Ankylosis of the temporo-mandibular joint after temporal craniotomy: a cause of difficult intubation

It is not generally appreciated that surgery in the region of the temporal fossa commonly produces, within a few weeks, a contracture of the temporalis muscle with "pseudo" ankylosis of the jaw. This usually, but not always, resolves within six months. The aetiotogical possibilities include, singly or in combination: 1. Postincisional scar formation within the muscle. 2. A Volkman's contracture due to devascularization of the muscle. 3. Organization of haematoma. It is recommended that active and passive jaw exercises be started early after surgery in the temporal fossa and that such postcraniectomy patients be carefully assessed for jaw ankylosis prior to undertaking anaesthesia.