Restoration of Functioning of Ankylosed TMJ by Inter Positional Arthroplasty with Temporalis Muscle Flap – A Case Report

Abstract

Ankylosis of TMJ is a disorder in which a stiff joint makes the mouth opening restricted. The restriction of mouth opening is mostly due to union between the condylar head and the glenoid foss of temporal bone. The most common etiology for this ankylosis is trauma. The other causes include local and systemic infections, inflammations, neoplasms, previous TMJ surgeries and congenital syndromes. This ankylosis alters the entire life style of the affected person because of its additional clinical presentations like speech, chewing, facial appearance disfigurements. If affected in the growth phase during early childhood, it may lead to deformations in the mandibular growth leading to facial asymmetry. Hence, early diagnosis and surgical intervention are of critical importance in the management of TMJ ankylosis. The surgical therapy usually aims to achieve joint movement with optimal mouth opening and without any recurrences. Joint reconstruction, interpositional arthroplasty and gap arthroplasty are the three main surgical treatment options. Inspite of availability of various alloplastic and autogenous graft materials, interpositioning of the temporalis muscle flap to the joint space offers specific advantages like ease of harvesting, comparatively less morbidity of donor site, and adequate coverage of surgical site. The efficiency and efficacy of this temporalis muscle flap is highlighted in the present case report of surgical management of unilateral TMJ ankylosis.