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Yoshida K. Superior Dislocation of the Mandibular Condyle into the Middle Cranial Fossa: A Comprehensive Review of the Literature. J Clin Med 2023; 12:jcm12113781. [PMID: 37297975 DOI: 10.3390/jcm12113781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The superior dislocation of the condyle into the cranium occasionally requires invasive procedures due to the absence of a timely diagnosis. This review analyzed the available clinical data to provide information on treatment decisions. The reports were assessed using electronic medical databases from inception to 31 October 2022. A total of 116 cases from 104 studies were assessed; among the patients, 60% and 87.5% of the affected women and men required open reduction, respectively. The ratio of closed to open procedures within 7 days after injury was maintained; however, closed reduction decreased over time, and all cases required open reduction after 22 days. Eighty percent of the patients with a total intrusion of the condyle required open reduction, whereas the frequency for both procedures was comparable in the remaining patients. Open reduction was significantly more frequently performed for men (p = 0.026, odds ratio; 4.959, 95% confidence interval; 1.208-20.365) and less frequently performed in cases with partial intrusion (p = 0.011; odds ratio: 0.186; 95% confidence interval: 0.051-0.684); the frequency varied according to the time until treatment (p = 0.027, odds ratio; 1.124, 95% confidence interval; 1.013-1.246). Appropriate diagnostic imaging and prompt diagnosis are indispensable for minimally invasive treatment of this condition.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
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Barreto D, López JP. Idiopathic Unilateral Intracranial Condylar Dislocation: A Case Report. J Oral Maxillofac Surg 2023:S0278-2391(23)00326-9. [PMID: 37084761 DOI: 10.1016/j.joms.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/02/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
Intracranial condylar dislocation to the middle fossa is rare, as it is not reported often. Known cases have an etiology, identified as erosion of the glenoid cavity from joint prostheses and/or traumatic events. As such, this case aims to offer a predisposing reason for the idiopathic condylar dislocation to the middle cranial fossa with nonfunctional limitations.
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Nikunj A, Khan N, Rajkhokar D, Mishra B, Rajurkar S. Drug-Induced Oromandibular Dystonia Presenting as Chronic Temporomandibular Joint Dislocation: A Rare Case Report. Cureus 2022; 14:e23478. [PMID: 35494907 PMCID: PMC9045546 DOI: 10.7759/cureus.23478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/22/2022] Open
Abstract
Approximately 15%-30% of patients receiving neuroleptic medication for a longer duration develop drug-induced dystonia. There are many variations of oromandibular dystonia (OMD), but the most common one is involuntary jaw-opening dystonia. A rare case of chronic mandibular dislocation under long-term neuroleptic therapy is reported with clinical features, diagnosis, and various treatment modalities. Chronic dislocation leads to changes in associated soft tissue and muscles. Therefore, besides alteration of bony articular surfaces (eminectomy), soft tissue remodeling is required to achieve the perfect balance for temporomandibular joint (TMJ) working and occlusion. Drug-induced orofacial dystonia presenting as chronic TMJ dislocation is rare. Therefore, in long-standing chronic dislocation cases during treatment, biomechanics of TMJ, its complex neurological system, and the physiology of the masticatory system should be considered to customize the treatment plan.
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Motazedian G, Khojasteh A, Salari F. Rare Complication of Orthognathic Surgery: Intrusion of Mandibular Condyle into the Middle Cranial Fossa. World J Plast Surg 2021; 10:111-113. [PMID: 34912675 PMCID: PMC8662687 DOI: 10.29252/wjps.10.3.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/18/2021] [Accepted: 08/31/2021] [Indexed: 10/31/2022] Open
Abstract
Dislocation of mandibular condyle into the middle cranial fossa is rare but diagnosis and treatment timely is very important due to significant complications. In this paper, we present a very rare case of asymptomatic intrusion of the mandibular condyle into the middle cranial fossa after orthognathic surgery in a 23 year old man from Iran.
