Primary mandibular distraction for management of nocturnal desaturations secondary to temporomandibular joint (TMJ) ankylosis

Objectives: Mandibular advancement is a proven method in the management of obstructive steep apnoea syndrome (OSAS) which may manifest as steep disturbances with nocturnal desaturations during steep (NDS). The purpose of this study is to evaluate the rote of primary osteo-distraction prior to ankylosis release in pediatric patients, diagnosed with NDS secondary to temporomandibular joint (TMJ) ankytosis. Methods: Three patients in the age group of 8-12 years diagnosed with OSAS secondary to TMJ ankylosis underwent primary osteo-distraction for mandibular advancement. They were evaluated pre- and post-operatively using radiographs, over night pulse oximetry, and subjective evaluation of their steep patterns. Results: All the three patients showed significant improvement in their saturation levels with a mean oxygen saturation of 94.66%. There was marked reduction in their snoring and steep/awakening patterns. The mean advancement of the mandible in the three patients was 13.8 mm. Conclusion: Primary mandibular distraction is an effective method of correction of nocturnal desaturations during steep in patients with TMJ ankylosis. (c) 2007 Elsevier Ireland Ltd. All rights reserved.