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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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Nunes Villafort R, Henrique Martins G, Jeferson Daruge R, Bruno Figueiredo Amaral M. Assessment Of Condyle Fractures Associated With Mandibular Fossa And/Or Tympanic Plate Fractures. Br J Oral Maxillofac Surg 2022; 60:1196-1201. [DOI: 10.1016/j.bjoms.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
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3
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Romano N, Fischetti A, Federici M, Castaldi A. Post-Traumatic Intracranial Dislocation of Unfractured Mandibular Condyle. World Neurosurg 2019; 131:194-195. [DOI: 10.1016/j.wneu.2019.08.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
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Holz F, Verhoff MA, Kettner M, Ramsthaler F, Ohlwärther TEN, Birngruber CG. Lochfrakturen der Schädelbasis durch dislozierte Mandibulaköpfchen. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Hira PG, Rikhotso RE. Superolateral extracapsular dislocation of the mandibular condyle: Review of the literature and report of two cases. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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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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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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Zamorano GM, Nuñez LF, Alvarez LA, Otayza FA, Fernández MA, Donoso-Hofer F. Temporomandibular joint ankylosis after condylar dislocation into the middle cranial fossa: A case report. ACTA ACUST UNITED AC 2016; 117:351-356. [PMID: 27473929 DOI: 10.1016/j.revsto.2016.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 04/21/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Dislocation of the mandibular condyle into the middle cranial fossa after a trauma is a rare event. The lack of appropriate treatment can lead to ankylosis of the temporomandibular joint (TMJ). We report about a case of TMJ ankylosis following intracranial dislocation of the mandibular condyle through the roof of the articular fossa. CASE REPORT A 9-year-old patient was referred for a severe limitation of mouth opening that began progressively one year before. A history of chin injury due to an accidental fall was found. Preoperative CT scan showed a TMJ ankylosis on the right side combined with a dislocation of the mandibular condyle into the middle cranial fossa. Treatment consisted in an intracranial resection of the mandibular condyle, partial removal of the ankylosis block and TMJ arthroplasty. DISCUSSION Our case is the second case of TMJ ankylosis following intracranial dislocation of the mandibular condyle and treated with arthroplasty alone published in the English literature. There is no consensus regarding the pathophysiology of TMJ ankylosis and regarding the attitude towards the ankylosis block. In our case, no recurrence was noticed after a one-year follow-up. An interdisciplinary approach is needed, including maxillofacial surgeon, neurosurgeon, physiotherapist and orthodontist.
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Affiliation(s)
- G M Zamorano
- Oral and Maxillofacial Surgery Department, School of dentistry, Universidad de Chile, Santiago, Chile.
| | - L F Nuñez
- Oral and Maxillofacial Surgery Department, School of dentistry, Universidad de Chile, Santiago, Chile
| | - L A Alvarez
- Oral and Maxillofacial Surgery Service, San Juan de Dios Hospital, San José, Costa Rica
| | - F A Otayza
- Neurosurgery Service, Las Condes Clinic, Santiago, Chile
| | - M A Fernández
- Oral and Maxillofacial Surgery Service, San Juan de Dios Hospital, Santiago, Chile; Oral and Maxillofacial Surgery Service, Las Condes Clinic, Santiago, Chile
| | - F Donoso-Hofer
- Oral and Maxillofacial Surgery Department, School of dentistry, Universidad de Chile, Santiago, Chile; Oral and Maxillofacial Surgery Service, San Juan de Dios Hospital, Santiago, Chile
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Abstract
Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted.
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Affiliation(s)
- Rodney C Diaz
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, California, United States
| | - Brian Cervenka
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, California, United States
| | - Hilary A Brodie
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, California, United States
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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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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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Pinares J, Urzúa R. Proposed radiographic protocol for central superior mandibular condyle dislocation into the middle cranial fossa: apropos of a case. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0229-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yildirim Y, Keller EE. Remodeling of Displaced Condylar Fractures with Functional Treatment: High-Quality Radiographic Documentation in Three-Patient Series. Craniomaxillofac Trauma Reconstr 2015; 8:334-40. [PMID: 26576239 DOI: 10.1055/s-0035-1550064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/12/2015] [Indexed: 10/23/2022] Open
Abstract
Treatment of condylar fractures is variable and controversial. Treatment options for management of condylar fractures include surgical and nonsurgical methods, and if a nonsurgical method is as effective as a surgical method, the former is preferred. Although plain film radiographs and functional outcomes attained through nonsurgical treatment are well established in literature, evidence of the remodeling process through detailed, high-quality imaging is lacking. The purpose of this case series is to describe and illustrate two adults and one pediatric patient with significantly displaced condylar fractures treated nonsurgically with excellent clinical results. It is unique for such patients to have pre- and posttreatment computed tomography scans with high-quality three-dimensional reconstruction as in the case of two adults and to have 3.5-year posttrauma radiographs and 14.5-year follow-up as in the case of the pediatric patient. As such, this report is useful in visually presenting three examples of repositioning and reformation of the temporomandibular joint structures in displaced condylar fractures in a postmenarche 14-year-old female patient, a 21-year-old male patient, and an 18-month-old male patient.
