Subankylotic ostectomy for release of TMJ ankylosis using the transmasseteric anterior parotid approach

Twelve patients with temporomandibular joint ankylosis (5 bilateral and 7 unilateral) with preoperative maximal mouth opening ranging from 0 to 11 mm (mean, 2.25 [SD, 3.19] mm) were treated with a subankylotic ostectomy. Inclusion criteria in the study were patients older than 18 years with restricted mouth opening of less than 30 mm and radiographic evidence of temporomandibular joint ankylosis. The mean maximal postoperative mouth opening was 38.92 (SD, 3.11) mm. All patients showed good functional rehabilitation in terms of movement and speech with no radiographic evidence of recurrence and no occurrences of temporary or permanent facial nerve palsy, sialoceles, or salivary fistulae. As this technique does not encroach upon the mass of ankylotic bone but creates a pseudarthrosis beneath it, chances of recurrences are minimized. The entire length and width of the right ramus from the condyle to the angle region can be accessed with this technique.