title: Primary mandibular distraction for management of nocturnal desaturations secondary to temporomandibular joint (TMJ) ankylosis.
abstract: OBJECTIVE
  Mandibular advancement is a proven method in the management of obstructive sleep apnoea syndrome (OSAS) which may manifest as sleep disturbances with nocturnal desaturations during sleep (NDS). The purpose of this study is to evaluate the role of primary osteo-distraction prior to ankylosis release in pediatric patients, diagnosed with NDS secondary to temporomandibular joint (TMJ) ankylosis.
  
  
  METHODS
  Three patients in the age group of 8-12 years diagnosed with OSAS secondary to TMJ ankylosis underwent primary osteo-distraction for mandibular advancement. They were evaluated pre- and post-operatively using radiographs, over night pulse oximetry, and subjective evaluation of their sleep patterns.
  
  
  RESULTS
  All the three patients showed significant improvement in their saturation levels with a mean oxygen saturation of 94.66%. There was marked reduction in their snoring and sleep/awakening patterns. The mean advancement of the mandible in the three patients was 13.8mm.
  
  
  CONCLUSIONS
  Primary mandibular distraction is an effective method of correction of nocturnal desaturations during sleep in patients with TMJ ankylosis.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Meenakshiammal Dental College & Hospital, Alappakkam Main Road, Maduravoyal, Chennai 600095, India. anantparameswaran@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Anantanarayanan
authors.forename: Vivek
authors.initials: V
authors.lastname: Narayanan
authors.forename: R
authors.initials: R
authors.lastname: Manikandhan
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Kumar
mesh_terms: D002648:Child; D005146:Facial Asymmetry; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008844:Micrognathism / Q000209:etiology; D019857:Osteogenesis, Distraction / Q000379:methods*; D010092:Oximetry; D010101:Oxygen Consumption / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires; D013704:Temporomandibular Joint / Q000503:physiopathology*; D020254:Tooth Ankylosis / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery