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Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge

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Abstract

Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management.

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References

  1. Roy Choudhury A, Parkash H, Trikha A (1999) Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87(2):166–169

    Article  CAS  Google Scholar 

  2. Li Z, Li ZB, Li JR (2007) Surgical management of posttraumatic temporomandibular joint ankylosis by functional restoration with disk repositioning in children. Plast Reconstr Surg 119(4):1311–1316

    Article  CAS  PubMed  Google Scholar 

  3. Sahoo NK, Tomar K, Kumar A, Roy ID (2012) Selecting reconstruction option for TMJ ankylosis: a surgeon’s dilemma. J Craniofac Surg 23(6):1796–1801

    Article  PubMed  Google Scholar 

  4. Maki MH, Al-Assaf DA (2008) Surgical management of temporomandibular joint ankylosis. J Craniofac Surg 19(6):1583–1588

    Article  PubMed  Google Scholar 

  5. Dimitroulis G (2012) Temporomandibular joint surgery: what does it mean to India in the twenty-first century? J Maxillofac Oral Surg 11(3):249–257

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vas L, Sawant P (2001) A review of anaesthetic technique in 15 paediatric patients with temporomandibular joint ankylosis. Paediatr Anaesth 11(2):237–244

    Article  CAS  PubMed  Google Scholar 

  7. Sarma UC, Dave PK (1991) Temporomandibular joint ankylosis: an Indian experience. Oral Surg Oral Med Oral Pathol 72(6):660–664

    Article  CAS  PubMed  Google Scholar 

  8. Miyamoto H, Kurita K, Ogi N, Ishimaru J, Goss AN (2000) The effect of an intra-articular bone fragment in the genesis of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 29(4):290–295

    Article  CAS  PubMed  Google Scholar 

  9. Jayavelu P, Shrutha SP, Vinit GB (2014) Temperomandibular joint ankylosis in children. J Pharm Bioallied Sci 6(Suppl 1):S178–S181

    Article  PubMed  PubMed Central  Google Scholar 

  10. Arakeri G, Kusanale A, Zaki GA, Brennan PA (2012) Pathogenesis of post-traumatic ankylosis of the temporomandibular joint: a critical review. Br J Oral Maxillofac Surg 50(1):8–12

    Article  PubMed  Google Scholar 

  11. Kumar R, Hota A, Sikka K, Thakar A (2013) Temporomandibular joint ankylosis consequent to ear suppuration. Indian J Otolaryngol Head Neck Surg 65(Suppl 3):627–630

    Article  PubMed  PubMed Central  Google Scholar 

  12. Güven O (2008) A clinical study on temporomandibular joint ankylosis in children. J Craniofac Surg 19(5):1263–1269

    Article  PubMed  Google Scholar 

  13. Guruprasad Y, Hemavathy OR (2012) Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis. Contemp Clin Dent 3(1):69–73

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yan YB, Liang SX, Shen J, Zhang JC, Zhang Y (2014) Current concepts in the pathogenesis of traumatic temporomandibular joint ankylosis. Head Face Med 10:35

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wang X, Wang XX, Liang C, Yi B, Lin Y, Li ZL (2003) Distraction osteogenesis in correction of micrognathia accompanying obstructive sleep apnea syndrome. Plast Reconstr Surg 112(6):1549–1557 discussion 1558-9

    Article  PubMed  Google Scholar 

  16. Shah FR, Sharma KR, Hilloowalla RN, Karandikar AD (2002) Anaesthetic considerations of temporomandibular joint ankylosis with obstructive sleep apnoea: a case report. J Indian SocPedodPrev Dent 20(1):16–20

    CAS  Google Scholar 

  17. Moss ML, Salentijn L (1969) The capsular matrix. Am J Orthod 56(5):474–490

    Article  CAS  PubMed  Google Scholar 

  18. Al-Kayat A, Bramley P (1979) A modified pre-auricular approach to the temporomandibular joint and malar arch. Br J Oral Surg 17(2):91–103

    Article  CAS  PubMed  Google Scholar 

  19. Sawhney CP (1986) Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg 77(1):29–40

    Article  CAS  PubMed  Google Scholar 

  20. Kaban LB, Perrott DH, Fisher K (1990) A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 48(11):1145–1151 discussion 1152

    Article  CAS  PubMed  Google Scholar 

  21. Kaban LB, Bouchard C, Troulis MJ (2009) A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg 67(9):1966–1978

    Article  PubMed  Google Scholar 

  22. Nogueira RV, Vasconcelos BC (2007) Facial nerve injury following surgery for the treatment of ankylosis of the temporomandibular joint. Med Oral Patol Oral Cir Bucal 12(2):E160–E165

    PubMed  Google Scholar 

  23. Sunder RA, Haile DT, Farrell PT, Sharma A (2012) Pediatric airway management: current practices and future directions. Paediatr Anaesth 22(10):1008–1015

    Article  PubMed  Google Scholar 

  24. Fiadjoe J, Stricker P (2009) Pediatric difficult airway management: current devices and techniques. Anesthesiol Clin 27(2):185–195

    Article  PubMed  Google Scholar 

  25. Patino M, Sadhasivam S, Mahmoud M (2013) Obstructive sleep apnoea in children: perioperative considerations. Br J Anaesth 111(Suppl 1):i83–i95