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Affiliation(s)
- Gholamreza Motazedian
- Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khojasteh
- Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Salari
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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5
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Periauricular Angiolipoma: A Case Report. World J Plast Surg 2021. [DOI: 10.52547/wjps.10.3.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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6
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Rare Complication of Orthognathic Surgery: Intrusion of Mandibular Condyle into the Middle Cranial Fossa. World J Plast Surg 2021. [DOI: 10.52547/wjps.10.3.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zumbrunn Wojczyńska A, Schuknecht B, Ettlin DA. Intermittent intracranial condylar dislocation with minimal functional sequelae. Int J Oral Maxillofac Surg 2020; 50:670-673. [PMID: 33082066 DOI: 10.1016/j.ijom.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
Degenerative changes of the temporomandibular joint (TMJ) present with a broad spectrum of morphological alterations. However, erosions leading to a glenoid fossa defect and condylar impingement of the temporal lobe are a rare finding. A 77-year-old female patient presented with limited mouth opening and pre-auricular pain during mastication on the left side. She denied any neurological dysfunction. Her medical history included poliomyelitis, multiple cancers, and osteonecrosis of the left tibial plateau. Computed tomography revealed advanced degeneration of both TMJs. On the left side, a glenoid fossa fragment was elevated towards the left middle cranial fossa. Real-time dynamic magnetic resonance imaging (MRI) showed repetitive intracranial condylar dislocation during mouth closure. She declined surgery and received instructions for self-management. At the 12-month follow-up, she reported resolution of the pain and normal masticatory function. A control MRI showed a stable radiographic appearance. This report illustrates that intermittent dislocation of the mandibular condyle into the middle cranial fossa can be successfully managed conservatively. The self-limiting nature of the TMJ degenerative joint disease, patient preference, and the patient's general health status require consideration when advising patients on the therapeutic strategy.
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Affiliation(s)
- A Zumbrunn Wojczyńska
- Orofacial Pain Unit, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - B Schuknecht
- Medizinisch Radiologisches Institut, Zurich, Switzerland
| | - D A Ettlin
- Orofacial Pain Unit, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland; São Leopoldo Mandic Institute and Research Centre, Campinas, São Paulo, Brazil
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Dislocation of the mandibular condyle into the middle cranial fossa. A case of temporomandibular joint arthroplasty with resorbable fixation system and temporalis myofascial flap: systematic review and meta-analysis. Br J Oral Maxillofac Surg 2020; 59:389-397. [PMID: 33757662 DOI: 10.1016/j.bjoms.2020.08.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022]
Abstract
The aims of the present study were to comprehensively assess all the published cases on dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) in the literature in English and describe the clinical, imaging, and therapeutic variables for this condition. An electronic search was undertaken in March 2020 using PubMed/MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases. Eligibility criteria included publications with sufficient information to confirm the diagnosis. In addition, we have presented the case report of a 13-year-old boy with DMCCF, who was treated with craniectomy, arthroplasty, and reconstruction with a resorbable osteosynthesis material obtaining favourable and functional results. A total of 72 cases reported in English, including ours, were analysed and discussed. Most of the patients were female (n= 49) with a mean (range) age of 23.4 (5-72) years, the most affected condyle was the right (n= 42), the main aetiology was a motor vehicle accident, and half of the patients had intracranial lesions. Open treatment was performed in the majority with condylar surgery that included condylotomy and condylectomy. Temporomandibular joint arthroplasty was performed with bone, osteosynthesis material, and flap rotation. Timely treatment before four weeks was performed in most of the cases and, despite this, the persistence of the deviation was observed in more than a third of cases, with functional and neurosensorial sequelae. The present study allows an update of the characteristics of DMCCF and gives a current vision of how to manage this rare and complex fracture.
