The sequential management of recurrent temporomandibular joint ankylosis in a growing child: a case report

Abstract

BackgroundTemporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible.Case reportThis is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed.ConclusionsThis is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.

Early Stage Physical Therapy After Ankylosing Temporomandibular Joint Surgery: A Multidisciplinary Approach: Case Report

“…Olguda uyguladı-ğımız gap artroplasti tekniğinin ise operasyon sü-resinin kısalığı ve basit bir prosedür olması gibi avantajlarının yanında; psödoartroz oluşması, ön ya da yan açık kapanışların meydana gelmesi, yüksek nüks olasılığı gibi dezavantajları mevcuttur. 24 Bütün bu dezavantajların postoperatif dönemde uygulanacak sistematik fizyoterapi protokolü ile giderilmesi hedeflenmiştir.…”

Treatment of Ankylosis in Children Associated With Osteogenic Distraction: Literature Review and Case Report

“…A necessary complement of surgical treatment is physical therapy (intensive exercise of opening the mouth). Based on the functional matrix theory of Moss [2,[22][23][24], surgical and functional restoration of both adjacent joint and adjacent soft tissues releases the growth potential of the mandible and may prevent the development of the deformity.…”

Correction of Malocclusion by Botulinum Neurotoxin Injection into Masticatory Muscles

“…This bone connects with the cranial bone by the articulation of TMJ [ 29 ]. In addition, mandible can be moved by the symmetric movement of TMJ and activation of both sides of masticatory muscles [ 33 ]. Disruption of this harmonious masticatory muscle function and movement of mandible affects the symmetric growth of maxillofacial bones [ 34 ].…”