Long-term management for TMJ ankylosis in a young child after arthroplasty

DOI 2 Citations 11 References
  • SUZUKI Hidehiro
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Science
  • TAKAGI Ritsuo
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Science
  • KOBAYASHI Tatsuaki
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Science
  • FUKUDA Jun-Ichi
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Science
  • YAMADA Kazuhiro
    Division of Orthodontics, Niigata University Graduate School of Medical and Dental Science
  • HANADA Kooji
    Division of Orthodontics, Niigata University Graduate School of Medical and Dental Science

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Other Title
  • 顎関節授動術後，長期管理を行った小児顎関節強直症の１例

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Abstract

In general, temporomandibular joint (TMJ) ankylosis occurs in childhood as a result of inflammation and/or trauma around the TMJ. This ankylosis, with limitation of the range of motion, inhibits mandibular growth gradually. In this presentation, we report a case of TMJ ankylosis that was managed for a long time after surgical mandibular mobilization. The patient was a girl of age 5 years and 3 months, with trismus and jaw asymmetry. She had a history of trauma to her mental region at age 17 months. Her mother had noticed her trismus at one year after the trauma. At the first visit, the range of mouth opening was only 5mm at the interincisors, and it was deviated 3mm to the left. On CT appearances, the left condylar head of the mandibular bone and mandibular fossa of the temporal bone were morphologically changed to an irregular radio-opaque mass. We performed an arthroplasty on the mandibular ramus, to get the enough movement of the mandible, at the age of 5 years and 8 months. As a result of long-term management after the arthroplasty, we gained some findings, as follows: 1. Asymmetry of the mental region of the mandible was increased to the left within a year after surgery. 2. The range of motion of the mandible was also increased, to approximately 30mm, within a year, and after that asymmetry of the mental region was almost stable. We think the mandibular growth of the left side was gradually improved to some degree because of the jaw function. 3. On CT appearances before her orthognathic surgery, bony fusion between the condylar head and the mandibular fossa was revealed. 4. There has been no abnormal finding morphologically and functionally on her right TMJ.

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