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Updated Review of Traumatic Dislocation of the Mandibular Condyle Into the Middle Cranial Fossa. J Oral Maxillofac Surg 2019; 77:132.e1-132.e16. [DOI: 10.1016/j.joms.2018.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022]
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Chronic Skull Base Erosion from Temporomandibular Joint Disease Causes Generalized Seizure and Profound Lactic Acidosis. Case Rep Crit Care 2018; 2018:8795036. [PMID: 30363607 PMCID: PMC6180988 DOI: 10.1155/2018/8795036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/06/2018] [Indexed: 11/18/2022] Open
Abstract
This report displays a rare presentation of lactic acidosis in the setting of status epilepticus (SE). The differential diagnosis of lactic acidosis is broad and typically originates from states of shock; however, this report highlights an alternative and rare etiology, SE, due to chronic skull base erosion from temporomandibular joint (TMJ) disease. Lactic acidosis is defined by a pH below 7.35 in the setting of lactate values greater than 5 mmol/L. Two broad classifications of lactic acidosis exist: a type A lactic acidosis which stems from global or localized tissue hypoxia or a type B lactic acidosis which occurs once mitochondrial oxidative capacity is unable to match glucose metabolism. SE is an example of a type A lactic acidosis in which oxygen delivery is unable to meet increased cellular energy requirements. This report is consistent with a prior case series that consists of five patients experiencing generalized tonic-clonic (GTC) seizures and lactic acidosis. These patients presented with a pH range of 6.8-7.41 and lactate range of 3.8-22.4 mmol/L. Although severe lactic acidosis following GTC has been described, this is the first report in the literature of chronic skull base erosion from TMJ disease causing SE.
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11
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Management of Intracranial Condylar Fracture With Intracranial Migration. J Craniofac Surg 2018; 29:1416-1420. [DOI: 10.1097/scs.0000000000004677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Total Alloplastic Joint Reconstruction in a Patient With Temporomandibular Joint Ankylosis Following Condylar Dislocation Into the Middle Cranial Fossa. J Oral Maxillofac Surg 2016; 74:2378.e1-2378.e5. [DOI: 10.1016/j.joms.2016.07.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/24/2016] [Accepted: 07/25/2016] [Indexed: 11/22/2022]
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Kanno C, Hasegawa H, Kaneko T, Endo M, Yamazaki M, Akimoto T, Sakuma T, Yamada M, Saito K. Traumatic dislocation of the mandibular condyle into the middle cranial fossa: A case of cranial base reconstruction and review of the literature. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2016. [DOI: 10.1016/j.ajoms.2016.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mishra M, Singh G. A Rare Case Report of an Unusual Dislocation of Fractured Mandibular Condyle. Craniomaxillofac Trauma Reconstr 2016; 9:166-9. [PMID: 27162576 DOI: 10.1055/s-0035-1566161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/05/2015] [Indexed: 10/22/2022] Open
Abstract
Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left condylar head was dislocated to the left anatomic angle of mandible. We have not found a single such case in the world English literature published till date. The presented case falls in the rarest of the rare category that will add to our previous knowledge about the types and extent of fracture dislocation of mandibular condyle.
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Affiliation(s)
- Madan Mishra
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gaurav Singh
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Lindell B, Thor A. A Case of Glenoid Fossa Fracture, Progressive Ankylosis, Total Joint Reconstruction with Alloplastic Prosthesis to Normalized Function Including Evaluation with F18-PET/CT-a Four Year Follow-up. Craniomaxillofac Trauma Reconstr 2016; 10:60-65. [PMID: 28210410 DOI: 10.1055/s-0036-1572493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Temporomandibular joint replacement (TJR) with alloplastic prosthesis has shown promising long-term results in end stage joint disorders. We present a case of young woman with painful ankylosis that where reconstructed with TJR, due to a complex mandibular fracture with dislocation of the left condyle into the middle cranial fossa two years earlier. At the age of 18 the subject underwent a total joint replacement with custom-made alloplastic TMJ prosthesis. To determine the bone response and remodeling activity around the prosthesis, a F18 PET/CT-scan was used. No sign of increased remodeling or pathology were seen in the imaging after the reconstruction. Four years postoperatively the subject reports no pain and excellent jaw function.
