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

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.