Prophylactic embolisation of the internal maxillary artery in patients with ankylosis of the temporomandibular joint

The aim of the present study was to assess the efficacy of using prophylactic embolisation of the internal maxillary artery to minimise the risk of bleeding during gap arthroplasty. We studied a prospective series of 14 patients with ankylosis of the temporomandibular joint (TMJ) between January 2011 and February 2016, who were under the care of one surgeon. They were all treated by embolisation of the internal maxillary artery 24 hours before gap arthroplasty. The main outcome variable was estimated blood loss, and others included the need to extend the gap arthroplasty, and the risk of reankylosis. We studied nine women and five men, mean (SD) age 51 (18) years, seven with unilateral and seven with bilateral ankylosis. Their mean (SD) estimated blood loss was 136 (77) ml, which we considered to be minimal. Patients were followed-up at six-monthly intervals, during which time there was no reankylosis or limitation of mouth opening. No patient lost more than 250 ml blood in total. Prophylactic embolisation of the internal maxillary artery seems to be beneficial and safe in the management of selected cases of ankylosis of the TMJ.