What if you were born unable to open your mouth – and could never eat a normal meal? For 35 years, Ahmed Khan could not manage a proper meal. When he was only one year old, a rare problem left his jaw stuck, so he had to live mostly on liquids. At age 36, things shifted. He moved from Afghanistan to Kolkata and had jaw surgery at CK Birla Hospitals, CMRI. Dr. Sujoy Mukherjee, Consultant Oral and Maxillofacial Surgeon, handled his care.
Tests showed Ahmed had complete bony TMJ ankylosis. In this condition, the jaw joint can fuse with nearby bone. In his situation, the joint had fused fully to the base of his skull. Because of that, he could open his mouth very little, if at all. With nil mouth opening, securing the airway from general anaesthesia was particularly challenging, hence, the team had to opt for fibre-optic/bronchoscopic intubation to secure the airway. This issue did not only affect food. For years, daily things were hard. Eating normally was difficult. So was speaking with ease. Even smiling the way other people do became a struggle
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Ahmed had undergone surgery at another healthcare facility in the past, but the procedure did not restore functional movement of his jaw. With little improvement even after treatment, he eventually travelled to Kolkata with a friend in search of another option.
At CK Birla Hospitals, CMRI, a detailed clinical evaluation and CT scan revealed the extent of the problem. The temporomandibular joint (TMJ)—the joint connecting the jawbone to the skull—had undergone severe bony fusion. The joint and the adjacent skull base had effectively become one solid mass, leaving Ahmed with extremely limited mouth opening.Given the severity of the ankylosis and the history of a previous unsuccessful surgery, the case required meticulous planning and a complex surgical approach.
Dr. Sujoy Mukherjee, Consultant Oral & Maxillofacial Surgeon, CK Birla Hospitals, CMRI, and his team undertook a nearly six-hour complex surgical procedure to remove the extensive bony fusion and restore movement to the jaw. The fused bony mass was carefully removed, enabling the joint and surrounding structures to regain functional movement.
“It was a challenging situation. The jaw joint had become fused with the skull base, and his mouth opening had remained severely restricted since childhood. He had also undergone surgery previously, but unfortunately, the functional movement he needed had not returned. On examination and CT scan, it was clear that his jaw joint was completely fused with the skull base. It was a Sawhney Type IV – the most severe form of bony ankylosis. The surgery was highly challenging. As per international performing site protocol, the operation was performed in the main operation theatre under general anaesthesia with advanced fibreoptic airway management. It took nearly 6 hours to cut and release the entire bony fusion. Our objective was not simply to increase the mouth opening. We wanted to restore meaningful jaw movement so that he could eat and speak with greater ease. After creating a sufficient gap and placing a temporalis muscle flap to prevent re-fusion, we achieved a mouth opening of 35mm – almost 3 fingers. Seeing him open his mouth and eat a regular meal after living with this limitation for 35 years was an extremely fulfilling moment for the entire team,” said Dr. Sujoy Mukherjee, Consultant Oral & Maxillofacial Surgeon, CK Birla Hospitals CMRI.Speaking on the success, Dr. Mukherjee said, “Cases like this need not only surgical expertise but also a proper hospital setup with HDU and anesthesia support. The biggest reward for a surgeon is to see the happiness on the face of the patient and his family.”
Following the surgery, Ahmed’s mouth opening improved to approximately 35 mm—close to three finger widths. This functional improvement has allowed him to gradually move from a predominantly liquid diet to eating regular meals.
For his family and friends, the transformation was particularly emotional. Having watched Ahmed struggle with the condition for decades, seeing him open his mouth properly after surgery was a moment of disbelief and relief. For the first time in years, they could clearly see his tongue and witness a movement that had once seemed almost impossible.
For Ahmed, however, the significance of the surgery extends far beyond the measurements of mouth opening. It means being able to sit down and eat a regular meal, communicate more comfortably and smile without the physical restriction that had shaped much of his life.
The case highlights how temporomandibular joint ankylosis, particularly when it develops in childhood and remains untreated or inadequately treated for years, can affect much more than jaw movement. Severe restriction can interfere with nutrition, speech, oral hygiene and everyday social interactions, significantly affecting a person’s quality of life.
Ahmed’s case also demonstrates the complexity of treating long-standing TMJ ankylosis, particularly in patients who have previously undergone surgery. In such cases, detailed imaging, careful surgical planning and a multidisciplinary approach can be crucial to restoring functional movement and improving quality of life.
After almost 35 years of living with a locked jaw, Ahmed’s ability to open his mouth and eat a regular meal represents not just a successful surgical outcome, but the return of a basic freedom he had been unable to experience for most of his life.