PMC4979329_01
Preoperative mouth opening
AMS-6-130-g001.jpg
PMC4979329_01_AMS-6-130-g001.jpg
F1
TMJ but with no movement at all in the left TMJ. The mouth opening (interincisal distance) was 1 mm [Figure 1].
(a) Posteroanterior view scout computed tomography showing enlarged diploe. (b) Three-dimensional computed tomography showing bony fusion of left temporomandibular joint. (c) Axial computed tomography section showing enlarged left condyle
AMS-6-130-g002.jpg
PMC4979329_01_AMS-6-130-g002.jpg
F2
The scout cranial computed tomography (CT) showed an enlarged diploe [Figure 2a] confirming the characteristic radiographic evidence of sickle-cell and CT scan with three-dimensional reconstruction revealed complete fusion of the left condyle to the temporal bone with enlargement into the sigmoid notch [Figure 2b]. The axial CT shows an enlarged left condyle [Figure 2c].
(a) Postrami surgical incision. (b) Gap arthroplasty of about 1 cm. (c) Interposition of masseter muscle
AMS-6-130-g003.jpg
PMC4979329_01_AMS-6-130-g003.jpg
F3
She had left TMJ ankylosis release via a postrami incision [Figure 3a] by gap arthroplasty of 1 cm [Figure 3b]. The gap was then interposed with a strip of the masseter muscle [Figure 3c].
Postoperative mouth opening
AMS-6-130-g004.jpg
PMC4979329_01_AMS-6-130-g004.jpg
F4
At the 7 months review, mouth opening was 3.5 cm [Figure 4] and the patient was satisfied.
Postoperative scar
AMS-6-130-g005.jpg
PMC4979329_01_AMS-6-130-g005.jpg
F5
Postoperative scar was minimal both from previous and recent surgeries [Figure 5].