AB290. SOH26AB_0394a. Temporomandibular joint (TMJ) ankylosis: an unusual presentation in the Irish population

Background: Temporomandibular joint (TMJ) ankylosis is a rare condition with unknown incidence in the Irish population. It results in trismus, impaired mandibular and maxillary development, compromised mastication, poor nutrition, speech problems, poor oral hygiene, and sleep apnoea. Access to the airway is a challenge in this population, necessitating awake fibreoptic intubation or tracheostomy. Management requires aggressive resection of the ankylotic mass and reconstruction. This study aimed to present the experience of TMJ ankylosis in the National Maxillofacial Unit.

Methods: Charts of four patients with TMJ ankylosis treated at the Maxillofacial Unit in St. James’s Hospital were reviewed. The following data were collected: age at onset of ankylosis, aetiology of ankylosis, age at presentation and intervention, surgical technique, post-operative complications, and outcome.

Results: Four patients are included. All presented with severe trismus. Patients underwent resection of the ankylotic mass according to the protocol. Patient 1 is a female 4-year-old treated with interpositional gap arthroplasty. Patient 2 is a male treated with distraction osteogenesis as a 6-year-old and subsequent costochondral graft (CCG) as a 12-year-old. Patient 3 is a female patient treated at age 16 with a CCG and subsequent bimaxillary orthognathic surgery as a 22-year-old for correction of asymmetry. Patient 4 is a 37-year-old female treated with CCG.

Conclusions: This paper presents a series of four patients with TMJ ankylosis. It discusses the surgical management and the impact of TMJ ankylosis on facial development, oral/dental hygiene, nutrition, and breathing (sleep apnoea).

Keywords: Airway; temporomandibular joint ankylosis (TMJ ankylosis); tempromandibular joint disorder; TMJ reconstruction; trismus