title: Facial nerve injury following surgery for temporomandibular joint ankylosis: a prospective clinical study.
abstract: OBJECTIVE
  The purpose of this prospective study was to evaluate the incidence and degree of facial nerve damage and time taken for its recovery following surgery for temporomandibular joint (TMJ) ankylosis.
  
  
  METHODS
  A total of 30 subjects with the TMJ ankylosis with or without history of previous surgery were included in this prospective study. House-Brackmann grading system was used to assess the function of the facial nerve post-operatively.
  
  
  RESULTS
  Most of the subjects were in the age range of 13-15 years. Eight subjects had bilateral ankylosis and remaining 22 had unilateral ankylosis. Out of 32 joints in which gap arthroplasty was performed, 4 had Grade 1 injury, 14 had Grade 2 injury, 12 had Grade 3, and 2 with the Grade 4 injury 24 h post-operatively. Whereas, out of 6 cases of interpositional arthroplasty 4 had Grade 1 injury and 2 had Grade 4 injury. According to House-Brackmann grading system, at 24 h, 78.9% patients had different grades of facial nerve injury, which gradually improved and came to normal limits within 1-3 months post-operatively. Comparison of change in the Grade of injury at 3 months follow-up as compared to baseline (24 h) showed full recovery in all the cases (100%) showing a statistically significant difference from baseline (P < 0.001).
  
  
  CONCLUSIONS
  When proper care is taken during surgery for TMJ ankylosis, permanent facial nerve injury is rare. However, the incidence and degree of temporary nerve injury could be either due to the heavy retraction causing compression and or stretching of nerve fiber resulting in neuropraxia.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, India.
authors.forename: S
authors.initials: S
authors.lastname: Gokkulakrishnan
authors.forename: Sanjay
authors.initials: S
authors.lastname: Singh
authors.forename: Ashish
authors.initials: A
authors.lastname: Sharma
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Singh
authors.forename: Rajshree
authors.initials: R
authors.lastname: Borah
mesh_terms: D000293:Adolescent; D002648:Child; D005154:Facial Nerve / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*