collins Syndrome and Hemifacial Microsomia

Patient-specific TMJ prostheses are increasingly being used to correct end-stage skeletal facial deformities in patients with mandibular malformations and syndromes like Treacher Collins or the spectrum of cases suffering from craniofacial microsomia (CFM). Both of these congenital craniofacial anomalies are frequently seen with hypoplastic growth of the ramus-condyle unit and/or glenoid fossa that is challenging to reconstruct. Total joint replacement (TJR) can predictably be combined with orthognathic surgery and completed in one or two stages. Virtual surgical planning has significantly enhanced predictability in these cases and plays a critical role in creating a custom-fitted prosthesis in the context of concomitant orthognathic surgery. This chapter will describe the sequencing and surgical protocol for combined orthognathic surgery and temporomandibular joint (TMJ) TJR surgery in patients with craniofacial microsomia and Treacher Collins syndrome.