An 18-year-old girl was brought to our hospital by her parents for expert treatment of her jaw joint defect. The girl had severely restricted mouth opening and her lower jaw deviated to one side when she opened her mouth. She had great difficulty in eating and speaking. She gave a history of a fall injury to her chin in her childhood.
A 3D CT scan revealed temporomandibular joint ankylosis of the right side. Maxillofacial Surgeon Dr. S.M. Balaji successfully treated the jaw joint defect using gap arthroplasty with temporalis fascia interpositioning and contralateral coronoidectomy. Under GA, Al-Kayat-Bramley’s incision (Preauricular incision) was made on the right side; a superior limiting cut was made along the demarcation between the rim of the glenoid fossa and the ankylosed head. The ankylotic mass was removed. Intraoral coronoidectomy on the contralateral side i.e. the left side was done to facilitate good mouth opening. On the right side, the temporalis muscle was rotated and folded inwards into the joint cavity and taken between the medial surface of the ramus taking good care of the adjacent mandibular nerve, facial and maxillary arteries. Then the muscle end was sutured to the medial side of the mandible to provide a submandibular anchorage. A suction drain was placed and the wound was closed in layers. Following surgery mouth-opening improved considerably and the girl and her parents are very happy with the surgery outcome.
A 3D CT scan revealed temporomandibular joint ankylosis of the right side. Maxillofacial Surgeon Dr. S.M. Balaji successfully treated the jaw joint defect using gap arthroplasty with temporalis fascia interpositioning and contralateral coronoidectomy. Under GA, Al-Kayat-Bramley’s incision (Preauricular incision) was made on the right side; a superior limiting cut was made along the demarcation between the rim of the glenoid fossa and the ankylosed head. The ankylotic mass was removed. Intraoral coronoidectomy on the contralateral side i.e. the left side was done to facilitate good mouth opening. On the right side, the temporalis muscle was rotated and folded inwards into the joint cavity and taken between the medial surface of the ramus taking good care of the adjacent mandibular nerve, facial and maxillary arteries. Then the muscle end was sutured to the medial side of the mandible to provide a submandibular anchorage. A suction drain was placed and the wound was closed in layers. Following surgery mouth-opening improved considerably and the girl and her parents are very happy with the surgery outcome.
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