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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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Reghunadhan P, Upasi AP, Rai KK, Shikha N, Vakil S. A spectrum of auditory canal injuries ensuing from direct or indirect trauma to the temporomandibular joint: A 2-year prospective study. J Craniomaxillofac Surg 2022; 50:S1010-5182(22)00145-7. [PMID: 36244893 DOI: 10.1016/j.jcms.2022.09.008] [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: 03/26/2022] [Revised: 09/11/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess various auditory canal injuries in patients with direct or indirect temporomandibular joint (TMJ) trauma, and, in collaboration with an otolaryngologist, evaluate the need for intervention. A prospective study was conducted at the institution. Patients who had sustained trauma to the TMJ were assessed for auditory canal injury through clinical and CT scan examination. All the patients were cross-consulted by an otolaryngologist for diagnosis and eventual management of any auditory canal injury. A close 3-month follow-up was carried out for all patients. Out of 32 cases (64 sides) of TMJ trauma, the following auditory canal injuries were documented: five cases (six sides) with tympanic plate fracture; five cases (five sides) with soft-tissue injury to the EAC; two cases (two sides) with tympanic membrane (TM) perforation; and one case (one side) with external auditory canal (EAC) hematoma (all p < 0.001). Corroborative results for the diagnosis of auditory canal injuries between the oral and maxillofacial surgeon (OMFS) and ENT surgeon were found to be statistically significant (p < 0.001). One case of tympanic membrane perforation required tympanoplasty and the rest were treated by conservative management. No complications were seen after 3 months of follow-up. To conclude, maxillofacial surgeons should perform a thorough bilateral ear examination to rule out any auditory canal injury in all the cases presenting with direct or indirect trauma to the TMJ. Timely management of such injuries should be undertaken by an otolaryngologist before TMJ trauma management to avoid any complications.
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Affiliation(s)
| | | | - Kirthi K Rai
- Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Nirdhum Shikha
- Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Samyak Vakil
- Bapuji Dental College and Hospital, Davangere, Karnataka, India
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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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Ali IK, Sansare K, Karjodkar FR, Salve P, Vanga K, Pawar AM. Maxillofacial trauma patterns associated with external auditory canal fractures: Cone beam computed tomography analysis. Dent Traumatol 2017; 33:276-280. [PMID: 28296040 DOI: 10.1111/edt.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma. MATERIALS AND METHODS One hundred patients were prospectively evaluated over 6 months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region. RESULTS External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test. CONCLUSION External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures.
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Affiliation(s)
- Ibrahim K Ali
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Prashant Salve
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kavita Vanga
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
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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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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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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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Menon S, Sinha R. Gap arthroplasty for mandibular condyle dislocation and impaction into the middle cranial fossa. J Oral Maxillofac Surg 2008; 66:2390-3. [PMID: 18940513 DOI: 10.1016/j.joms.2008.01.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 01/18/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Suresh Menon
- Department of Maxillofacial Surgery, Armed Forces Medical College, Pune, India.
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Traumatic unilateral temporomandibular joint dislocation overlooked for more than two decades. J Craniofac Surg 2008; 18:1466-70. [PMID: 17993903 DOI: 10.1097/scs.0b013e31814fb5af] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Forward dislocation of the temporomandibular joint commonly can be easily diagnosed and successfully reduced by manual repositioning. In this report, we discuss a rare case of prolonged temporomandibular dislocation that had persisted for more than 20 years because the otolaryngologist and dentist had missed the dislocation. This patient underwent open reduction and mandibular joint plasty with preoperative orthodontic therapy. It is possible that strong pain and mouth-closing disability may gradually remit and only deviated mandibular prognathism like malocclusion may persist. Therefore, abnormal occlusion warrants careful attention to temporomandibular joint dislocation.
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Healy SM, Zwickey MR, Stamboulieh JN, Throndson RR. Closed reduction of an intracranially displaced subcondylar fracture: a case report. J Oral Maxillofac Surg 2008; 66:389-93. [PMID: 18201630 DOI: 10.1016/j.joms.2006.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Accepted: 09/07/2006] [Indexed: 10/22/2022]
Affiliation(s)
- Sean M Healy
- The Physicians Centre, Brazos Valley Oral and Maxillofacial Surgery, 3201 University Drive, Suite 100, Bryan, TX 77802, USA.
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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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Rosa VLM, Guimarães AS, Marie SKN. Intrusion of the mandibular condyle into the middle cranial fossa: case report and review of the literature. ACTA ACUST UNITED AC 2006; 102:e4-7. [PMID: 16831663 DOI: 10.1016/j.tripleo.2006.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 02/02/2006] [Accepted: 02/03/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To describe a case of mandibular condyle intrusion into the middle cranial fossa in a young child and to systematically review the literature pertaining to this condition. STUDY DESIGN The diagnostic procedures comprised clinical examination, health history, and both magnetic resonance imaging and computerized tomography. A systematic review of the literature from PubMed, Medline, and Web of Science databases from 1960 to 2005 was made and a total of 55 cases in 51 references were found, of which 36 were described in detail. CONCLUSIONS Prompt diagnosis of mandibular condyle intrusion into the middle cranial fossa is essential to minimize complications. Advanced imaging modalities of computed tomography and magnetic resonance imaging are indicated.
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Affiliation(s)
- Vera L M Rosa
- Paulista School of Medicine, Federal University of São Paulo, SP, Brazil.
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Ohura N, Ichioka S, Sudo T, Nakagawa M, Kumaido K, Nakatsuka T. Dislocation of the Bilateral Mandibular Condyle Into the Middle Cranial Fossa: Review of the Literature and Clinical Experience. J Oral Maxillofac Surg 2006; 64:1165-72. [PMID: 16781355 DOI: 10.1016/j.joms.2006.03.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2004] [Indexed: 10/24/2022]
Affiliation(s)
- Norihiko Ohura
- Department of Plastic and Reconstructive Surgery, Saitama Medical School, Saitama, Japan.
