Anaesthesia for TMJ Ankylosis with the Use of TIVA, Followed by Endotracheal Intubation

Abstract

TMJ ankylosis, though it is not common, is an anaesthetic challenge, as it is a difficult airway situation with a moderate to a severely limited mouth opening. Fiber-optic intubation is the gold standard for such cases, but it may not be readily available at all centres. Blind nasal intubation, retro-grade intubation and tracheostomy are the other alternatives, but they require patient co-operation and are associated with considerable morbidity. We are presenting a case of unilateral TMJ ankylosis in a 12 years old boy who was posted for condylectomy and interpositional arthroplasty. He was maintained on TIVA for condylectomy and was then intubated for the remaining procedure. The procedure and the recovery were uneventful.