Obstructive Sleep Apnea Syndrome occurring after
Bilateral Low Operations Performed for
the Treatment of TMJ Ankylosis, report of a case


Masaki KOHNO, Yoshiyuki TAKATA, Ichiro SUZUKI,
Susumu SHINGAKI, Tamio NAKAJIMA
First Department of Oral and Maxillofacial Srugery, Niigata University School of Dentistry


Abstract:
A case of obstructive sleep apnea syndrome (OSAS) occurred after bilateral low operations of the ascending rami performed for the treatment of TMJ ankylosis is reported. The patient was a 52-year-old woman with bilateral ankylosis of the TM joints which developed after surgery of a mandibular tumor. The OSAS resulting from the narrowed pharyngeal space occurred immediately after surgery because of a down and backward movement of the mandible associated with a backward change in the position of the tongue base. Apnea index (arrest of respiration over 10 seconds/hr) was 26.8. The longest apnea was 82 seconds and it was accompanied by the occurrence of ventricular extrasystoles. The symptoms of OSAS gradually disappeared with the patient's adaptation to the new oral and pharyngeal environments by up and forward change of the tongue position and subsequent widening of the pharyngeal airway. The adaptation was facilitated with the aid of dentures used to increase the vertical dimension of the mandible to enable the up and foreward movement of the tongue.


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