Bilateral Lateral Arthroplasty in a Growing Patient for Type III TMJ Ankylosis
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CLINICAL REPORT
Bilateral Lateral Arthroplasty in a Growing Patient for Type III TMJ Ankylosis Mahesh Goel1 • V. Ashwin1
•
Narwade Pallavi Uddhav1
Received: 10 October 2020 / Accepted: 3 November 2020 Ó Association of Otolaryngologists of India 2020
Abstract A 10 year old male patient reported with a chief complaint of inability to open mouth since 4 years. There was a history of fall from height, following which there was progressive limitation in mouth opening and jaw movements. Clinically there was maximal mouth opening (MMO) of 1–2 mm with restricted protrusive and laterotrusive jaw movements. On radiographic evaluation, there was a bifid condyle appearance which showed a medially displaced condyle along with complete lateral fusion of joint components bilaterally. With a diagnosis of Sawhney’s type III ankylosis, lateral arthroplasty was planned under G.A. for both sides. On 2 years follow-up MMO of 30–34 mm was maintained along with unrestricted protrusive and bilateral laterotrusive movements. In this case, we show that the comparatively less invasive treatment plan of lateral arthroplasty involving preservation of medial condylar stump is adequate for the return of TMJ movements to near normalcy.
maintenance of oral hygiene and plays a major role in patient’s nourishment status [1]. In 1986, Sawhney was the first to classify TMJ ankylosis radiographically into four types according to the anatomical relationships between the TMJ structure and the osseous fusion [2]. In 1998, Nitzan et al. reported a series of four patients with ankylosis type III underwent a bone fusion resection, and the medially displaced condyles were retained and left in that position [3].Normal functionality of the TMJ was restored for all patients and normal development of mandibles were noticed in two young patients. Hence, it is believed that whenever the anatomy of the medially displaced condyle is maintained and there is evidence of ankylosis affecting only the lateral part of the joint in ankylosis type III cases, the condyle can be excluded from osteotomy and retained rather than removing and replaced by a graft [4]. In this article, we report a case of type III ankylosis managed by lateral arthroplasty bilaterally in a 10 year old male patient.
Keywords Ankylosis Medial condyle Preservation Lateral arthroplasty Mouth opening
Case Report Introduction Variety of diseases affect temporomandibular joint leading to Mandibular hypomobility disorders. Ankylosis of the temporomandibular joint (TMJ) is a disabling condition that causes problems in chewing, speech, appearance, & V. Ashwin [email protected] 1
Pandit Bhagwat Dayal Sharma Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001, India
A 10 year old male patient reported with a chief complaint of inability to open mouth since 4 years with a history of fall from height of 5 feet following which there was progressive limitation in mouth opening and jaw movements. Patient seeked second opinion as no improvement had been attained by physiotherapy as a
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