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Affiliation(s)
- Björn Lindell
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Andreas Thor
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
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Arya V, Chigurupati R. Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle. J Oral Maxillofac Surg 2016; 74:569-81. [DOI: 10.1016/j.joms.2015.09.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/29/2015] [Accepted: 09/30/2015] [Indexed: 11/26/2022]
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Intracranial Dislocation of the Mandibular Condyle: A Case Report and Literature Review. World Neurosurg 2016; 86:514.e1-11. [DOI: 10.1016/j.wneu.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/04/2015] [Accepted: 09/05/2015] [Indexed: 11/18/2022]
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Saikrishna D, Shyam Sundar S, Mamata KS. Superolateral Dislocation of Intact Mandibular Condyle: A Case Report and Review of Literature. J Maxillofac Oral Surg 2015; 15:309-14. [PMID: 27408459 DOI: 10.1007/s12663-015-0856-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022] Open
Abstract
Anteromedial fracture dislocation of the mandibular condyle is common but a superolateral dislocation of an intact condyle is quite rare. This type of dislocation is often misdiagnosed or completely overlooked and hence inadequately addressed. We report a case of a 41-year-old male patient who experienced superolateral dislocation of the intact condyle with symphysis fracture and panfacial fracture following a road-traffic accident, and review of literature of superolateral dislocations from 1967 to 2014.
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Affiliation(s)
- Degala Saikrishna
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS University, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
| | - S Shyam Sundar
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS University, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
| | - K S Mamata
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS University, Sri Shivarathreeshwara Nagara, Mysore, 570015 Karnataka India
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Dislocation of Mandibular Condyle Into Middle Cranial Fossa: Two Alternative Methods for Two Patients. J Oral Maxillofac Surg 2015; 73:1563.e1-16. [DOI: 10.1016/j.joms.2015.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/27/2015] [Accepted: 04/07/2015] [Indexed: 11/18/2022]
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He Y, Zhang Y, Li ZL, An JG, Yi ZQ, Bao SD. Treatment of traumatic dislocation of the mandibular condyle into the cranial fossa: development of a probable treatment algorithm. Int J Oral Maxillofac Surg 2015; 44:864-70. [DOI: 10.1016/j.ijom.2014.12.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/23/2014] [Indexed: 11/25/2022]
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Debelmas A, Bertoïa C, Moreau A, Khonsari RH. [Superolateral dislocation of the temporomadibular joint: Case report]. ACTA ACUST UNITED AC 2015; 116:166-9. [PMID: 25991509 DOI: 10.1016/j.revsto.2015.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 02/23/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Superolateral disclocations of the temporomandibular joint are rare. They mostly occur after high-energy trauma and are frequently associated with fractures of the mandibular body. CASE REPORT A 35-year-old man was admitted for the management of a high-energy craniofacial trauma due to a road accident. The initial assessment revealed bilateral superolateral temporomandibular joint disclocations, with bilateral sagittal fractures of the condyle head and a fracture of the right parasymphysis. The treatment consisted in an external reduction of both condyles, followed by open reduction and internal fixation of the parasymphysis. The patient quickly started physiotherapy after the procedure and recovered a normal mouth opening after a month of follow-up. DISCUSSION For most authors, a quick management of superolateral dislocations is necessary in order to achieve a proper reduction of the temporomandibular joint dislocation and avoid surgical reduction. Temporomandibular joint ankylosis is the main complication of such lesions. Early physiotherapy is indicated in order to prevent ankylosis.
