True bony TMJ ankylosis in children: Case report

Highlights • Ankylosis in children can affect growth, function, esthetic. • Un observed or missed facial trauma in children can end with serious complication. • Re-ankylosis is convoluted bothersome complication should kept in mind. • Mouth opening should be at maximum range by the end of surgery. • Patient follow up is mandatory for a period of time.
Introduction The clinical importance of ankylosis in children is concerning with its massive effect and disturbance on the mandibular future growth causing gross deformity apart from the limited mouth opening. Trauma is the most common cause of bony and fibrous ankylosis. History, physical examination and radiographical examination of each patient with ankylosis of TMJ is mandatory in arriving to a final diagnosis, severity, involvement of adjacent structures and ultimately to plan the treatment. Case presentation Ten years old girl presented with her family seeking solution for a severely limited mouth opening. From the history, the child has suffered from height fall at the age of 4 years. She had complained from swelling and pain near the ear, treated by analgesics, gradually subsided and neglected. This limitation affects on feeding and had an impact on the child's health, seeking for management for the condition became mandatory. Clinical examination, radiographical examination is prepared in beside that ethical approval with full discussion with the parents done. Blind nasal intubation done. Discussion Patients with true bilateral ankylosis are considered as the aggressive type. It’s not just because of ankylosis. Surgeons should keep in their minds that well experienced anesthetist is important; also extension of the ankylosed bone with amount of cutting is important and re ankylosis as a complication must be avoided. Conclusion The surgeons agree with the statement that success in the preventing reankylosis after TMJ gap arthroplasty. Its primarily refers to the early postoperative physiotherapy, maintained on a long term.