Protocol for management of TMJ Ankylosis by Kaban, Perrot and Fisher

Temporomandibular Joint Ankylosis: It is the painless, loss (or) limitation of movement of the Temporomandibular joint which can be due to Stiffening or Immobility and Fixation due to Fusion of the Temporomandibular joint.

Ankylosis is of 2 types:

  • True Ankylosis: Which is also called as Intra-Articular Ankylosis, here we can see that both physical and physiological trauma is seen in the patient with a Bird like face and here Speech, Chewing and Swallowing difficult. True Ankylosis can be either Unilateral or Bilateral.
  • False Ankylosis: Which is also called as Extra-auricular Ankylosis. It is caused by enlargement of Coronoid process, depressed fracture of the Zygomatic Arch, Irradiation, Infection, Scarring after Injury.

Protocol for Management of TMJ Ankylosis

Protocol for management of TMJ Ankylosis which was given by Kaban, Perrot and Fisher in 1990:

The protocol for treatment of TMJ ankylosis is given in 9 steps which guides us through the treatment procedure.

  1. Early Surgical Intervention
  2. Aggressive resection – where a gap of at least 1 to 1.5 cm should be created
  3. Ipsilateral Coronoidectomy and temporalis myotomy
  4. Lining of the Glenoif fossa region with Temporalis fascia
  5. Reconstruction of Ramus with a Costochondral graft
  6. Early mobilization and aggressive physiotherapy for a period of at least 6 months post operative.
  7. Regular long term follow up
  8. Cosmetic surgery at a later date when the growth of the patient is completed



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