Mandibular distraction osteogenesis for obstructive sleep apnoea secondary to TMJ ankylosis

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Mandibular distraction osteogenesis for obstructive sleep apnoea secondary to TMJ ankylosis

AR Nurliza, F Hariri, ZA Abdul Rahman, MN Jabar, R Nordin, AFM Bustaman, S Nabil: Mandibular distraction osteogenesis for obstructive sleep apnoea secondary to TMJ ankylosis. Mal. J. Oral Maxillofac. Surg. 2015; 13: 11–15.

Abstract: Temporomandibular joint (TMJ) ankylosis in a paediatric population is uncommon and a challenging problem to treat. From a technical perspective, ankylosis is difficult to treat as the surgeon should consider the potential effects of time and growth on the outcome. The cognitive and emotional development of the patient and the role of the parents are other factors that can affect the management and treatment results in children. Therefore, surgical planning, post-operative management and comprehensive multidisciplinary approach are needed to ensure an ideal outcome. We present a case of a four years old girl presented with mandible hypoplasia in anterior-posterior direction secondary to left TMJ ankylosis. Her condition is further complicated with presence of severe trismus, adenoid hyperplasia grade III and moderate obstructive sleep apnoea. She underwent two stages of surgical intervention which were bilateral mandibular distraction osteogenesis via submandibular approach followed with left condylectomy and gap arthroplasty with interpositional myofascial temporalis flap 4 months later. Mouth opening successfully improved from an initial interincisal opening of 2mm to 28mm
post-surgery. Her obstructive sleep apnoea was also resolved. In this case report, we highlight the role of sterolithography model in surgical planning and a multidiscipline approach for optimum surgical correction of this maxillofacial deformity.