Surgical Release of Bilateral Jaw Joint Fusion Probability of Injury to the Temporomandibular Joint from falls Childhood is a time of fun and frolic and a lot of play. This can lead to a lot of bruises and scrapes from falls. Many instances of direct falls on the chin are common. This is the most common cause of injury to the temporomandibular joint (TMJ). Relative Minor Joint Injuries Leading to Complete Bony Ankylosis Many of these falls are minor with only minor pain and discomfort arising in the joint. Initial management is usually through analgesics prescribed by family physicians. Many of the patients are not followed up once there is symptomatic relief from the pain. Classification of TMJ Ankylosis into Fibrous and Bony Ankylosis Even relatively minor injuries can result in bleeding into the jaw joints. This gradually results in fusion of the jaw joints to the skull bones. There are two types of ankylosis of the TMJ. Fibrous ankylosis affords a little movement while bony ankylosis results in immobility of the joint. Patient Suffers a fall to the Chin with Resultant Injury to the Jaw Joints This young boy had suffered an injury to his jaw joints a few years ago. He had fallen on his chin during play at school. A local doctor had prescribed analgesics and he did not have any pain. His parents did not follow up on the possibility of temporomandibular joint injury. Increasing Mouth Opening Limitation and Lower Jaw Retrusion He gradually developed limitation in his mouth opening as well as mandibular retrognathism. This has now reached a point where he now has very limited mouth opening. They presented to a local doctor who explained the condition to them. Initial Diagnosis of Bony Jaw Joint Ankylosis at Hometown Hospital He stated that he had complete bony ankylosis. Explaining that he needed surgical treatment for TMJ, he reiterated the need for expert care. A referral was then made to our hospital for management of his condition. Renowned Jaw Surgery Hospital in the Southeast Asian region Our hospital is a superspecialty jaw surgery hospital. We have won recognition from our peers for being a premier jaw surgery hospital. Treatment of TMJ problems are a hallmark of a good jaw surgery hospital. Dr. SM Balaji of Balaji Dental, Craniofacial Hospital & Research center is a world renowned jaw joint surgeon. He has over 30 years of experience in handling complex cases. Meeting Stringent Requirements for Surgery for TMJ Abnormalities Our hospital is world renowned for our services for surgery for TMJ abnormalities. The range of surgery for TMJ problems include trauma and congenital deformities of the joint. We perform recessive jaw surgery through advancement of the jaw. Recessive Jaw Surgery through Jaw Advancement Surgery Two modalities are usually utilized to perform setback surgery for jaw correction. The most common procedure for recessive jaw surgery is bilateral sagittal split osteotomy. This is effective and recovery is quick in the postsurgical period. We offer a wide range of surgical services for correction of facial deformities. Our hospital is one of the pioneers in the field of facial feminization surgery in India. We perform correction of all congenital and traumatic jaw deformities in our hospital. Orthognathic surgery is a specialized treatment to correct jaw problems. Our hospital is a surgical center of excellence for joint space correction of TMJ disorders. TMJ arthroscopy is a procedure that is used to investigate the tissues of the joint. Conservative treatments include physiotherapy and exercises for the jaw joint. Fibrous ankylosis is caused by scar tissue like fibrous union of the joint. Jaw joint surgical procedures are always performed under general anesthesia. Recovery time is quick from this surgery. Long term exercises are necessary to manage and reduce chronic pain. The oral surgeon is the specialist who deals with upper jaw pain and pain in the jaw joint. Anti-inflammatory medications only provide temporary relief for many cases. Leading Center for Facial Cosmetic Surgery and Facial Plastic Surgery Our hospital is a superspecialty center for correction of nasal deformities. Many patients from across the globe present to our hospital for rhinoplasty correction. Nose correction surgery is technique sensitive. Experienced surgeons provide the best results for such surgeries. Another superspecialty surgery performed in our hospital is microtia ear reconstruction. This surgery is offered in very few surgical centers in our country. The surgery is a two stage surgery performed over a period of three months. First stage of the surgery involves harvesting the fourth, fifth and sixth costal rib cartilages. These are crafted with care to mimic the cartilaginous outer ear structure. This is then carefully placed in an ear pocket crafted at the site of the ear. This is followed by the second stage surgery. The previously placed cartilaginous ear structure is lifted up. The posterior portion of the ear is then addressed through a skin graft. This skin graft is most often harvested from the abdominal region of the patient. Imaging Studies reveal Bilateral Bony Ankylosis of Jaw Joints Imaging studies were obtained including a 3D CT scan and he was examined. There was a thick medial callus of the ankylosed jaw joints. Treatment planning was explained to the parents and they consented to surgery. Release of Ankylosed Jaw Joints with Good Mouth Opening The jaw joints were approached through bilateral submandibular incisions. His bilaterally ankylosed jaw joints were released using a burr. There was greatly increased mouth opening following his surgery of up to 2 inches. Importance of Jaw Exercises in Preventing Relapse of Jaw Ankylosis His parents have been advised to perform rigorous jaw exercises. This would ensure that there was no recurrence of his ankylosis. They expressed understanding of the instructions before discharge from the hospital. Surgical Release of Bilateral Jaw Joint Fusion CLICK HERE TO WATCH THE SURGERY VIDEO
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