TEMPOROMANDIBULAR JOINT ANKYLOSIS: A CASE REPORT

CASE REPORT: A 5-year-old boy reported with the complaint of inability to open mouth since two to three years. Parents didn't give any history of trauma or infection. Parents recognized the inability to open mouth only after the child started with solid diet. Extra oral examination revealed facial asymmetry with fullness of cheek on the right side. Mandible was micrognathic. The child showed almost nil mouth opening Radiographic examinations comprised of orthopantomogram and computerized tomography that revealed a lack of structural organization and obliteration of right TMJ space. Based on these findings, a diagnosis of unilateral right bony TMJ ankylosis was confirmed. TREATMENT: A sequential protocol for the treatment of TMJ ankylosis is based on aggressive resection of ankylotic mass. While respecting, a special approach has to be directed particularly from the medial aspect of the joint which is in close proximity with internal maxillary artery to ensure that bony, fibrous, and granulation tissues are completely removed. After complete evaluation, a surgical treatment with gap arthroplasty on right TMJ was planned under general anesthesia. Gap arthroplasty is a term used to describe the operation in which a section of bone is removed and no substance is interposed between the two cut bony surfaces. The surgical approach consisted of alkayat and bramley preauricular incision. Full thickness mucoperiosteal flap was reflected and the ankylotic mass was exposed. The section consisted of two horizontal osteotomy cuts which were placed at the level of joint (below the zygomatic arch) and