According to her mother's account, had bilateral ear infections (otitis media) that were untreated with antibiotics. The infection somehow triggered inflammation in her temporomandibular joints (TMJ, or jaw joints). Our Face the Challenge teams have heard similar stories related to complications from untreated ear infections before.
At about the age of one, "L" could no longer open her mouth. For 25 years she should could only drink liquids and eat soft foods. Her mother mentioned that "L" had to swallow each of her baby teeth since she could not open her mouth wide enough to spit them out.
Her mandible (lower jaw) essentially quit growing since the main area of jaw growth in the condyle (angle of the jaw) was restricted by bony overgrowth at the TMJ. So her lower mouth remained the size of a toddler. The CT scan photos show how the jaw joints in front of the ears had become fused, unable to move at all.
Her tongue, however, continued to grow. As a strong muscle, her tongue then pushed her front teeth forward.
Included in these photos is one of "L" with the anesthetist. It shows how frail she is. Barely able to eat at all or ever, her weight at the time of her ankylosis release surgery was 33 kg (~72.5 lbs).
"L's" facial expression is one of the saddest looks we have seen in Saigon during our screenings. She seemed to have little energy and virtually no hope.
She will need more reconstructive surgeries to continue to enlarge her mouth and jaw. But at least now, about two-and-a-half decades later, she can breathe, eat, and speak with more ease. Her mother remained at "L's" side during the screening and while "L" recovered from surgery. She was so grateful!
"L" will soon need to have all her teeth removed due to decay. In 25 years it was not possible to brush her teeth. Next she will be fitted for dentures - likely some of the smallest set the prosthodontist has ever had to make.