Congenital temporomandibular joint ankylosis

Congenital temporomandibular joint (TMJ) ankylosis is a rare craniofacial condition present at birth in which the temporomandibular joint is fused or immobile due to bony or fibrous union between the mandibular condyle and the temporal bone. This fusion restricts or completely prevents mouth opening (trismus), leading to significant difficulties with feeding, speech development, oral hygiene, and dental care from the neonatal period onward. The condition affects the musculoskeletal system of the jaw and can lead to secondary deformities including facial asymmetry, micrognathia (small jaw), and malocclusion. If bilateral, it may cause severe airway compromise in neonates due to mandibular hypoplasia and posterior displacement of the tongue. Growth disturbances of the mandible are common, as the fused joint impairs normal condylar growth, resulting in progressive facial deformity during childhood. The etiology of congenital TMJ ankylosis is not fully understood but may be related to intrauterine trauma, forceps delivery, or developmental abnormalities of the joint. It must be distinguished from acquired TMJ ankylosis, which results from postnatal trauma or infection. Treatment is primarily surgical and aims to restore jaw mobility and promote normal mandibular growth. Surgical approaches include gap arthroplasty, interpositional arthroplasty, or joint reconstruction using costochondral grafts. Early surgical intervention is recommended to minimize growth disturbances and functional impairment. Postoperative physiotherapy with aggressive jaw-opening exercises is essential to prevent re-ankylosis, which remains a significant complication. Long-term orthodontic management and possible orthognathic surgery may be needed to address residual facial asymmetry and dental malocclusion.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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