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Affiliation(s)
- A Debelmas
- Service de chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, 4, place Jussieu, 75252 Paris cedex 05, France
| | - C Bertoïa
- Service de chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, 4, place Jussieu, 75252 Paris cedex 05, France
| | - A Moreau
- Service de chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, 4, place Jussieu, 75252 Paris cedex 05, France
| | - R H Khonsari
- Service de chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, 4, place Jussieu, 75252 Paris cedex 05, France.
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Khilji MF, Malik AK. Bilateral temporomandibular joint dislocation in a 26-month-old child: A rare emergency. JOURNAL OF EMERGENCY MEDICINE, TRAUMA AND ACUTE CARE 2015. [DOI: 10.5339/jemtac.2015.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Bilateral temporomandibular joint (TMJ) dislocation is very rare in children with only three cases previously reported in the literature. We report a case of a 26-month-old female child who presented to the emergency department of a tertiary care hospital with complaints of inability to close her mouth and drooling of saliva for the last two hours. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved with the Hippocratic method after giving analgesia and procedural sedation. The child was able to close her mouth post-reduction, and was discharged with post-TMJ reduction instructions given to the mother and with maxillofacial clinic follow up. Our report is the first case of a child presenting to the emergency department with bilateral TMJ dislocation.
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Affiliation(s)
- Muhammad Faisal Khilji
- 1Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Aftab Khalid Malik
- 2Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
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Vaezi T, Rajaei SA, Hosseini Abrishami M, Erfanian Taghvaei M. Dislocation of the mandibular condyle into the middle cranial fossa: a case report. Oral Maxillofac Surg 2014; 18:69-73. [PMID: 23377997 DOI: 10.1007/s10006-013-0395-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 01/22/2013] [Indexed: 06/01/2023]
Abstract
INTRODUCTION A 32-year-old woman was admitted to our hospital following a motor vehicle accident. Her chief complaint was severe limited mouth opening and unilateral open bite on the left. METHODS Axial and coronal CT scans showed penetration of right condyle into the middle cranium through the fractured roof of glenoid fossa. A craniotomy exactly above the glenoid fossa was done. RESULTS The condyle was reduced and the glenoid fossa was reconstructed. CONCLUSION On postoperative follow-up at 6 months, the patient had no complaint, but there was a small deviation to the affected side on opening.
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Affiliation(s)
- Touraj Vaezi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Science, Vakil Abad Ave., Mashhad, Iran
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Traumatic dislocation of intact mandibular condyle into middle cranial fossa. Am J Otolaryngol 2014; 35:251-3. [PMID: 24462110 DOI: 10.1016/j.amjoto.2013.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 11/03/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION A 10-year-old girl presented to the Emergency Department with temporomandibular joint pain, malocclusion, and trismus after a bicycle accident. METHODS CT of the temporal bones showed displacement of the right mandibular condyle into the middle cranial fossa with small intraparenchymal hemorrhage. The condyle was reduced using closed reduction technique and the patient was placed in maxillomandibular fixation. RESULTS Complete reduction of the displaced condyle with resultant normal occlusion and persistent bony defect in the temporal bone. CONCLUSION In early follow-up assessments the patient has had complete resolution of symptoms with residual bony defect from the site of fracture in the temporal bone.
