Outcome of Mouth Opening Assessment in Trismus Release Secondary to Noma: A Retrospective Study

Abstract

Background: The most important aspects in the management of trismus are to achieve satisfactory mouth opening, and it is best evaluated by measuring the interincisal distance (IID). Hence, this study aimed to evaluate the pre-, intra- and postoperative IID achieved during the management of trismus secondary to noma. Materials and Methods: This was a retrospective study conducted at Noma Children’s Hospital Sokoto using 3-year record. After obtaining ethical approval from the state ministry of health, the case records of patients who were managed for trismus secondary to noma were retrieved. Patients’ demographics, site of ankylosis, surgical procedure, preoperative, intraoperative and postoperative IID were extracted and analysed using SPSS version 25. Results: There were 16 (38.1%) males and 26 (61.9%) females in the range of 5–25 years with mean ± SD of 10.0 ± 5.1 years. Unilateral ankylosis constitutes the majority 32 (76.2%). The mean ± SD preoperative (P1) and intraoperative (P2) IID are 5.0 ± 4.7 mm and 41 ± 6.6 mm, respectively. The mean ± SD postoperative IID at first and second reviews (P3 and P4) are 35 ± 8.2 mm and 32 ± 8.0 mm, respectively. Comparison of age categories and P3 yielded a reduction in IID with decreasing age which was not statistically significant ( χ 2 = 12.336) df=6, P value = 0.055. However, a comparison of age categories and P4 revealed a reduction in IID which was significant ( χ 2 = 30.707 df=6, P value = 0.000). Conclusion: The amount of mouth opening achieved following noma trismus release has been shown to be decreasing over time and has been also affected by age. Aggressive jaw exercise is a key factor in maintaining the achieved intraoperative IID during TMJ ankylosis management.