Surgical approaches can be selected to treat temporomandibular joint ankylosis when favorable effects are not achieved with conservative treatment. We report a case of bilateral temporomandibular joint ankylosis in which a combined AlKayat–Bramley and endoscopic approach was implemented. A 65-year-old man was transported to the Emergency and Critical Care Center of our hospital due to trauma in a traffic accident. Computed tomography showed bilateral condylar head fractures and a midline fracture of the mandible. Four days after the injury, we performed open reduction and internal fixation of the midline fracture of the mandible. The bilateral condylar head fractures were managed conservatively. It was difficult to perform mouth-opening training for one month after the surgery due to disturbance of consciousness and diffuse axonal injury accompanied by traumatic subarachnoid hemorrhage. At the beginning of the rehabilitation, an opening disorder occurred, and no improvement was observed even after continuing mouth-opening training after discharge from our hospital. Three years after the injury, we performed bilateral arthroplasty with a temporalis muscle flap using an endoscope for post-traumatic temporomandibular joint ankylosis. We were able to perform the surgery correctly and safely using an endoscope, particularly when we removed the condylar head, which was dislocated inside the ramus. The maximum mouth-opening distance improved from 15mm to 42mm after the surgery. Three years postoperatively, maximum interincisal opening was maintained and no recurrence with functional disturbance was found.
