Airway Management of Temporomandibular Joint Ankylosis Patients based on Upper and Lower Pharyngeal Width in Lateral Cephalogram - A Retrospective Study

Vaishali Gautam, Pushkar Desai, Kinjal Shah

Abstract: The aim of this study was to evaluate the changes in the oro-pharyngeal airway and its correlation to the clinical outcome associated with two different airway management techniques in temporomandibular (TMJ) ankylosis patients after assessing upper and lower pharyngeal width in Lateral Cephalometric Analysis. This study included 25 patients aged between 5 years to 30 years diagnosed with TMJ ankylosis. The Awake Fibre-optic intubation attempts were carried out in 23 cases in cases who had upper pharyngeal width of more than 10 mm and lower pharyngeal width of more than 6 mm. Elective tracheostomy was done preoperatively in 2 patients with upper pharyngeal width less than 10 mm and lower pharyngeal width less than 6mm. Fibre-optic intubation can be performed with minimal complications in patients with normal upper and lower pharyngeal width while elective tracheostomy is recommended in patients with reduced pharyngeal width. The study highlights the diagnostic as well as prognostic role of cephalometry for clinical perception of geometry of pharyngeal airway in patients having Temporomandibular ankylosis

Keywords: Airway Management, TMJ ankylosis, Temporomandibular joint ankylosis, Fibreoptic intubation, Tracheostomy, Anaesthesiology