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Kisnisci R. Management of Fractures of the Condyle, Condylar Neck, and Coronoid Process. Oral Maxillofac Surg Clin North Am 2013; 25:573-90. [DOI: 10.1016/j.coms.2013.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Traumatic Dislocation of the Mandibular Condyle Into the Middle Cranial Fossa in an Elderly Patient. J Craniofac Surg 2013; 24:1703-5. [DOI: 10.1097/scs.0b013e31828a76b1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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28
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Shen L, Li P, Li J, Long J, Tian W, Tang W. Management of superolateral dislocation of the mandibular condyle: a retrospective study of 10 cases. J Craniomaxillofac Surg 2013; 42:53-8. [PMID: 23688593 DOI: 10.1016/j.jcms.2013.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 02/18/2013] [Accepted: 02/19/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Superolateral dislocation of the mandibular condyle (SDMC) is rarely described. The best treatment for superolateral dislocation of the fractured mandibular condyle (SDMC) is debated. This study investigated selection of the timing and techniques used in treating these fractures. PATIENTS AND METHODS A retrospective clinical study was conducted on clinical data from 10 SDMC patients. Maximum mouth opening and occlusal relationships were compared following treatment using different techniques. RESULTS The 10 patients were followed for 6-25 months. Patients who had dislocation for less than 1 week had condylar reduction and rigid internal fixation of the fractures. Mandibular sagittal split ramus osteotomy and articular reduction and fixation were performed in seven cases. Postoperative mouth opening and occlusal relationships were satisfactory in all patients with the exception of one case with mouth opening of only 27 mm. CONCLUSIONS For all patients with superolateral dislocation, our first approach was to reduce the bone stump through surgery. When the dislocated joint had become adherent to the surrounding tissues and ankylosis developed, mandibular sagittal split ramus osteotomy was performed with good results.
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Affiliation(s)
- Longduo Shen
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Peng Li
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Jia Li
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Jie Long
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China.
| | - Wei Tang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China.
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Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma. J Craniomaxillofac Surg 2012; 40:396-9. [DOI: 10.1016/j.jcms.2011.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 07/17/2011] [Accepted: 07/23/2011] [Indexed: 11/17/2022] Open
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Tauro D, Lakshmi S, Mishra M. Superolateral dislocation of the mandibular condyle: report of a case with review of literature and a proposed modification in the classification. Craniomaxillofac Trauma Reconstr 2011; 3:119-23. [PMID: 22110826 DOI: 10.1055/s-0030-1254381] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Anteromedial fracture dislocation of the mandibular condyle is common but a superolateral dislocation of an intact condyle is quite rare. Only ~19 cases of such dislocation have been reported in the world English literature. This type of dislocation is often misdiagnosed or completely overlooked and hence inadequately addressed. A case of superolateral dislocation of the condyle associated with a symphyseal fracture is presented. We discuss the dynamics, diagnostic features and clinical management of such dislocations with the review of literature and propose a modification in the existing classification.
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Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011; 7:10. [PMID: 21676208 PMCID: PMC3127760 DOI: 10.1186/1746-160x-7-10] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 06/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. METHOD AND MATERIALS A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. RESULT A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. CONCLUSION The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.
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Affiliation(s)
- Babatunde O Akinbami
- University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
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32
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Anterior Dislocation of the Intact Mandibular Condyle Caused by Fracture of the Articular Eminence: An Unusual Fracture of the Temporomandibular Joint Apparatus. J Oral Maxillofac Surg 2011; 69:1046-51. [DOI: 10.1016/j.joms.2010.02.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/26/2010] [Indexed: 11/19/2022]
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33
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Alemán Navas RM, Martínez Mendoza MG. 'Inverse' temporomandibular joint dislocation. Int J Oral Maxillofac Surg 2011; 40:877-9. [PMID: 21419600 DOI: 10.1016/j.ijom.2011.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 12/23/2010] [Accepted: 02/09/2011] [Indexed: 11/25/2022]
Abstract
Temporomandibular joint (TMJ) dislocation can be classified into four groups (anterior, posterior, lateral, and superior) depending on the direction of displacement and the location of the condylar head. All the groups are rare except for anterior dislocation. 'Inverse' TMJ dislocation is a bilateral anterior and superior dislocation with impaction of the mandible over the maxilla; to the authors' knowledge only two cases have previously been reported in the literature. Inverse TMJ dislocation has unique clinical and radiographic findings, which are described for this case.
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Affiliation(s)
- R M Alemán Navas
- Department of Oral and Maxillofacial Surgery, Zacamil's Nacional Hospital, Evangelic University of El Salvador, El Salvador.
