Early Rehabilitation of Temporomandibular Joint Ankylosis after Interpositional Arthroplasty

Spastic hypertonia, which is often a component of an upper motor neuron lesion, is a not uncommon sequela after cerebrovascular accident (CVA). Though satisfactory mouth opening in patients with temporomandibular joint ankylosis can be achieved by some surgery methods, data on rehabilitation immediately after the Lai's interpositional arthroplasty operation is still not available. We report a case of spastic hypertonia leading to severe trismus after brain stem stroke that was successfully treated by early rehabilitation of the temporomandibular joint ankylosis immediately after Lai's interpositional arthroplasty. The maximal dimension of mouth opening was found to be 38mm at the 6 months follow-up. Furthermore, the ankylosis had disappeared after one year of follow-up. Thus early active rehabilitation was able to achieve a good functional outcome.