This webpage has been designed to improve understanding of Open Jaw Joint Surgery and contains answers to the most commonly asked questions about this treatment. If you have any other questions that the website does not answer or would like further explanation please ask a member of our medical staff.

The problem
A Surgeon may decide that the best way to sort out the problems a patient is experiencing from the jaw joint is to perform “open” surgery. Open surgery involves exposing the jaw joint fully by making a cut in front of the ear rather than using keyhole techniques.

What does the operation involve?
In order to gain access to the joint the surgeon will make a cut immediately in front of the ear. Although the cut extends from the top to the bottom of the ear, where possible it will be placed in a skin crease so that when it heals fully it will be difficult to see. Sometimes it is necessary to extend the cut from the top of the ear upwards into the hairline. Once the joint has been opened and any treatment carried out, the incision is put back together again with stitches. These need to be removed around a week after surgery. At the end of the operation a small tube may also be placed through the skin into the underlying wound to drain any blood that collects. This “drain” is usually removed on the morning following surgery.

How long will the operation take?
The length of the operation depends on what the surgeon will be doing on the jaw joint. If the procedure is relatively simple (eg repositioning of a slipped cartilage) surgery may take less than an hour. If the procedure is more complicated (eg partial or total joint replacement) then the operation will last for several hours.

What can be expected after the operation?
The area in front of the ear is likely to be sore for several days after surgery. Regular painkillers will be arranged. It is also necessary to make sure that the area heals without any infection and so patients may also be given antibiotics.

Immediately after the operation the patient's face will be swollen and feel tight, the jaw will be stiff and patients will find that they cannot open their mouth widely. Bruising is variable and can last several days. Any swelling can be reduced by using cold compresses and sleeping propped upright for a few days. Most of the swelling will have disappeared after a week.

Can patients eat normally after surgery?
To begin with no. For the first week or so patients will only want a soft diet. Some may find that their bite feels strange for a couple of weeks.

How long will the hospital stay be?
This obviously varies from person to person and depends on what sort of surgery has been performed. Most patients spend one or two nights in hospital after their operation.

Does this procedure require any time off work?
Again this varies enormously from person to person. Most people require a week or so off work. It is important to remember that patients will not be able to drive or operate machinery for 48 hours after general anaesthetic.

Will this procedure leave a scar?
All cuts made through the skin leave a scar but the majority of these fade with time and are difficult to see when they are fully healed. It may take several months for the scar to fade but eventually it should blend into the natural folds and contours in front of the ear.

What are the possible problems?
There are potential complications with any operation. Fortunately with this type of surgery complications are rare and may not happen. However it is important that patients are aware of them and have the opportunity to discuss them with their surgeon.

		Bleeding – some oozing from the incision in front of the ear on the night of the operation is normal and to be expected. Should patients have any bleeding when they get home it can usually be stopped by applying pressure over the area for at least 10 minutes with a clean handkerchief or swab.
		Infection is uncommon particularly if patients have been prescribed antibiotics.

What is the possible nerve damage that can occur?
The facial nerve runs close to the jaw joint. It is this nerve that makes the muscles of the face work. Damage to some or all of that nerve can result in weakness of the muscles on one side of the face. Most nerve damage occurs as a result of bruising since the nerve is protected during surgery. If nerve damage occurs it is usually temporary although it can take several months to recover fully.

The nerve that supplies feeling to the earlobe (great auricular nerve) can sometimes be bruised as a result of surgery. Patients may end up with a numb or tingling feeling in their earlobe.

Is permanent nerve damage possible?
While the majority of damage to the nerves is temporary, permanent damage is possible but usually only occurs in the most difficult cases.

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