Mumbai doctors have successfully treated Renu (name changed) to restore her jaw function after conducting a complex surgical procedure. The 36-year-old was suffering after experiencing excruciating pain and discomfort for six months due to Temporomandibular Joint Dysfunction (TMJ), a disorder of the hinge-like joint connecting the lower jaw (mandible) to the skull. This limited her ability to open her mouth only as wide as the slender gap of a single finger, making it difficult for her to talk and eat.
As her daily life took a big toll, Renu decided to consult Dr Tofiq Bohra, oral and maxillofacial surgeon, S. L. Raheja Hospital, Mahim – A Fortis Associate, who diagnosed her with Synovial Chondromatosis, a rare and benign condition in which bone tumors affect the joints, and counselled her to undergo surgery to help restore proper jaw function. After which, she can now open her mouth wide enough to eat and to sneak in a laugh every now & then at her children’s antics and experience the joy of unbridled laughter.
“Renu would not take a day off from household chores when she was in pain and even when we begged her to rest. She started experiencing pain on the left side of her jaw in July this year, we took her to a local doctor who put her on a course of painkillers. However, the medicine stopped working after a few months and the pain spread to her left shoulder & arm, that is when we decided to take her to a specialist for better evaluation,” recalled her husband Jatin (name changed).
Usually, a Magnetic Resonance Imaging (MRI) is often prescribed when a patient with a joint issue consults an orthopedic specialist or an oral and maxillofacial surgeon. The MRI is mainly used to assess bone density and detect any inflammatory fluid within the joint. In the scans, inflammation appears as a white band, which is typically interpreted as a sign of inflammatory fluid in the joint. The challenge with Renu’s case was that every time she underwent an MRI, the results indicated a simple joint inflammation. However, the medical team at the hospital, led by Dr Bohra, had prior experience and they were able to diagnose that it was not a simple case of joint inflammation, but rather a complex case of TMJ and she needed surgery.
Talking about the case, Dr Bohra said, “Synovial Chondromatosis is a rare condition. Before Renu came to me, I treated only one patient with a similar condition. Even though the MRI pointed towards inflammation, we recommended a combination of open joint surgery and Arthroscopy (minimally invasive surgical procedure used to diagnose & treat joint problems), instead of proceeding with more conservative treatments like a simple Arthroscopy. Open jaw surgery helped us access the affected joint through an incision near the impacted temporomandibular joint. This decision was based on my experience with a similar case, where Arthroscopy alone didn’t fully address the underlying issues.”
Dr Bohra added, “On November 25, we performed an open joint surgery on the left side, while on the right side, a more advanced level 3 TMJ Arthroscopy was done. Arthroscopy being a minimally invasive procedure involves small incisions, which means less tissue damage, a shorter recovery time, and a lower risk of complications. This approach allowed us to address displaced disks and flush the joint. During the surgery, we found cartilage (a connective tissue which connects the joint) in the joint, which was an unexpected complication. The joint was difficult to open due to the presence of this cartilage, and we had to remove it carefully before flushing the joint & closing it.”
Immediately after surgery, Renu was able to open her mouth wide enough to fit in three fingers, much to the relief of her family members, who remember her grit and resilience during this harrowing ordeal.
Renu is currently on a liquid diet and is diligently adhering to her post-surgery precautions, which include oral physiotherapy. Her recovery is being carefully monitored, with a detailed diet and care routine to guide her healing process. Though she remains on her liquid regimen for now, she and her family are eagerly anticipating the day when she can once again enjoy solid food.
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