Facial Deformity in an Operated Case of Bilateral Temporomandibular Joint Ankylosis.

Abstract

Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical objectives in the treatment of TMJ ankylosis are to establish joint movement, prevent relapse, and achieve normal growth and development. Here, we present an operated case ofsurgical correction of mandibular hypoplasia; however, the patient came back after three years due to unsatisfactory results and underwent bilateral coronoidectomy and gap arthroplasty. Bones were osteotomized at the LeFort I level and the maxillary segment was down-fracturedand mobilized to bring into occlusion with the mandible. In the present case, the lower pharyngeal airwaychanged from 5 mm pre-treatment to 10 mm post-treatment, and the facial angle was changed from 73 to 84 post-treatment. Assessment of the pharyngeal airwayis done with a high suspicion of obstructive sleep apnea and facial deformity is mandatory in the management of TMJ ankylosis.