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Case Reports
. 2018 Aug;18(3):e379-e382.
doi: 10.18295/squmj.2018.18.03.019. Epub 2018 Dec 19.

A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

Issa K Al-Nuumani  1 , Abdulaziz Bakathir  2 , Ahmed Al-Hashmi  3 , Mohammed Al-Abri  4 , Hussein Al-Kindi  5 , Intisar Al-Macki  6 , Zainab Al-Balushi  7
Affiliations
Case Reports

A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

Issa K Al-Nuumani et al. Sultan Qaboos Univ Med J. 2018 Aug.

Abstract

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.

Keywords: Case Report; Obstructive Sleep Apnea; Oman; Retrognathia; Temporomandibular Ankylosis; Temporomandibular Joint Disorders.

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Figures

Figure 1
Figure 1
Preoperative photographs of a nine-year-old boy showing (A) limited mouth opening and (B) mandibular retrognathia.
Figure 2
Figure 2
A: Preoperative orthopantomogram of a nine-year-old boy showing unilateral temporomandibular joint ankylosis. B: Preoperative lateral neck imaging showing obstructed airway space.
Figure 3
Figure 3
A: Postoperative orthopantomogram of a nine-year-old boy showing adequate joint space with a costochondral graft in situ. B: Postoperative lateral neck imaging showing adequate airway space.
Figure 4
Figure 4
Postoperative photographs of a nine-year-old boy demonstrating (A) optimal mouth opening and (B) good facial symmetry. The photographs were taken a few days apart.
See this image and copyright information in PMC

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