Abstract:
:Alloplastic replacement of temporomandibular joint is the preferred treatment for temporomandibular joint ankylosis (TMJA) in ankylosing spondylitis (AS) patients. These patients exhibit neck rigidity due to fixed flexion deformity or fusion of vertebrae that make the intubation and surgical positioning of patients difficult and challenging. Chin on the chest makes tracheostomy almost impossible. Fiberoptic-assisted intubation is recommended. It is mandatory that no neck flexion or rotation is performed during intubation or surgical positioning. The use of an operating table that permits lateral tilt is recommended for surgical positioning. 15-20-degrees tilt of table or a lateral positioning of the patient, can provide sufficient neck support and reduce the chances of lateral neck rotation or neck flexion. Improper positioning may result in readjusting the patient's neck repeatedly during operative procedure. This may cause serious neurological injury. Minimal documentation exists for proper and secure positioning of the patient for bilateral alloplastic joint replacement in AS patients. The authors present a case of bilateral TMJA in AS patient who was managed successfully by awake fiberoptic intubation and lateral positioning for alloplastic total joint replacement (TJR).
journal_name
J Oral Biol Craniofac Resjournal_title
Journal of oral biology and craniofacial researchauthors
Goswami D,Singh A,Yadav P,Roychoudhury Adoi
10.1016/j.jobcr.2021.07.010keywords:
["Ankylosing spondylitis","Awake fiberoptic intubation","Temporomandibualr joint ankylosis","Total joint replacement"]subject
Has Abstractpub_date
2021-10-01 00:00:00pages
544-546issue
4eissn
2212-4268issn
2212-4276pii
S2212-4268(21)00079-8journal_volume
11pub_type
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