A 6 year old boy was brought to our hospital with a complaint of decreased mouth opening and facial deformity. No history of trauma elicited by his parents. Extra oral examination revealed severely retruded mandible, flattened lower face and complete restriction in mouth opening.
OPG revealed obliterated right joint space elongated coronoid process, reduced ramal height and prominent antegonial notch. The case was diagnosed as true right TMJ bony ankylosis with developing secondary facial deformity.
Maxillofacial Surgeon Dr. S. M. Balaji successfully performed gap arthroplasty using temporalis flap interpositioning. Followed by active physiotherapy, mouth opening improved dramatically. But patient failed to be on regular follow up.
After 9 years, exactly at the age of 15, patient reported with the complaint of restricted mouth opening, severe secondary facial deformity and retruded chin giving bird face appearance.
On thorough clinical and radiological examination, it was diagnosed as left TMJ ankylosis with functional right pseudo joint. Dr. S. M. Balaji performed left gap arthroplasty and bilateral condylar component reconstruction using 5th and 7th costochondral rib graft (CCG).
Postoperative mouth opening was adequate. Over 8 years follow up, bilateral CCG was favorable and lower facial projection was improved significantly with increased mouth opening.
OPG revealed obliterated right joint space elongated coronoid process, reduced ramal height and prominent antegonial notch. The case was diagnosed as true right TMJ bony ankylosis with developing secondary facial deformity.
Maxillofacial Surgeon Dr. S. M. Balaji successfully performed gap arthroplasty using temporalis flap interpositioning. Followed by active physiotherapy, mouth opening improved dramatically. But patient failed to be on regular follow up.
After 9 years, exactly at the age of 15, patient reported with the complaint of restricted mouth opening, severe secondary facial deformity and retruded chin giving bird face appearance.
On thorough clinical and radiological examination, it was diagnosed as left TMJ ankylosis with functional right pseudo joint. Dr. S. M. Balaji performed left gap arthroplasty and bilateral condylar component reconstruction using 5th and 7th costochondral rib graft (CCG).
Postoperative mouth opening was adequate. Over 8 years follow up, bilateral CCG was favorable and lower facial projection was improved significantly with increased mouth opening.
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