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Lypka M, Urata M, Hammoudeh J. Delayed middle cranial fossa perforation after autologous temporomandibular joint reconstruction. J Oral Maxillofac Surg 2011; 69:1613-6. [PMID: 21367501 DOI: 10.1016/j.joms.2010.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 09/03/2010] [Accepted: 11/02/2010] [Indexed: 11/18/2022]
Affiliation(s)
- Michael Lypka
- Division of Pediatric Plastic and Craniofacial Surgery, University of Texas Medical School, Houston, TX 77030, USA.
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MANFREDINI D, BUCCI MB, MONTAGNA F, GUARDA-NARDINI L. Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil 2010; 38:101-19. [DOI: 10.1111/j.1365-2842.2010.02131.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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36
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Lloyd TE, Sivarajasingam V. An unusual cranial dislocation of the mandibular condyle. Br J Oral Maxillofac Surg 2010; 48:176-7. [PMID: 19857915 DOI: 10.1016/j.bjoms.2009.08.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 08/22/2009] [Indexed: 11/18/2022]
Affiliation(s)
- Timothy E Lloyd
- Department of Oral Maxillofacial Surgery, Cardiff University, United Kingdom.
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Vasconcelos B, Rocha N, Cypriano R. Posterior dislocation in intact mandibular condyle: an unusual case. Int J Oral Maxillofac Surg 2010; 39:89-91. [PMID: 19804958 DOI: 10.1016/j.ijom.2009.07.061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 06/02/2009] [Accepted: 07/21/2009] [Indexed: 11/24/2022]
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38
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Bassou D, El Kharras A, El Fenni J, El Haddad A, Amil T, Benameur M, Darbi A. [A rare cause of TMJ pain: isolated occult fracture of the glenoid fossa]. JOURNAL DE RADIOLOGIE 2009; 90:615-617. [PMID: 19503052 DOI: 10.1016/s0221-0363(09)74030-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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39
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Li Z, Li ZB, Shang ZJ, Wu ZX. An Unusual Type of Superolateral Dislocation of Mandibular Condyle: Discussion of the Causative Mechanisms and Clinical Characteristics. J Oral Maxillofac Surg 2009; 67:431-5. [PMID: 19138624 DOI: 10.1016/j.joms.2008.06.088] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 05/13/2008] [Accepted: 06/18/2008] [Indexed: 11/24/2022]
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40
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Magge SN, Chen HI, Heuer GG, Carrasco LR, Storm PB. Dislocation of the mandible into the middle cranial fossa. Case report. J Neurosurg 2007; 107:75-8. [PMID: 17644926 DOI: 10.3171/ped-07/07/075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dislocation of the mandibular condyle into the middle cranial fossa is a rare event due to anatomical and biomechanical factors. The authors report the case of a 12-year-old girl who presented with this condition after colliding with a classmate. One day after her injury, the patient demonstrated an inability to close her mouth completely, and she had minor tenderness to palpation anterior to the tragus, without neurological deficits. Imaging studies demonstrated a fractured glenoid fossa with intrusion of the mandible into the cranial cavity. Open reduction of the mandibular condyle was performed, and the glenoid fossa was reconstructed with a split-thickness bone graft and titanium screws. Several dural tears noted at the time of surgery were repaired primarily. Mandibular condyle dislocation into the middle cranial fossa is often misdiagnosed initially because of its low incidence and nonspecific symptoms. Computed tomography scanning is the most sensitive diagnostic study for detecting this injury. Closed reduction after induction of general anesthesia has been recommended in recently suffered injuries without neurological deficits, but this approach may overlook damage to intracranial structures. Surgical repair is recommended if neurological injury is suspected. Treatment options should be tailored to the individual factors of each case.
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Affiliation(s)
- Suresh N Magge
- Department of Neurosurgery, University of Pennsylvania Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia, 19104, USA.
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