    Article  PubMed  Google Scholar 

  26. Schwengel DA, Sterni LM, Tunkel DE, Heitmiller ES (2009) Perioperative management of children with obstructive sleep apnea. Anesth Analg 109:60–75

    Article  PubMed  Google Scholar 

  27. Isono S (2006) Developmental changes of pharyngeal airway patency: implications for pediatric anesthesia. Paediatr Anaesth 16:109–122

    Article  PubMed  Google Scholar 

  28. Raj D, Luginbuehl I (2015) Managing the difficult airway in the syndromic child. Cont Edu Anaesth Crit Care Pain 15(1):7–13

    Article  Google Scholar 

  29. Graciano AL, Tamburro R, Thompson AE, Fiadjoe J, Nadkarni VM, Nishisaki A (2014) Incidence and associated factors of difficult tracheal intubations in pediatric ICUs: a report from National Emergency Airway Registry for children: NEAR4KIDS. Intensive Care Med 40(11):1659–1669

    Article  PubMed  Google Scholar 

  30. Valois-Gómez T1, Oofuvong M, Auer G, Coffin D, Loetwiriyakul W, Correa JA (2013) Incidence of difficult bag-mask ventilation in children: a prospective observational study. Paediatr Anaesth 23(10):920–926

    Article  PubMed  Google Scholar 

  31. K M, Rupa LM, Krishna Murthy SG, P G G, U B (2012) Anaesthesia for TMJ ankylosis with the use of TIVA, followed by endotracheal intubation. J Clin Diagn Res 6(10):1765–1767

    PubMed  PubMed Central  Google Scholar 

  32. Kang JM, Lee KW, Kim DO, Yi JW (2013) Airway management of an ankylosing spondylitis patient with severe temporomandibular joint ankylosis and impossible mouth opening. Korean J Anesthesiol 64(1):84–86

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sims C, von Ungern-Sternberg BS (2012) The normal and the challenging pediatric airway. Paediatr Anaesth 22(6):521–526

    Article  PubMed  Google Scholar 

  34. Weiss M, Engelhardt T (2010) Proposal for the management of the unexpected difficult pediatric airway. Paediatr Anaesth 20(5):454–464

    Article  PubMed  Google Scholar 

  35. McNiece WL, Dierdorf SF (2004) The pediatric airway. Semin Pediatr Surg 13(3):152–165

    Article  PubMed  Google Scholar 

  36. Gupta K, Jain M, Gupta PK, Rastogi B, Saxena SK, Manngo A (2012) Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: a randomized clinical trial. Saudi J Anaesth. 6(3):219–223

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kundra P, Vasudevan A, Ravishankar M (2006) Video assisted fiberoptic intubation for temporomandibularankylosis. Paediatr Anaesth 16(4):458–461

    Article  PubMed  Google Scholar 

  38. Varughese I, Varughese PI, Soman T, Mathew J (2011) Fluroscopic assisted airway intubation in temporomandibular joint ankylosis: a novel technique. Saudi J Anaesth 5(2):226–228

    Article  PubMed  PubMed Central  Google Scholar 

  39. Dhasmana S, Singh V, Pal US (2010) Awake blind nasotracheal intubation in temporomandibular joint ankylosis patients under conscious sedation using fentanyl and midazolam. J Maxillofac Oral Surg 9(4):377–381

    Article  PubMed  Google Scholar 

  40. Arora MK, Karamchandani K, Trikha A (2006) Use of a gum elastic bougie to facilitate blind nasotracheal intubation in children: a series of three cases. Anaesthesia 61(3):291–294

    Article  CAS  PubMed  Google Scholar 

  41. Viitanen H, Annila P, Viitanen M, Tarkkila P (1999) Premedication with midazolam delays recovery after ambulatory sevoflurane anesthesia in children. Anesth Analg 89:75–79

    CAS  PubMed  Google Scholar 

  42. Luscri N, Tobias JD (2006) Monitored anesthesia care with a combination of ketamine and dexmedetomidine during magnetic resonance imaging in three children with trisomy 21 and obstructive sleep apnea. Paediatr Anaesth 16:782–786

    Article  PubMed  Google Scholar 

  43. Aiello G, Metcalf I (1992) Anaesthetic implications of temporomandibular joint disease. Can J Anaesth 39(6):610–616

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anaesthesiology and Critical Care, AIIMS, Ansari Nagar, New Delhi, 110029, India

    Devalina Goswami, Dalim Baidya & Chhavi Sawhney

  2. Department of Oral and Maxillofacial Surgery, AIIMS, Ansari Nagar, New Delhi, 110029, India

    Sweta Singh & Ongkila Bhutia

  3. Quarter 17, Type 5, Lodhi Road Complex, New Delhi, 110001, India

    Devalina Goswami

Authors
  1. Devalina Goswami
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  2. Sweta Singh
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  3. Ongkila Bhutia
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  4. Dalim Baidya
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  5. Chhavi Sawhney
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Correspondence to Devalina Goswami.

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Goswami, D., Singh, S., Bhutia, O. et al. Management of Young Patients with Temporomandibular Joint Ankylosis—a Surgical and Anesthetic Challenge. Indian J Surg 78, 482–489 (2016). https://doi.org/10.1007/s12262-016-1551-5

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  • DOI: https://doi.org/10.1007/s12262-016-1551-5

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