A case report on temporomandibular joint ankylosis (pediatric difficult airway)

Temporomandibular joint (TMJ) ankylosis is a restriction of movements caused by intracapsular fibrous adhesions, fibrous ankylosis and osseous ankylosis of TMJ joint. Trauma is the main cause of TMJ ankylosis. The anesthetic management of pediatric patient with TMJ ankylosis is highly difficult task because child will be anxious with limited mouth opening. Fiberoptic nasotracheal intubation is the gold standard method of securing airway but in resource limited setting we have described a retrograde intubation with the help of guide wire and bougie for securing airway after giving sedation with dexemeditomidine, ketamine, superior laryngeal and transtracheal block. Spontaneous ventilation was maintained till securing the airway. The airway was secured without any complications and elective extubation was done as per AIDAA (All India Difficult Airway Associaton) pediatric extubation algorithm.