Aim The aim of this study was to evaluate the effect of temporomandibular joint bony ankylosis and surgical sequelae of gap arthroplasty on middle ear volume (MEV).Patients and methods Sixteen Egyptian individuals were selected and divided into two equal groups. The first group (group I) included eight patients with 14 bony ankylosed joints; the second group (group II) included eight normal individuals. The operated patients were chosen from those attending the outpatient clinic of the Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University. Gap arthroplasty was utilized for the management of such patients. Radiographic assessments for MEV for the first group were obtained for all the participants preoperatively and also 3 months postoperatively. Comparison of MEV was carried out with normal individuals both preoperatively and 3 months postoperatively.Results It was observed that there was a significant decrease in MEV of ankylosed patients preoperatively when compared with normal individuals and a significant decrease in MEV 3 months postoperatively when compared with the preoperative volume.Conclusion Patients with temporomandibular joint bony ankylosis showed a decrease in MEV compared with normal individuals; also, gap arthroplasty has a decreasing effect on MEV.

Abstract:Objective: This study was designed to evaluate the effect of temporomandibular joint (TMJ) bony ankylosis on Eustachian tube (ET) functions. Subjects and Methods: Twelve patients suffering from TMJ bony ankylosis were selected from those attending the out-patient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo University. Twelve subjects (control group) underwent Eustachian tube function test were selected also. Tympanometry was utilized to assess Eustachian tube function. Three pressure reading (P1, P2, and P3) of the middle ear and external ear canal volume were recorded by the use of tympanometry. Comparisons were performed between patient and control group to evaluate the change of pressure. Results: Throughout the results, four ears showed type (C) tympanogram representing Eustachian tube dysfunction, two ears showed type (B) tympanogram which represent otitis media with effusion. While other ears showed type (A) tympanogram. On comparing the pressure values between the patients and the control, significant decrease was recorded in (P2) value in the patients group and no significant difference existed in the external canal volume. Conclusions: The Eustachian tube function is affected in patients of temporomandibular joint bony ankylosis, it cannot adapt to changes in pressure effectively. Patients of TMJ ankylosis are more liable to develop otitis media. Inflation-deflation test is a reliable method for evaluating Eustachian tube function in patients of (TMJ) ankylosis. The external ear canal volume was not affected in this group of patients.

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Objectives: This study was designed to clarify the changes that might be induced in the maxillary sinus walls thickness in response to TMJ bony ankylosis Subjects and methods: Forty five (45) subjects were included in the study. They were divided into two groups Group I, (patients group) comprised fifteen 15 patients were suffering from temporomandibular joint bony ankylosis (26 maxillary sinuses involved) and Group II, (control group) contained thirty (30) healthy volunteer. Maxillary sinus walls thickness has been measured by computerized tomography scan for both groups and was compared. Results: There was significant increase in mean thickness of all walls of maxillary sinus in patients group. The thickness of lateral wall of recurrent cases of TMJ ankylosis showed significant decrease when compared with the non-recurrent cases. Conclusion: Observable Increase in the thickness of maxillary sinus walls. This may be attributed to bone apposition from outer side without resorption from inner side. This explanation is ascribed to lack of pneumatization associated with hindrance of upper air way that usually existing with cases of TMJ bony ankylosis.

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