Case report: early rehabilitation as a key determinant of successful functional recovery after temporomandibular joint surgery in a juvenile dog with pseudo-ankylosis

Canine temporomandibular joint (TMJ) pseudo-ankylosis is a rare condition where extra-articular bone fusion locks the jaw. While standard treatment usually involves simple removal of the bone bridge, severe cases can require more aggressive procedures like gap ostectomy and condylectomy, which are typically reserved for true intra-articular ankylosis. In addition to the use of the inter-positional barrier, early postoperative rehabilitation is considered a more critical factor for preventing re-fusion. A 7-month-old dog presented with a completely locked jaw caused by bilateral osseous bridging between the mandibular angular processes and the tympanic bullae. Because the mouth could not be opened at all, retrograde intubation was necessary to secure the airway. Utilizing a ventral approach adapted from a Ventral Bulla Osteotomy (VBO), we performed a bilateral gap ostectomy between the right mandibular angular process and the ventrolateral aspect of the tympanic bulla without the use of inter-positional material. This was followed by a condylectomy. Intensive rehabilitation, including passive range-of-motion (PROM) exercises, was started on the second day after surgery. The patient made a full functional recovery, reaching a stable 32 mm jaw opening at a 6-month follow-up. The need for retrograde intubation highlighted the extreme severity of the case. This report shows that creating a wide surgical gap followed immediately by structured rehabilitation can prevent re-ankylosis and restore normal function, even in severe cases where complex grafting might otherwise be considered.