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Case Reports
. 2023 Apr:105:108039.
doi: 10.1016/j.ijscr.2023.108039. Epub 2023 Mar 23.

Role of distraction osteogenesis and flip genioplasty to correct sleep apnea and aesthetics in long standing TMJ ankylosis - A case report

Murtaza Mohemadali Contractor  1 , Kalyani Bhate  2 , Pushkar P Waknis  3 , Sayali Awate  1 , Sherwin Samuel  1
Affiliations
Case Reports

Role of distraction osteogenesis and flip genioplasty to correct sleep apnea and aesthetics in long standing TMJ ankylosis - A case report

Murtaza Mohemadali Contractor et al. Int J Surg Case Rep. 2023 Apr.

Abstract

Introduction and importance: Temporomandibular joint (TMJ) ankylosis triad includes TMJ ankylosis, micrognathia, and obstructive sleep apnea (OSA) which is common in long-standing cases of TMJ ankylosis. Unilateral long-standing cases of TMJ ankylosis also result in a severe discrepancy in the midline of the chin.

Case presentation: A young adult female presented with restricted mouth opening and daylight sleepiness. Her AHI was mild and there was excessive facial disfigurement. Right-side TMJ ankylosis was diagnosed with compromised posterior airway space and Ramal height was also short on the affected side. Chin has severely deviated to the affected side.

Clinical discussion: Treatment protocols for TMJ ankylosis are different for different case scenarios. A proper protocol derivation is a must looking into the clinical and radiographical examination of the patient. As mentioned in previous literature, anti-Kaban's protocol has been shown to provide good results. A genioplasty improves the chin midline deviation.

Conclusion: A careful assessment and a proper treatment plan should be selected for the management and early relief of the symptoms of the patient. Thorough knowledge and update should be available to the operating surgeon to choose the correct treatment plan for the management of a triad patient.

Keywords: Case report; Obstructive sleep apnea; TMJ ankylosis; TMJ triad.

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Conflict of interest statement

Conflict of interest None.

Figures

Fig. 1
Fig. 1
Right profile showing a convex profile of the patient.
Fig. 2
Fig. 2
Preoperative orthopantomogram showing distorted anatomy of right TMJ with deep antegonial notch on the right side.
Fig. 3
Fig. 3
Postoperative COGS analysis showing obtuse cervico-mental angle.
Fig. 4
Fig. 4
Comparison of pre- and postoperative front and lateral profile.
See this image and copyright information in PMC

References

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