Recurrent ankylotic mass treated with aggressive resection and myofascial flap with aggressive physiotherapy

Abstract

We are presenting a case with multiple recurring ankylosis, as the child had exhibited the clinical signs and symptoms of an ankylotic right temporomandibular joint. She was operated for the 1st time when she was 6 years old with poor compliance and was reoperated with a distraction unit when she was 10 years old. The research points out to frequent relapses in younger patients operated as they had less compliance relative to the adult ankylotic patients. Henceforth, we dealt with an aggressive approach of planning only on the resection of the mass and if the mouth opening ensues to progress with further correction of the asymmetry and the residual defect. The patient had nil mouth opening and hence was consented for tracheostomy, and fiber-optic intubation was arranged. The aggressive resection of the ankylotic mass was done and the cavity was lined with temporalis myofascial flap. This was followed by aggressive physiotherapy. The patient now has 28 mm of mouth opening and is continuing aggressive physiotherapy for the same. After 6 months of surgery, the patient is planned to undergo corrective jaw surgery for the asymmetry present.