Ankylosis of the temporo-mandibular joint after temporal craniotomy: a cause of difficult intubation

  • T. J. Coonan
  • C. E. Hope
  • W. J. Howes
  • R. O. Holness
  • E. L. Maclnnis
Article

Abstract

It is not generally appreciated that surgery in the region of the temporal fossa commonly produces, within a few weeks, a contracture of the temporalis muscle with “pseudo” ankylosis of the jaw. This usually, but not always, resolves within six months. The aetiotogical possibilities include, singly or in combination:
  1. 1.

    Postincisional scar formation within the muscle.

     
  2. 2.

    A Volkman’s contracture due to devascularization of the muscle.

     
  3. 3.

    Organization of haematoma.

     
It is recommended that active and passive jaw exercises be started early after surgery in the temporal fossa and that such postcraniectomy patients be carefully assessed for jaw ankylosis prior to undertaking anaesthesia.

Key words

INTUBATION ENDOTRACHEAL difficult SURGERY craniotomy complications joint ankylosis 

Résume

Il n’est généralement pas reconnu qu’une chirurgie dans la région de la fosse temporale peut produire souvent, en quelques semaines, une contraction du muscle temporal avec une “pseudo” ankylose de la mâchoire. Souvent, mais pas toujours, celle-ci se dissipe en-dedans de six mois. Les possibilités étiologiques incluent un ou une combinaison des facteurs suivants:
  1. 1.

    La formation de cicatrice musculaire post-incisionnelle.

     
  2. 2.

    Une contracture de Volkman par dévascutarisation du muscle.

     
  3. 3.

    L’organisation d’un hématome. Il est recommandé de commencer aussitôt que possible après la chirurgie sur la fosse temporale des exercices passifs et actifs. Les patients post crânieclomie doivent être soigneusement évalués pour l’ankylose de la mâchoire avant d’entreprendre l’anesthésie.

     

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Copyright information

© Canadian Anesthesiologists 1985

Authors and Affiliations

  • T. J. Coonan
    • 1
  • C. E. Hope
    • 1
  • W. J. Howes
    • 1
  • R. O. Holness
    • 1
  • E. L. Maclnnis
    • 1
  1. 1.From the Departments of AnaesthesiaNeurosurgery and Oral Surgery, Dalhousie UniversityCanada

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