Awake Nasotracheal Intubation via Fibreoptic Bronchoscope for Surgical Treatment of Temporomandibular Joint Ankylosis: A Case Report

Temporomandibular joint ankylosis (TMJA) causes immobility due to fusion of the joint. It most often results from trauma or infection, but it may be congenital or a result of rheumatoid arthritis. The condition is very common in children and rarely seen in adults. Administration of effective and safe anesthesia to patients with TMJA often poses a serious challenge during surgical correction. Hence, we report a case of a 68-year-old Nigerian woman with no comorbidities who presented to the Oral and Maxillofacial Surgery clinic of our facility with a 5-year history of progressive limitation of mouth opening associated with a painful left cheek swelling. Examination revealed severely limited mouth opening with an interincisal distance of 6 mm. Computerized tomogram of the jaws and the TMJ showed fusion of the condylar head and the temporal articular fossa on the left TMJ. She underwent gap arthroplasty after successful awake nasotracheal intubation via fibreoptic bronchoscope and recovered uneventfully with no recurrence.