The Temporo-mandibular joint (TMJ) is the articulation between the mandible and the cranium [1]. It is a highly specialized joint, depicted by the fact that the articulating surfaces of bones are covered by fibrocartilage unlike other joints in the body that are covered by hyaline cartilage [1,2]. Temporomandibular joint ankylosis (TMJA) is the fusion of the head of mandibular condyle to the glenoid fossa of temporal bone. The main clinical features of TMJA are gradual limitation of mouth opening, facial deformity, and obstructive sleep apnoea syndrome [3,4]. It is classified according to location (intra-articular or extra-articular), type of tissue involved (bony, fibrous, fibro-osseous) and extend of fusion (complete or incomplete) [3,4]. Trauma is the major cause of TMJA globally (13–100%). The other causes include local (noma) or systemic infection, systemic autoimmune diseases, forceps delivery, neoplasia, or unknown etiology [3,4]. Post traumatic TMJA is increasing dramatically especially in developing countries due to the delay in treatment and difficulty access to specialized healthcare. Additionally, patients seek medical advise only when the problem is at an advanced stage and mouth opening is almost insignificant [[5], [6], [7]].

TMJA presents a difficult anesthetic and airway management glitches as rigid laryngoscopy is not possible in these patients [8]. Ideally, administration of general anesthesia to TMJA patients requires the availability of flexible fibreoptic bronchoscope and trained personnel that use the equipment's regularly together with monitoring gadgets [8]. In developing and resource limited countries, these equipment's and manpower are lacking and often not available, therefore other methods of airway management are frequently employed such as retrograde tracheal intubation, blind naso-tracheal intubation and tracheostomy [8]. These other methods of airway management in TMJA patients has very high failure rates such as retrograde and blind naso-tracheal intubation even in the experienced hands. Tracheostomy, which an invasive procedure is considered the last option in difficult airway management because of risk of post-operative complications [8].

In developing climes like ours, despite the lack of equipment's and manpower, there have been changing trends in the airway management in TMJA patients. The main aim of this study, therefore, was to review airway management in patients with TMJA and to showcase the changing trends involved in the past 9 years.