AIIMS Jammu conducts rare jawbone fusion deformity surgery

Jammu, Jul 23: All India Institute of Medical Sciences (AIIMS) Jammu has achieved yet another distinction by conducting a successful surgery to treat a rare and technically demanding case of temporomandibular joint (TMJ) ankylosis, involving a 4-cm bony fusion between the mandibular condyle and the skull base.

Surgery was conducted at the Department of Oral and Maxillofacial Surgery, bringing significant relief and renewed function to an elderly patient who had been living with jaw immobility and pain for years.

The 62-year-old patient presented with an inability to open the mouth completely, resulting from a large, abnormal bone mass (approximately 4 cm) fusing the lower jaw to the skull base – an extremely rare and debilitating form (Type IV Sawhney’s classification) of TMJ ankylosis.

After thorough clinical and radiological evaluation, the surgical team proceeded with an interpositional arthroplasty with buccal fat pad, where the fused bone was removed and a soft tissue graft was placed to prevent recurrence.

The Oral and Maxillofacial Surgery team carried out the surgery under the leadership of Dr Amanjot Kaur and her team members, Dr Nandkishor, Dr Vishwajeet, and Dr Rupinder, with careful dissection around critical structures, including the facial nerve, skull base, and maxillary artery.

“Post-surgical recovery has been smooth, and the patient is now able to open the mouth and eat soft foods, with ongoing physiotherapy to support long-term function,” said Dr Amanjot Kaur.

She said, “The case was especially challenging due to the massive extent of the ankylosis and patient age. This achievement was made possible through the visionary support and encouragement of the ED and CEO, Prof Shakti Kumar Gupta, whose continued emphasis on advanced surgical care and infrastructure has enabled teams to undertake high-end procedures.”

Speaking on the occasion, Prof Gupta said, “This case reflects the calibre of clinical expertise and collaboration we are building at AIIMS Jammu. It is our mission to bring cutting-edge, patient-centric care to the region, and I commend the surgical, anaesthesia, and support teams for their exemplary effort in managing such a rare and technically complex condition.”

A significant aspect of the surgery was also the expert involvement of the Department of Anaesthesiology, led by Dr Kanika Gupta and Dr Sandeepika Dogra and their team members – Dr Anu and Dr Marvi, who skilfully managed a difficult airway scenario due to limited mouth opening—a common challenge in TMJ ankylosis cases.

Safe induction and extubation in such patients require advanced planning and expertise, and their contribution was instrumental in ensuring a smooth intraoperative course.

The surgery team also acknowledged the leadership of Prof Saurabh K Gupta, whose mentorship played a central role in the case’s success.

Reflecting on the case, he stated, “This surgery is a landmark not just for our department but for the entire institute. It reflects our commitment to restoring function and dignity to patients suffering from rare and debilitating conditions. I’m proud of the team for handling such a technically demanding case with precision and compassion.”

“This case is a true example of multidisciplinary teamwork and institutional synergy,” said Dr Amanjot Kaur.

“From OT scheduling to anaesthesia, postoperative care, and physiotherapy- each component was critical. We are grateful for the enabling environment created by our Director, MS and all departments involved,” she said.

“AIIMS Jammu continues to emerge as a premier centre of excellence in surgical and medical care, offering cutting-edge diagnostics and advanced interventions across specialities. The institute remains committed to pushing the frontiers of clinical innovation while delivering compassionate, comprehensive, and patient-centred care to the region,” Executive Director and CEO AIIMS Jammu, Prof Shakti Kumar Gupta said.