Health

Ankylosis: The girl whose mouth was locked shut

Liliana Cernecca Image copyright UCLH

A six-year-old girl is able to smile and eat properly for the first time after having surgery to unlock her jaw.

Liliana Cernecca was able to open her mouth only a couple of millimetres after one of her jaw joints fused - a rare condition called ankylosis.

She is one of the youngest people to have had such surgery, which took place at King's College Hospital in London.

Her family said Liliana had been "bouncing" ever since the operation and was now more confident.

The problem started after an ear infection when Liliana, from south London, was 18 months old.

The bone, which has a similar structure to pumice stone, became full of infection which eventually led to ankylosis - the fusing of the jaw-bone to the skull.

Liliana's mother, Sonia, told the BBC: "Eating was difficult and messy and it was difficult brushing teeth, she'd never really known being able to take a bite from an apple, we had to just cut food up really small."

The right side was fused, but the left was growing normally. It meant the shape of her face was becoming progressively skewed to the right as she got older.

Mr Shaun Matthews, consultant oral and maxillofacial surgeon at King's, said: "We couldn't leave her like this as things would only get worse.

"Although she already had extremely limited mouth opening - 5mm or thereabouts - the chances are it was going to get worse to the point where she had none at all and clearly that was going to be entirely unacceptable."

Problems concerned with the brushing of teeth can cause life-threatening consequences as poor dental hygiene can lead to tooth infections, which can readily spread into the head and neck.

'Pretty darn rare'

Image copyright King's
Image caption Liliana Cernecca's right jaw became fused to her skull

The head of the jaw joint was removed during an operation so that the jaw was only held on by muscle and ligaments on the right hand side.

The jaw head is expected to re-grow normally with time.

Liliana was nervous about trying to move her mouth after the operation and then "she yawned for the first time, oh my God, it was amazing", her mum said.

She added: "She was shocked and just touched her face it was just wonderful, I'm getting goosebumps thinking about it.

"She can eat and chew and it just gets better every week, she can eat a banana now."

One of the biggest differences was in school where she is now more talkative and confident.

Mr Matthews said the procedure was "pretty darn rare" especially in the UK.

He said it was a wonderful and lovely moment when Liliana yawned for the first time, but that she may need more surgery in the future.

"We will monitor her growth very carefully over the next several years and through puberty in particular.

"She may well need to have further interventional surgery as she gets older, particularly once she's gone through her adolescent growth spurt, but that should be easier to correct now that her main problem has been overcome."

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