early times report
Jammu, July 24: A rare and technically demanding case of temporomandibular joint (TMJ) ankylosis, involving a 4-centimeter bony fusion between the mandibular condyle and the skull base, was successfully treated at the Department of Oral and maxillofacial Surgery, AIIMS Jammu, bringing significant relief and renewed function to an elderly patient who had been living with jaw immobility and pain for years.
The 62-year old patient presented with an inability to open the mouth completely, resulting from a large, abnormal bone mass (approximate size 4 cm) fusing the lower jaw to the skull base—an extremely rare and debilitating form (Type IV Sawhney’s classification) of TMJ ankylosis. After thorough clinical and radiological evaluation, the surgical team proceeded with an interpositional arthroplasty with buccal fat pad, where the fused bone was removed and a soft tissue graft placed to prevent recurrence. Post-surgical recovery has been smooth, and the patient is now able to open the mouth and eat soft foods, with ongoing physiotherapy to support long-term function.
The Oral and Maxillofacial Surgery team carried out the surgery under the leadership of Dr. Amanjot Kaur and her team members, Dr. Nandkishor, Dr. Vishwajeet, and Dr. Rupinder, with careful dissection around critical structures, including the facial nerve, skull base, and maxillary artery. She said, “The case was especially challenging due to the massive extent of the ankylosis and patient age. This achievement was made possible through the visionary support and encouragement of the ED and CEO, Prof. (Dr) Shakti Kumar Gupta, whose continued emphasis on advanced surgical care and infrastructure has enabled teams to undertake high-end procedures. Speaking on the occasion, Prof. Gupta said,
“This case reflects the caliber of clinical expertise and collaboration we are building at AIIMS Jammu. It is our mission to bring cutting-edge, patient-centric care to the region, and I commend the surgical, anesthesia, and support teams for their exemplary effort in managing such a rare and technically complex condition.”
The surgery was also made possible by the expert involvement of the Department of Anaesthesiology, led by Dr Kanika Gupta and Dr Sandeepika Dogra and their team members (Dr Anu and Dr Marvi) who skilfully managed a difficult airway scenario due to limited mouth opening—a common challenge in TMJ ankylosis cases. Safe induction and extubation in such patients require advanced planning and expertise, and their contribution was instrumental in ensuring a smooth intraoperative course.
The team also acknowledges the leadership of Prof. Saurabh K Gupta, whose mentorship played a central role in the case’s success. Reflecting on the case, he stated, “This surgery is a landmark not just for our department but for the entire institute. It reflects our commitment to restoring function and dignity to patients suffering from rare and debilitating conditions. I’m proud of the team for handling such a technically demanding case with precision and compassion.”
“This case is a true example of multidisciplinary teamwork and institutional synergy,” said Dr. Kaur. “From OT scheduling to anaesthesia, postoperative care, and physiotherapy—each component was critical. We are grateful for the enabling environment created by our Director Sir, MS Sir, and all departments involved.”
AIIMS Jammu continues to emerge as a premier center of excellence in surgical and medical care, offering cutting-edge diagnostics and advanced interventions across specialties. The institute remains committed to pushing the frontiers of clinical innovation while delivering compassionate, comprehensive, and patient-centered care to the region.
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