Abstract
Temperomandibular joint (TMJ) ankylosis is loss of joint movement that results from a union of the mandibular condyle to the base of the skull. Managing airway is considered to be one of the most difficult and challenging procedures when there is a diseased temperomandibular joint as a result of inadequate mouth opening. Although TMJ ankylosis is well known risk factors of difficult airway management, the techniques used are dependent on the expertise of the concerned anesthesiologists and available resources. Techniques used to secure airway in adults may not be ideal for children and sometimes dedicated equipment may not be available. In this case report we described a case of 14-year-old female patient diagnosed with bilateral TMJ ankylosis and who underwent surgery for left side temperomandibular ankylosis release and temperomandibular joint reconstruction under general anesthesia with a blind nasal intubation. Key words: Temporomandibular joint ankylosis, difficulty airway, blind nasal intubation.
Highlights
Temporomandibular joint ankylosis results in restricted or nil mouth opening and jaw function get affected (Sankar et al, 2016)
Deviation of mandible and chin on affected side, hypoplastic mandible with receiding chin and fullness of face on affected side are the features of unilateral Temperomandibular joint (TMJ) ankylosis (Choudhary and Gupta, 2014; Gayle et al, 2013)
The technique such as blind nasal intubation, retrograde intubation using a guide wire, intubating with the help of a fibreoptic laryngoscope, and the time tested tracheostomy have been used for a long time to manage airway (Sankar et al, 2016)
Summary
Temporomandibular joint ankylosis results in restricted or nil mouth opening and jaw function get affected (Sankar et al, 2016). Deviation of mandible and chin on affected side, hypoplastic mandible with receiding chin and fullness of face on affected side are the features of unilateral TMJ ankylosis (Choudhary and Gupta, 2014; Gayle et al, 2013) The technique such as blind nasal intubation, retrograde intubation using a guide wire, intubating with the help of a fibreoptic laryngoscope, and the time tested tracheostomy have been used for a long time to manage airway (Sankar et al, 2016). A 14-year-old female patient (40 kg, ASA physical status II) was admitted to the hospital by the maxillofacial surgeons for release of bilateral fibrous TMJ ankylosis under general anesthesia. She had painless gradual deformity since 3 years back. He understood that the patient’s information and findings are going to be published without his child name attached and the text and any pictures published in the article will be freely available on the internet and may be seen by the general public
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