# Temporomandibular Joint Ankylosis in a Three-Year-Old Female: Anaesthesia, Airway Management, and Mandibular Distraction Osteogenesis

## TL;DR

This case report details the challenges and treatment of TMJ ankylosis in a young child, emphasizing the importance of early diagnosis and multidisciplinary care.

## Contribution

The report highlights the use of mandibular distraction osteogenesis and awake fiberoptic intubation in managing TMJ ankylosis in a pediatric patient.

## Key findings

- Mandibular distraction osteogenesis and awake fiberoptic intubation were successfully used in the surgical and anaesthetic management.
- A multidisciplinary approach, including otorhinolaryngology support, was crucial for managing complications like obstructive sleep apnea.
- Prompt diagnosis and treatment are essential to avoid life-altering complications and improve patient well-being.

## Abstract

Temporomandibular joint (TMJ) ankylosis is generally characterised by a complex aetiology, with several contributing causes, including infections, autoimmune diseases, trauma, and congenital anomalies. This case report describes a three-year-old female suffering from traumatic temporomandibular ankylosis with retrognathia, severe mouth-opening restriction, and obstructive sleep apnea (OSA). The present case highlights the difficulties with TMJ ankylosis, especially when access to healthcare is sought out late and delayed diagnosis is prevalent. Mandibular distraction osteogenesis and awake fiberoptic intubation were used in the surgical and anaesthetic management of this case, with the otorhinolaryngology team on standby to perform a tracheostomy if required, highlighting the necessity of a multidisciplinary approach in such cases. Patients with TMJ ankylosis have significant life-altering changes, including psychological stress, chewing difficulty, speech difficulties, facial distortion, and speech impediment. When OSA progresses, it also presents more health risks. For the purpose of treating TMJ ankylosis, avoiding serious problems, and enhancing patient well-being, prompt diagnosis and therapy are crucial. In order to optimise patient results, this case study highlights the need for knowledge and research in the treatment of TMJ ankylosis as well as the requirement of medical professionals working together in a synergistic way.