Unable to open her mouth since birth, 30-year-old Astha Mongia, who had a rare congenital fusion of the jaw joint with the skull bone, has undergone a successful operation at a private hospital. Diagnosed with the medical condition called temporomandibular (TMJ) disorder at birth, Mongia couldn’t eat solid food, had difficulty in speaking, and had lost almost all her teeth.
The TMJ acts like a sliding hinge, connecting the jawbone to the skull, and dysfunction can lead to pain and discomfort, difficulty chewing, and clicking and locking of the jaw joint.
Doctors said the woman’s mouth opening was so small that she couldn’t even touch her tongue with her hand. The situation got worse as she had a neuro-vascular malformation (tumour) over the right half of the face, orbit and forehead, due to which there was no vision in the right eye.
“For such patients to open the mouth, both the condyles (ball like head of jaw joint) have to be removed. Many a times a tongue like bony extension in front of ball joint known as coronoid process has to be either removed surgically or at least fractured, but in her case this was easier said than done as there were bunch of vessels surrounding the coronoid process on the right side,” said Dr Rajeev Ahuja, senior plastic surgeon at Sir Ganga Ram Hospital.
After contacting several experts in the UK and Dubai but in vain, the family reached out to the hospital, and in February, her treatment began with a team of radiology and vascular experts.
Three weeks before the surgery, she was injected with a sclerosant — a solution that stops bleeding by hardening the blood — to shrink blood filled vessels as much as possible. The woman was operated on March 20.
“At the operation table, the mouth opening of the patient was 2.5 cm,” said Dr Ahuja.
At the time of discharge on March 25, her mouth opening increased to 3 cm; in normal circumstances it is 4-6 cm. Doctors said her mouth opening will further increase by way of exercises.
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