Krzysztof Dowgierd1, Anna Lipowicz2, Małgorzata Kulesa-Mrowiecka3, Wojciech Wolański4, Paweł Linek5, Andrzej Myśliwiec6,7. 1. Department of Clinical Pediatrics, Regional Specialized Children's Hospital, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury, Olsztyn, Poland. 2. Department of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, Poland. 3. Department of Physiotherapy, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University, Medical College, Cracow, Poland. 4. Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland. 5. Musculoskeletal Elastography and Ultrasonography Laboratory, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland. 6. Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Science, Academy of Physical Education, Katowice, Poland. 7. Specialized Physiotherapy Center, Rybnik, Poland.
Abstract
BACKGROUND: Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. CASE DESCRIPTION: : In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. INTERVENTION: : Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. OUTCOMES: : Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. CONCLUSIONS: : This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.
BACKGROUND: Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. CASE DESCRIPTION: : In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. INTERVENTION: : Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. OUTCOMES: : Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. CONCLUSIONS: : This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.
Entities:
Keywords:
Temporomandibular joint; ankylosis; physical therapy; surgery
Authors: Krzysztof Dowgierd; Rafał Pokrowiecki; Małgorzata Kulesa Mrowiecka; Martyna Dowgierd; Jan Woś; Piotr Szymor; Marcin Kozakiewicz; Anna Lipowicz; Małgorzata Roman; Andrzej Myśliwiec Journal: J Clin Med Date: 2022-01-14 Impact factor: 4.241