Anaesthetic Management of A Case of A Bilateral Temporo Mandibular Joint Ankylosis Secondary to Congenital Stuck Disc with left Frontal Intracerebral Space Occupying Lesion.
Journal Title: IJAR-Indian Journal of Applied Research - Year 2015, Vol 5, Issue 6
Abstract
The temporo mandibular joints are highly specialized bilateral joints comprising an articulation between temporal bone and mandible. It is a synovial hinge joint. Among the various causes of bilateral TM-J an kylosis congenital variant - stuck disk is common. Patients with bilateral TMJ ankylosis is a difficult airway situation with a severely restricted mouth opening, near total trismus and uncooperativeness while securing airway ,in awake state. Awake fibreroptic nasal intubation remains a gold standard method for intubation in such cases. Blind nasal intubation, retrograde intubation and tracheostomy are other alternatives, but are associated with significant morbidity. However in all methods of awake intubations patient cooperation is required. We are presenting a case of bilateral temporo -man dibular joint ankylosis secondary to congenital bilateral stuck disc with 5 mm mouth opening in a 30 year old female, who was posted for craniotomy and excision of frontal ICSOL. In this scenario the management of airway becomes a challenge and the patient was intubated successfully by awake fibreroptic nasal intubation and surgery continued with an uneventful recovery.
Authors and Affiliations
Dr. Hari Bhagavan, Dr. B. Kishan Sing Naik
Keywords
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