OUTCOMES OF COSTOCHONDRAL GRAFTING IN THE MANAGEMENT OF UNILATERAL PEDIATRIC TEMPOROMANDIBULAR JOINT ANKYLOSIS AT TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY

Authors

  • Saman Bibi Mardan Medical Complex, Mardan, Pakistan. Author
  • Sartaj Khan Mardan Medical Complex, Mardan, Pakistan. Author

DOI:

https://doi.org/10.71000/whx6mz93

Keywords:

Costochondral grafting pediatric TMJ ankylosis maximum interincisal opening reankylosis graft resorption unilateral ankylosis.

Abstract

Objective: To assess the outcomes of costochondral grafting in managing unilateral temporomandibular joint (TMJ) ankylosis among pediatric patients at a tertiary care hospital.

Methodology: Conducted as a cross-sectional investigation the research took place at the Department of Oral and Maxillofacial Surgery Mardan Medical Complex from 25-08-2024 to 25-05-2025. A total of 126 children aged 4 to 12 years were recruited using non-probability convenient sampling with inclusion limited to those with unilateral TMJ ankylosis and exclusion of Swahney Type 2 cases previously operated patients non-traumatic etiologies or those with growth abnormalities. Each child underwent a detailed history review and clinical examination with ankylosis type confirmed via CT scan. Surgery involved removal of the ankylotic mass and reconstruction with a costochondral graft from the sixth or seventh rib. Outcomes maximum interincisal opening (MIO) reankylosis and graft resorption were evaluated clinically and radiographically at one three and six months post-surgery.


Results: Findings revealed an average participant age of 8.44 years (±2.557) with 55.6% male (70 children) and 44.4% female (56 children). Normal MIO (30–35 mm) was achieved by 67.5% (85 children) while 32.5% (41 children) fell below this range. Reankylosis occurred in 11.1% (14 children) and graft resorption affected 19.0% (24 children) with 88.9% and 81.0% remaining free of these complications respectively.

 

Conclusion: The study concludes that costochondral grafting proved largely effective though reankylosis and resorption posed challenges in a minority. These insights suggest refining surgical techniques and enhancing follow-up care to optimize results.

Author Biographies

  • Saman Bibi, Mardan Medical Complex, Mardan, Pakistan.

    Trainee Medical Officer, Department of Oral and Maxillofacial Surgery, Mardan Medical Complex, Mardan, Pakistan.

  • Sartaj Khan, Mardan Medical Complex, Mardan, Pakistan.

    Professor, Department of Oral and Maxillofacial Surgery, Mardan Medical Complex, Mardan, Pakistan.

References

Roychoudhury A, Yadav P, Bhutia O, Mane R, Yadav R, Goswami D, et al. Alloplastic total joint replacement in management of temporomandibular joint ankylosis. J Oral Biol Craniofac Res. 2021;11(3):457-65.

Zhang X, Huang D, Lu C, Zhao J, Yang C, He D. Analysis of the effect on costochondral graft for TMJ ankylosis with jaw deformities in pediatrics. Clin Oral Investig. 2024;28(6):317.

Gibson AC, Merrill TB, Boyette JR. Complications of Mandibular Fracture Repair. Otolaryngol Clin North Am. 2023;56(6):1137-50.

Li H, He D, Xie Q, Abdelrehem A, Huang D, Yang C. Do simultaneous mandibular advancement and temporomandibular joint prosthesis impact the upper airway in TMJ ankylosis patients? Ann Transl Med. 2021;9(22):1638.

Kelly M, Bowen A, Murray DJ. Efficacy of temporomandibular joint arthroplasty and insertion of a Matthews device as treatment for ankylosis of the joint: a case series. Br J Oral Maxillofac Surg. 2021;59(10):1113-9.

Gholami M, Labafchi A. Management of Temporomandibular Joint Ankylosis Using Temporoparietal Fascia Flap. World J Plast Surg. 2021;10(2):93-7.

Zhang Y, He Y. [Management of traumatic temporomandibular joint ankylosis: a perspective]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2023;58(10):985-90.

Amarista FJ, Jones JP, Brown Z, Rushing DC, Jeske NA, Perez DE. Outcomes of total joint alloplastic reconstruction in TMJ ankylosis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022;134(2):135-42.

