Maxillofacial Surgeon Dr. S. M. Balaji planned to open her mouth by following gap arthroplasty with temporalis muscle interpositioning. Under GA, Al-Kayat-Bramley’s incision (Preauricular incision) was made on the left 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. After ressecting the callous, the gap was further widened by removing adequate bone.
On the left 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 is placed for 24-36 hrs and the wound was closed in layers. Results are immediate and mouth opening of width up to 44mm was achieved. Patient is put on post surgery physiotherapy to maintain the mouth opening.