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Restricted opening of the mouth with an extra-articular cause in children
1Dept. of Oral and Maxillofacial Surgery, University Hospital, Nijmegen, The Netherlands.
Insights
Restricted opening of the mouth with an extra-articular cause (ROMEC) in children presents diagnostic and surgical challenges. Treatment outcomes are often mediocre, necessitating careful timing for final corrections.
Area of Science:
- Oral and Maxillofacial Surgery
- Pediatric Dentistry
- Anesthesiology
Background:
- Restricted opening of the mouth with an extra-articular cause (ROMEC) encompasses diverse etiologies.
- Common causes like trauma, tumors, and TMJ dysfunction are excluded to focus on rarer conditions.
Observation:
- A series of 6 pediatric cases with ROMEC, treated under 4 distinct diagnoses, are presented.
- Challenges in diagnosis, surgical intervention, and postoperative rehabilitation are highlighted.
Findings:
- Surgical outcomes for ROMEC in children were not consistently optimal, with some results being disappointing.
- Absolute trismus requires treatment regardless of patient age, with expectations of mediocre results.
Implications:
- Delayed surgical correction, particularly after the second growth spurt, may be beneficial for final functional outcomes.
- Management of ROMEC in children necessitates a nuanced approach considering diagnostic complexities and long-term results.
Abstract:
Restricted opening of the mouth with an extra-articular cause (ROMEC) can have very different aetiologies. A series of 6 children, who have been operated on under 4 different diagnoses, are presented. Excluded are common problems such as recent trauma and posttraumatic scarring, craniomandibular dysfunction or elongated coronoid process, and also tumours. Problems of establishing the diagnosis, surgical treatment, postoperative physiotherapy and timing are discussed. It is shown that none of the cases is a perfect result, some outcomes are even very disappointing. It is therefore concluded that absolute trismus should be treated independently of age. The result expected will be mediocre. For final correction it is suggested that the operator should wait preferably until the second growth spurt has passed. The same goes for children presenting primarily with a mouth opening greater than 20 mm.