Cohen Atsmoni S, Hennedige A, Richardson D, De S. Pediatric temporomandibular joint (TMJ) arthritis, an elusive complication of acute mastoiditis. Int J Pediatr Otorhinolaryngol. 2022;158:111163.

Parrino D, Val M, Lovato A, de Filippis C, Nardini LG. Pediatric temporomandibular joint ankylosis and arthritis: Forgotten complications of acute otitis media. Am J Otolaryngol. 2022;43(5):103599.

Worede F, Alsaikhan N, Chang CP, Granquist EJ, Cahill AM. Preoperative Arterial Coil Embolization for Temporomandibular Joint (TMJ) Surgery in Children with TMJ Ankylosis. J Craniofac Surg. 2022;33(7):2001-4.

Prasad C, Deepa M, Triveni P, Arunkumar K. Role of Magnetic Resonance Imaging in Temporomandibular Joint Ankylosis - An Evaluative Study. Ann Maxillofac Surg. 2022;12(1):39-45.

Setyawan A, Montessory M, Baehaqi R, Rizqiawan A, Mulyawan I, Rahman MZ. Surgical Management of Temporomandibular Joint Ankylosis with Mersilene Mesh Interpositional Arthroplasty: A Case Series Study. J Int Soc Prev Community Dent. 2023;13(1):75-82.

Ramly EP, Yu JW, Eisemann BS, Yue O, Alfonso AR, Kantar RS, et al. Temporomandibular Joint Ankylosis in Pediatric Patients With Craniofacial Differences: Causes, Recurrence and Clinical Outcomes. J Craniofac Surg. 2020;31(5):1343-7.

Mishra N, Sharma NK, Dhiman NK, Jaiswara C, Tiwari P, Singh AK. Temporomandibular joint ankylosis: A tertiary center-based epidemiological study. Natl J Maxillofac Surg. 2021;12(3):392-6.

Bhalerao N, Paunikar S, Wanjari D, Ninave S. Temporomandibular Joint Ankylosis: Anesthetic Challenge. Cureus. 2024;16(2):e54379.

Kalita F, Kv A. Temporomandibular joint re-ankylosis: a case report and literature review. J Korean Assoc Oral Maxillofac Surg. 2023;49(4):218-22.

Ukwas A, Elshik M, Elbialy M. TMJ Ankylosis in Children: A Case Report and Literature Review. Case Rep Dent. 2023;2023:6474478.

Yadav P, Roychoudhury A, Kumar RD, Bhutia O, Bhutia T, Aggarwal B. Total Alloplastic Temporomandibular Joint Replacement. J Maxillofac Oral Surg. 2021;20(4):515-26.

Rauniyar D, Upadhyaya C, Chaurasia N, Shakya M, Sharma S. Total temporomandibular joint replacement in recurrent temporomandibular joint ankylosis: a case report. J Surg Case Rep. 2023;2023(7):rjad426.

Yew TF, Kiong CT, Sng TJH, Hariri F. Triad of temporomandibular joint ankylosis, micrognathia, and obstructive sleep apnoea: a systematic review of surgical management. Br J Oral Maxillofac Surg. 2024;62(9):857-65.

Dowgierd K, Pokrowiecki R, Kulesa Mrowiecka M, Dowgierd M, Woś J, Szymor P, et al. Protocol for multi-stage treatment of temporomandibular joint ankylosis in children and adolescents. J Clin Med. 2022;11(2):428.

Choi MG. Temporomandibular joint reconstruction with costochondral graft: Case series study. J Korean Assoc Oral Maxillofac Surg. 2021;47(2):128-134.

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Published

2025-06-28

How to Cite

1.
Bibi S, Sartaj Khan. OUTCOMES OF COSTOCHONDRAL GRAFTING IN THE MANAGEMENT OF UNILATERAL PEDIATRIC TEMPOROMANDIBULAR JOINT ANKYLOSIS AT TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY. IJHR [Internet]. 2025 Jun. 28 [cited 2025 Aug. 28];3(3 (Health & Rehabilitation):812-9. Available from: https://insightsjhr.com/index.php/home/article/view/1011