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Harstall R, Gratz KW, Zwahlen RA. Mandibular Condyle Dislocation Into the Middle Cranial Fossa: A Case Report and Review of Literature. ACTA ACUST UNITED AC 2005; 59:1495-503. [PMID: 16394930 DOI: 10.1097/01.ta.0000199241.49446.80] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Roger Harstall
- Department of Orthopedic Surgery, University Hospital, Berne, Switzerland
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Cillo JE, Sinn DP, Ellis E. Traumatic Dislocation of the Mandibular Condyle into the Middle Cranial Fossa Treated With Immediate Reconstruction: A Case Report. J Oral Maxillofac Surg 2005; 63:859-65. [PMID: 15944989 DOI: 10.1016/j.joms.2005.02.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Joseph E Cillo
- Division of Oral and Maxillofacial Surgery, The University of Texas Southwestern Medical Center, Dallas 75390-9109, USA
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Cheynet F, Guyot L, Richard O, Layoun W, Gola R. Discomallear and malleomandibular ligaments: anatomical study and clinical applications. Surg Radiol Anat 2003; 25:152-7. [PMID: 12802513 DOI: 10.1007/s00276-003-0097-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2002] [Accepted: 12/17/2002] [Indexed: 10/26/2022]
Abstract
Phylogenesis, ontogenesis and anatomy show the existence of two discomallear and malleomandibular ligaments, arising from the first branchial arch and uniting the middle ear with the temporomandibular joint and to the mandible. The intra-articular discomallear ligament is the involuted tendon of the lateral pterygoid muscle on the primitive quadrato-articular joint. The malleomandibular ligament is the fibrous remnant of Meckel's cartilage. In the physiology of the temporomandibular joint, the discomallear ligament alone limits the anterior movement of the disc. Its stretching accompanies disco-condylar disunity, hyperlaxity and temporomandibular dislocation. The malleomandibular ligament, wrongly limited to its sphenomandibular part in classic anatomy, has no physiological role. However, it can be responsible for the dislocation of the ear ossicle chain after disarticulation or temporomandibular trauma. These two ligaments do not play any role in otological manifestations in dysfunction of the manducatory apparatus.
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Affiliation(s)
- F Cheynet
- Department of Oral, Maxillofacial and Facial Plastic Surgery, Northside University Hospital, Marseille, France
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Barron RP, Kainulainen VT, Gusenbauer AW, Hollenberg R, Sàndor GKB. Fracture of glenoid fossa and traumatic dislocation of mandibular condyle into middle cranial fossa. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:640-2. [PMID: 12142868 DOI: 10.1067/moe.2002.122824] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Traumatic mandibular condyle dislocations into the middle cranial fossa are rare. Thirty-three cases of middle cranial fossa injuries caused by condylar dislocations have been reported in the literature. A case report of a patient with a traumatic dislocated condyle into the middle cranial fossa, which was treated conservatively, is presented.
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Affiliation(s)
- Robert P Barron
- Hadassah Medical Center, The Hebrew University, Jerusalem, Israel
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Spanio S, Baciliero U, Fornezza U, Pinna V, Toffanin A, Padula E. Intracranial dislocation of the mandibular condyle: report of two cases and review of the literature. Br J Oral Maxillofac Surg 2002; 40:253-5. [PMID: 12054720 DOI: 10.1054/bjom.2001.0782] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fractures of the mandibular condylar process are common and account for up to 40% of all mandibular fractures. Penetration of the condylar head into the middle cranial fossa is, however, rare. We have found reports of only 43 cases since 1834. The diagnosis of intracranial condylar dislocation is difficult, there are usually no particular symptoms or neurological signs. As a result, detailed radiological studies are necessary. In the absence of clear radiographic images of the condylar structures, computed tomography (CT) is essential to locate the fragments and to investigate and monitor intracranial lesions. This paper describes the diagnostic and surgical procedures used in two cases of condylar dislocation and discusses them with reference to previous cases. The use of a titanium screw, which was positioned intracranially in the first case, has not, to our knowledge, been described previously.
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Affiliation(s)
- S Spanio
- Department of Maxillofacial Surgery, Regional Hospital of Vicenza, Italy.
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Koretsch LJ, Brook AL, Kader A, Eisig SB. Traumatic dislocation of the mandibular condyle into the middle cranial fossa: report of a case, review of the literature, and a proposal management protocol. J Oral Maxillofac Surg 2001; 59:88-94. [PMID: 11152197 DOI: 10.1053/joms.2001.19301] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L J Koretsch
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA
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Chong VF, Fan YF. Technical report. External auditory canal fracture secondary to mandibular trauma. Clin Radiol 2000; 55:714-6. [PMID: 10988052 DOI: 10.1053/crad.2000.0505] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- V F Chong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
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Psimopoulou M, Antoniades K, Magoudi D, Karakasis D. Tympanic plate fracture following mandibular trauma. Dentomaxillofac Radiol 1997; 26:344-6. [PMID: 9482010 DOI: 10.1038/sj.dmfr.4600297] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bleeding from the external auditory canal following head trauma is not unusual. It can be caused by a posterior dislocation of the mandibular condyle associated with a fracture of the tympanic bone. Although posterior dislocation is uncommon, it is the second most frequent complication after antero-medial displacement of the condyle. We report four cases of tympanic plate fracture and present CT images demonstrating the range of injuries seen.
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Affiliation(s)
- M Psimopoulou
- Department of Oral & Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, Greece
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