An eight-year-old girl, who was unable to open her mouth resulting in her inability to eat or chew food and difficulty in speech, was treated at a private hospital in the city.
The girl, who hailed from Tirunelveli, was brought to Kauvery Hospital with complaints of inability to open her mouth. She had developed early stages of temporomandibular joint ankylosis, a condition in which the lower jaw bone (mandible) is fused to the fossa by bony or fibrotic tissues and could open her mouth only up to 1 mm, according to a press release.
Manikandan Ramanathan, Oral and Maxillofacial Surgeon at the hospital, said she had the problem for three to four years. When the doctors were looking into the possible causes — whether it was due to an injury from a fall that might have damaged the joint or possible chronic ear infection — the parents said that she had a history of ear infection and underwent a surgery for the same. It was after this surgery that she was unable to open her mouth.
When not treated at the right time, the damaged joint would get fused, leading to such complications, the release said. CT scans and MRI showed that the right side temporomandibular joint was completely fused with the rest of her skull. “We then proceeded to make a model of the child’s head based on the CT scans. We planned how to tackle the complexities, and perform the surgery using the head model. This particular procedure is called the Stereolithographic model,” he said.
The doctors opted to use a procedure called fiberoptic bronchoscopy to intubate the child and put her under anaesthesia. In surgery, they removed the bone mass, which restricted the opening of the mouth and placed a growing joint from the chest rib in the operated region, he said.
The girl was able to open her mouth to almost 30 mm within two days of surgery. She would need regular monitoring for the next 18 years as growth continues to take place actively, the release said.