Temporomandibular Joint Ankylosis in Children: Surgical Approaches and Outcomes in 16 Cases

Abstract

Background: Temporomandibular joint (TMJ) ankylosis in children causes restricted mouth opening, facial deformity, and functional impairment. This study aimed to evaluate the surgical approaches and treatment outcomes of pediatric TMJ ankylosis managed at a tertiary care center. Methods: This retrospective study was conducted at the Department of Oral and Maxillofacial Surgery, Bangladesh Medical University and Bangladesh Multicare Hospital from January to December 2024. Sixteen pediatric patients (1–18 years) with TMJ ankylosis underwent surgical management. Procedures included interpositional arthroplasty, gap arthroplasty with or without coronoidectomy, and costochondral graft reconstruction. Outcomes were assessed using maximal interincisal opening (MIO). Results: The mean age of the patients was 9.3 ± 3.2 years, with male predominance (62.5%). Trauma was the most common etiology (62.5%), followed by infection (18.8%). Unilateral ankylosis was present in 68.8% of cases. Interpositional arthroplasty was the most commonly performed procedure (37.5%). Mean preoperative MIO improved significantly from 5.9 ± 3.4 mm to 27.1 ± 7.2 mm at final follow-up (p < 0.001), with an overall mean improvement of 21.2 ± 6.3 mm. Bilateral cases showed comparatively lower postoperative mouth opening than unilateral cases. Reankylosis occurred in 12.5% of patients. Other complications included isolated cases of bleeding, wound infection, and temporary facial nerve weakness. Conclusion: Surgical management of pediatric TMJ ankylosis provides significant functional improvement with acceptable complication rates. Early intervention, individualized surgical planning, and rigorous postoperative physiotherapy are essential for optimal outcomes and prevention of reankylosis.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 67-72