title: Management of severe sleep apnea secondary to juvenile arthritis with temporomandibular joint replacement and mandibular advancement.
abstract: Variations affecting the growth centers can severely affect the normal formation and subsequent function of vital musculoskeletal structures. We report a case of bilateral condylar atrophy with a history of juvenile arthritis (JA) resulting in progressive obstructive sleep apnea (OSA) in adulthood. In addition to this, the case report emphasizes the role of temporomandibular joint replacement and advancement of the mandible to correct progressive OSA secondary to idiopathic JA. Computed tomography revealed micrognathia, condylar hypoplasia, and decreased pharyngeal airway space. The resultant increase in the retrolingual-pharyngeal airway space following the surgery, helped to completely resolve the presenting symptoms. It is hoped that the described technique could be used in similar cases with a predictable outcome.
authors.affiliation: Dental and Oral Surgery Unit-1, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: S Arun
authors.initials: SA
authors.lastname: Paul
authors.affiliation: Dental and Oral Surgery Unit-1, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: S Sibu
authors.initials: SS
authors.lastname: Simon
authors.affiliation: General Surgery, Head and Neck, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Barney
authors.initials: B
authors.lastname: Issac
authors.affiliation: Dental and Oral Surgery Unit-1, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Saurav
authors.initials: S
authors.lastname: Kumar
keywords: Condylar analogue; condylar atrophy; juvenile arthritis; mandibular advancement; obstructive sleep apnea; temporomandibular joint replacement