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53209 - Glenoid Fossa and Zygomatic Reconstruction

MBS service description:

Glenoid fossa, zygomatic arch and temporal bone, reconstruction of (Obwegeser technique) (H) (Anaes.) (Assist.)
Schedule Fee:
1878.75
@85% Benefit Fee:
@75% Benefit Fee:
Last updated on
March 28, 2025

When is item code 53209 (Glenoid Fossa and Zygomatic Reconstruction) typically used?

The need for reconstruction of the glenoid fossa, zygomatic arch, and temporal bone using the Obwegeser technique arises when a patient suffers severe trauma, congenital deformity, or pathology—such as fractures or tumour resection—affecting these structures, requiring complex surgical rebuilding under anesthesia with assistance in a hospital to restore the TMJ’s socket, cheekbone contour, and cranial support. This procedure is indicated for extensive damage to this region, critical in the maxillofacial framework where these bones support jaw movement, facial aesthetics, and cranial integrity.

Several scenarios underscore the necessity of this intervention:

  • Severe trauma: A high-impact facial injury fracturing the zygomatic arch and glenoid fossa might impair jaw motion and facial shape, necessitating reconstruction to realign the TMJ and cheekbone.
  • Congenital deformity: Conditions like hemifacial microsomia could result in an underdeveloped glenoid fossa or zygomatic arch, requiring surgical enhancement to improve symmetry and function.
  • Post-surgical defect: Removal of a temporal bone tumour might leave a structural gap, prompting reconstruction to restore the cranial contour and TMJ stability.
  • Functional restoration: Loss of these structures could severely limit chewing or cause pain, driving the need to rebuild them for normal jaw mechanics.

For instance, a patient with a shattered zygomatic arch and glenoid fossa from a car accident might undergo this Obwegeser reconstruction to regain jaw mobility and facial symmetry, with the assistant ensuring precise bone alignment. In an aged care context, an elderly patient with a traumatic defect could benefit from this to restore chewing ability, adjusted for their frailty and bone quality. By reconstructing these critical structures using advanced techniques, this service restores TMJ function, enhances facial aesthetics, and supports cranial stability, making it an essential procedure for managing complex damage within the maxillofacial region.

Benefits to the patient

Restores TMJ function, improves facial contour, and supports cranial stability.

Recovery considerations

Recovery of 6-8 weeks with swelling, jaw restriction, and bone healing; hospital stay required.

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