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For 35 years, Ahmed Khan could barely open his mouth, forcing him to survive largely on liquids. The problem began when he was just one year old due to a rare condition affecting his jaw.
Rare condition restricted his mouth opening severely
Now 36, Ahmed travelled from Afghanistan to India with a friend seeking treatment. Doctors at a private hospital diagnosed him with complete bony temporomandibular joint (TMJ) ankylosis, in which the jaw joint becomes fused with surrounding bone.
Jaw joint fused with skull base
In Ahmed’s case, the joint had completely fused with the base of his skull, leaving him with virtually no mouth opening. CT scans confirmed the severity of the condition, which was classified as Sawhney Type IV, the most severe form of bony ankylosis.
Previous surgery failed to restore movement
Ahmed had previously undergone surgery at another healthcare facility, but it failed to restore functional jaw movement. His condition affected not only eating but also speaking, smiling and everyday activities.
Surgeons carefully removed extensive bony fusion
A surgical team led by Dr Sujoy Mukherjee, Consultant Oral and Maxillofacial Surgeon, performed a complex procedure lasting nearly six hours. Since Ahmed had virtually no mouth opening, securing his airway under general anaesthesia was particularly challenging. Doctors used fibre-optic/bronchoscopic intubation for airway management.
Surgeons carefully removed extensive bony fusion
The surgeons carefully removed the extensive bony fusion to release the joint and restore movement. A temporalis muscle flap was then placed to create a barrier and reduce the risk of re-fusion.
Surgery improved his everyday quality of life
Following the surgery, Ahmed’s mouth opening improved to around 35 mm, nearly three finger widths. He was gradually able to shift from a predominantly liquid diet to regular meals.
The doctors said the case highlights the significant impact of long-standing TMJ ankylosis on nutrition, speech and quality of life, while also demonstrating the challenges of treating severe childhood-onset cases.
