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TMJ Ankylosis as a Complication of Severe Mastoiditis in Toddlers: Pilot Study
Omri Emodi1,2, Yair Israel1, Boaz Frenkel1
1From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Campus, Haifa, Israel.
Background:
Acute otitis media is among the most common infections in children. Mastoiditis is a rare complication of acute otitis media in developed countries. When overlooked, mastoiditis can lead to temporomandibular joint (TMJ) ankylosis, which can impair function and hinder normal development of the child.
Methods:
This report describes a new protocol for treating TMJ ankylosis in toddlers, using a modified surgical method and in-house 3D technology. It presents a multidisciplinary approach that includes maxillofacial surgeons, pediatric anesthesiologists, orthodontists, and physical therapists.
Results:
A 3D-printed model of the bony nasal airway assists the pediatric anesthesiology specialist in preoperative planning and simulation of nasal intubation. The modified surgical technique prevents herniation of the temporalis muscle and reduces the risk of facial nerve paralysis. The postoperative posterior bite blocks resist soft tissue contraction, maintaining normal mouth opening.
Conclusions:
A modified surgical technique, integrated into a multidisciplinary approach, yields improved functional and aesthetic postoperative outcomes for treating TMJ ankylosis in toddlers.
Insights
A new surgical protocol and 3D technology offer improved outcomes for toddlers with temporomandibular joint (TMJ) ankylosis, a rare complication of acute otitis media. This multidisciplinary approach enhances function and aesthetics post-treatment.
Area of Science:
- Pediatric Surgery
- Oral and Maxillofacial Surgery
- Biomedical Engineering
Background:
- Acute otitis media is a common childhood infection.
- Mastoiditis, a rare complication, can lead to temporomandibular joint (TMJ) ankylosis if untreated.
- TMJ ankylosis impairs function and hinders child development.
Purpose of the Study:
- To introduce a novel protocol for treating TMJ ankylosis in toddlers.
- To highlight the integration of a modified surgical technique with 3D technology.
- To emphasize a multidisciplinary approach involving various pediatric specialists.
Main Methods:
- Utilized a modified surgical technique for TMJ ankylosis.
- Incorporated in-house 3D technology for preoperative planning and simulation.
- Employed a multidisciplinary team including maxillofacial surgeons, pediatric anesthesiologists, orthodontists, and physical therapists.
Main Results:
- A 3D-printed nasal airway model aided in planning nasal intubation.
- The surgical technique minimized risks of temporalis muscle herniation and facial nerve paralysis.
- Postoperative bite blocks effectively prevented soft tissue contraction, maintaining mouth opening.
Conclusions:
- A modified surgical technique within a multidisciplinary framework improves outcomes for pediatric TMJ ankylosis.
- The approach enhances both functional recovery and aesthetic results.
- This protocol offers a promising solution for treating TMJ ankylosis in young children.
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