PMC3800373_01
(a and b): Scar in the center of cheek with restricted mouth opening and computed tomography showing bone involvement
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F1
On examination, a large cheek scar with loss of subcutaneous tissue severely restricted mouth opening (inter incisor distance < 3 mm) and maxillary hypertrophy in the infra orbital region were observed [Figure 1]. Post-operatively child was put on extensive physiotherapy using an acrylic dynamic jaw exerciser [Figure 4 and Video 1].
Restoration of mouth opening
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F2
Coronoidectomy was done to release the bony block between the infra orbital rim, zygomatic arch and the mandible with dramatic improvement in mouth opening [Figure 2].
Silicone sheet placed between bone segment
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F3
After complete transaction of the ankylotic bone, the gap was kept bare enough so as to pass 0.2 mm ultra-thin silicon sheet of size 5 x 5 cm [Figure 3].
Dynamic jaw exerciser in place
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F4
Post-operatively child was put on extensive physiotherapy using an acrylic dynamic jaw exerciser [Figure 4 and Video 1].