the mandibular branch with narrowing of the space between the mandibular angles. A clinical indicator of the severity of ankylosis is the interincisal opening; when the opening is less than 5 mm it is named as a complete ankylosis. 7,6 According to Kaban et al,8 the TMJ ankylosis control protocol should follow the following steps: 1) aggressive resection, 2) ipsilateral coronoidectomy, 3) contralateral coronoidectomy when necessary, 4) ATM lining with temporal flap, 5) ramus reconstruction with costochondral graft, 6) rigid fixation, and 7) early mobilization and aggressive physiotherapy is recommended. In our case report, we opted for aggressive resection of the affected mandibular condyle to remove the ankylotic mass and ipsilateral coronoidectomy concomitant to the technique of mandibular ramus sliding on the affected side for mandibular reconstruction and sagittal osteotomy on the contralateral side to restore occlusion and for correction of dentofacial deformity associated with physiotherapy in the postoperative period.Vertical osteotomy of the mandibular ramus is indicated for correction of mandibular prognathism, facial asymmetry, osteogenic distraction of the mandible, and for posttraumatic reconstruction. Animal and clinical model studies have shown that this technique can be used as a good alternative to reconstruct a condyle with satisfactory TMJ function. 9 The advantages are that, firstly, in contrast to grafts (eg, costochondral and cranial bones), the use of the posterior mandible edge as a pedicled graft can be performed safely and easily, avoiding complications associated with the local donor. In addition, the posterior ramus border is attached to the medial pterygoid muscle, which can provide sufficient blood to prevent bone resorption/necrosis, resulting in less bone resorption, lower mandibular ramus height decrease, and mouth opening deviation and better clinical outcomes in the long term. 9,10 There are many reported surgical procedures and protocols accepted with the use of various grafts, such as chondroosseous grafts and alloplastic prosthesis for TMJ reconstruction purposes, but there is no standard concept for ankylosis treatment of TMJ. The general agreement is that patient cooperation, early surgical intervention, and postoperative physiotherapy are the most important aspects for good long-term outcomes. 1 A variety of surgical flaps have been described for exposing TMJ through a preauricular approach with temporal extensions associated with the use of retromandibular approach, if necessary, to access the mandibular ramus. The most common surgical approach for the treatment of this condition is the preauricular and the modified preauricular. 10 Sufficient exposure requires a flap that can be extended to the size and extent of the ankylotic mass. A modified type of access for temporal extension rhytidectomy and endaural was performed in this case report, allowing to access both the TMJ and the mandibular ramus. This approach hides the neck line incision and eliminates the scar from...