Twist of fate: Woman diagnosed with arthritis after eating pretzel has jaw mended in unique operation

Amanda Cullen suffered 'continuous agony' before treatment by London surgeons
Amanda Cullen, 53, was diagnosed with arthritis after eating a pretzel
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Daniel Keane26 October 2023

A woman who was diagnosed with arthritis after eating a pretzel has had her jaw mended thanks to a unique operation by London surgeons.

Amanda Cullen, 53, first became aware of a problem with her jaw in 2020 when she felt it clicking.

She later noticed “intense pain” after biting into a pretzel while out for lunch with a friend, which developed into “continuous agony” a few months later.

Ms Cullen was diagnosed with arthritis of the jaw, which can cause mild to severe pain and can get worse over time.

She was referred to Chase Farm Hospital (CFH) in Enfield, where she had a unique treatment called therapeutic temporomandibular joint (TMJ) arthroscopy.

This involves keyhole surgery under general anaesthetic in which a small telescope is inserted into the jaw. Surgeons then remove scar tissue and thickened cartilage, reposition displaced tissue, remove inflamed tissue, reshape the jawbone, and insert anti-inflammatory medicine.

Keyhole surgery is a technique allowing surgeons to perform a procedure inside the body through a very small incision in the skin. It results in significantly less pain and bleeding.

CFH is the only NHS hospital to offer “arthroplasty” – the surgical procedure to restore the function of a joint - through the keyhole access.

Dr Komath and his team
Supplied

Since 2018, over 300 patients have been treated at CFH, with more than 85 per cent who have had TMJ arthroscopy reporting a significant reduction in pain and increased mouth opening.

Following her surgery, Ms Cullen said: “My bite isn’t 100 per cent perfect and my teeth can still click a bit but I can eat anything I want and I’m no longer in any pain. I’m so grateful to Mr Komath and his team. Having the operation has made such a huge difference to my quality of life.”

Surgeon Deepak Komath said that other NHS trusts were looking to follow suit after the success of the procedure.

He said: “Jaw joint arthritis is very common but has been poorly understood over the years. It’s been treated in different ways until now, including physio and wearing a night guard, but the outcomes have been consistently poor.

“One of the things that has helped us offer a better solution is that we now have access to high quality images through MRI which shows the disease in greater detail. Previously we would have had to wait until there were bone changes to see it on an X-ray or CT scan, but with the MRI scan we can see the arthritic process affecting the joint at a much earlier stage of disease and go in and do something about it.”

Dr Komath added: “For those whose keyhole surgery is unsuccessful, jaw replacement surgery can be considered but this is very much the last resort as it is a much bigger surgery with all the associated risks that entails.”

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