Surgical challenges after misdiagnosis of mandibular condylar fracture: A case report

Abstract

TMJ ankylosis is a partial or complete loss of movement in mandible that occurs as a result of several causes. Trauma is the most common cause of TMJ ankylosis. Surgical procedures are aimed at restoring anatomic structure, function and providing growth potential as well as preventing reoccurrences. In this paper, we are introducing a case of 28 years old woman, who suffered from unaesthetic appearance and TMJ ankylosis since the age of 5 but her treatment has been delayed due to misdiagnosis of her problem. She underwent two bilateral condylectomies with and without costochondral grafting, condylar shaving, and orthognathic surgery to solve a problem that could have been avoided. Costochondral graft has been suggested as the “Gold Standard” for TMJ reconstruction in the growing patient but overgrowth and reankylosis are two of its unwanted outcomes that happened after her first and second surgeries. Although the results of TMJ reconstruction is not fully in surgeons hand, with respect to our knowledge about these operations, it seems reankylosis, overgrowing and all other post-operative complications can become preventable.

Keywords

• Misdiagnosis
• TemporomandibularJoint ankylosis
• Costochondral graft
• Temporomandibular reconstruction.