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Indian Journal of Anesthesia and Analgesia 12(2):p 115-119, April -June 2025. | DOI: https://doi.org/0.21088/ijaa.2349.8471.12225.5
Case Report
Anaesthetic Management of Patient with Temporomandibular Ankylosis
Emy Maria Eloor, Suresh Kumar Nagaiah, Abhinaya Manem, Arun Seth
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 115-119, April -June 2025. | DOI: https://doi.org/0.21088/ijaa.2349.8471.12225.5
How Cite This Article:
Eloor EM, Nagaiah SK, Manem A, Seth A. Anaesthetic management of patient with temporomandibular ankylosis. Ind J Anesth Analg. 2025;12(2):115-119.Timeline
Received : February 13, 2025
Accepted : April 05, 2025
Published : June 23, 2025
Abstract
Introduction: Temporomandibular joint ankylosis cases serve as a challenge for both surgeons and anaesthesiologists. Trauma is the most common cause of TMJ ankylosis, followed by infection. The management goal in TMJ ankylosis is to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent re-ankylosis. Case Report: A 9-year-old female presented with difficulty in mouth opening, leading to difficulty in maintaining oral hygiene. The patient had no comorbidities. She was diagnosed with left temporomandibular joint (TMJ) ankylosis and scheduled for left gap arthroplasty. On preoperative evaluation, vitals were stable, and systemic examination was normal. Airway assessment revealed restricted mouth opening, trismus, left TMJ tenderness. Neck movements were unrestricted, but a Mallampati class IV airway suggested difficulty. Investigations were normal. She was premedicated .Induction was done using Inj. Propofol 60 mg, followed by Inj. Atracurium 15 mg. After 3 failed attempts with a Macintosh and video laryngoscope, intubation was achieved using a Miller laryngoscope (size 0). Surgery lasted three hours with 150 mL blood loss. The patient remained stable intraoperatively and recovered uneventfully. Conclusion: Anaesthesia management in patients with temporomandibular joint ankylosis presents unique challenges, particularly in securing the airway and maintaining hemodynamic stability during surgery. A thorough preoperative assessment and careful planning are essential for success. With appropriate preparation and the ability to adapt to unexpected difficulties, the anaesthetic management of TMJ ankylosis can be successfully navigated, minimizing complications and ensuring optimal patient outcomes.
References
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- 2. Bhalerao N., Paunikar S., Wanjari D., Ninave S. Temporomandibular Joint Ankylosis: Anesthetic Challenge. Cureus. 2024 Feb 17; 16(2): e54379. doi: 10.7759/cureus.54379. PMID: 38505438; PMCID: PMC10948624.
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Funding
This research received no funding."
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
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The authors report no conflicts of interest in this work.
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Cite this article
Eloor EM, Nagaiah SK, Manem A, Seth A. Anaesthetic management of patient with temporomandibular ankylosis. Ind J Anesth Analg. 2025;12(2):115-119.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| February 13, 2025 | April 05, 2025 | June 23, 2025 |
DOI: https://doi.org/0.21088/ijaa.2349.8471.12225.5
Keywords
Anaesthetic managementPaediatric airwayTemporomandibular joint (TMJ) disordersDifficult airway managementSearch for Similar Articles
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Timeline
| Received | February 13, 2025 |
| Accepted | April 05, 2025 |
| Published | June 23, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
