ANAESTHETIC CONSIDERATION OF TM JOINT ANKYLOSIS: A CASE REPORT

Dr. Neelam Meena, Dr. Vikas Rajpurohit, *Dr. Deepak Meena and Dr. Deepika Meena

ABSTRACT

The Temperomandibular joints are bilateral joints comprising an articulation between the cranium and the mandible. Its ankylosis presents unusaual problem. The commonest are inflamation and trauma which is often missed and noticed only when the mouth opening is severly restricted as a result of which chlid cannot bite and masticate solid foods. TMJ ankylosis especially with mandibular hypoplasia presents a serious problem for airway management. In children with long standing bilateral TMJ ankylosis during the active growth phase, a hypoplastic and retrognathic mandible with severe bird face deformity is noted and hence obstructive sleep apnoea is common problem. Airway obstruction is secondary to structural encroachment on or pharyngeal and hypopharyngeal lumen, subatmospheric interpharyngeal pressure and hypotonicity of oropharyngeal muscles.[1] Due to above patient may have anaesthetic risks.[2]

Keywords: Temperomandibular joint ankylosis, blind awake intubation, obstructive sleep apnoea, blind nasal intubation.