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Affiliation(s)
- Yavuz Yildirim
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Eugene E Keller
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
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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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Zhang S, Wu J, Xu B, Shi J, Shen SGF, Gui H. Features and management of intracranial mandibular condyle dislocation after trauma. Cranio 2014; 32:63-7. [PMID: 24660649 DOI: 10.1179/0886963413z.0000000007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Dislocation of the mandibular condyle into the middle cranial fossa is rare in clinics. It often occurs when the mouth is open wide during the injury. It causes restriction of mandibular motion, lower facial asymmetry, pain in the temporomandibular joint (TMJ), etc. OBJECTIVE To introduce the features of intracranial mandibular condyle dislocation and discuss the management to this kind of trauma. MAJOR FINDINGS In this paper, the authors present two cases, describing the diagnosis, surgical management, and 1-year follow-up evaluation. The results of the authors' treatment to intracranial mandibular condyle dislocation were satisfactory and stable, and no surgical complications were detected. CONCLUSION Advanced imaging studies are mandatory for exact diagnosis and successful treatment of intracranial mandibular condyle dislocation, and individualized management is recommended.
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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: 11] [Impact Index Per Article: 1.1] [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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Ogura I, Sasaki Y, Kaneda T. Analysis of mandibular condylar and glenoid fossa fractures with computed tomography. Eur Radiol 2013; 24:902-6. [PMID: 24337861 DOI: 10.1007/s00330-013-3085-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). METHODS A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using χ(2) test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. RESULTS The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. CONCLUSIONS The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. KEY POINTS • The prevalence of condylar fracture was 64.8 % in patients with mandibular fractures. • Glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. • The study suggests a focus on incidental findings such as glenoid fossa fractures.
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Affiliation(s)
- Ichiro Ogura
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-Nishi, Matsudo, Chiba, 271-8587, Japan,
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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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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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Dislocation of the intact mandibular condyle into the middle cranial fossa: a case report. Int J Oral Maxillofac Surg 2011; 40:118-20. [DOI: 10.1016/j.ijom.2010.02.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 07/13/2009] [Accepted: 02/01/2010] [Indexed: 11/22/2022]
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Taglialatela Scafati C, Aliberti F, Scotto di Clemente S, Taglialatela Scafati S, Facciuto E, Cinalli G. Dislocation of a fractured mandibular condyle into the middle cranial fossa: a case treated by an extracranial approach. Childs Nerv Syst 2008; 24:1067-70. [PMID: 18575874 DOI: 10.1007/s00381-008-0659-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Penetration of the mandibular condyle into the middle cranial fossa is a rare complication usually due to blunt traumas to the chin. Particular anatomical and dynamic conditions can lead to the intracranial dislocation of the condyle in spite of the fracture of the condylar neck that usually prevents this event from dissipating the kinetic force of the impact. DISCUSSION We report the case of a 10-year-old female patient suffering from symphyseal and bilateral condilar fracture with intrusion of the left condyle into the middle cranial fossa. The diagnosis of intracranial dislocation was initially missed because of the nonspecific symptomatology and insufficient radiologic data provided by conventional investigations (plain X-rays and panoramic views). The persistence of the limitation of the mouth opening and the worsening of the preauricular pain with irradiation to the temporal region led us to perform further radiological investigations (computed tomography scan and magnetic resonance imaging) that revealed the intracranial complication. A successful removal of the displaced condyle was carried out through an extracranial approach, and at a 3-year follow-up temporomandibular joint function is satisfactory. CONCLUSION The case is reported to emphasize the need for careful radiological investigation in case of condylar fractures and the effectiveness of the extracranial route to surgically treat these rare complications.
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A Clinical Study on Treatment of Temporomandibular Joint Chronic Recurrent Dislocations by a Modified Eminoplasty Technique. J Craniofac Surg 2008; 19:1275-80. [DOI: 10.1097/scs.0b013e31818437b3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Temporal Bone Fractures: A Review for the Oral and Maxillofacial Surgeon. J Oral Maxillofac Surg 2008; 66:513-22. [DOI: 10.1016/j.joms.2007.08.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Revised: 07/30/2007] [Accepted: 08/30/2007] [Indexed: 11/20/2022]
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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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Tsunoda A, Sumi T, Shirakura S, Kishimoto S, Akita K. Bony eminence on the middle cranial fossa corresponding to the temporomandibular joint. Clin Anat 2007; 20:512-5. [PMID: 17226822 DOI: 10.1002/ca.20447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report a nameless bony eminence over the temporomandibular joint (TMJ) and its possible clinical significance. Forty-two half heads of 21 UK Caucasian cadavers (61-95 years old, mean 84.3 +/- 8.2 years, male:female = 11:10) were used to investigate the surface of the middle cranial fossa (MCF) over the TMJ. The thickness of the bony roof of the glenoid fossa was also measured. A bony eminence over the glenoid fossa was observed in half of the specimens. Some showed a complete oval bulge, which completely reflected the contour of the glenoid fossa. The others showed a bony bulge, which partially reflected that contour. The mean (+/-SD) thickness of the bone in the roof of glenoid fossa was 1.5 +/- 1.2 mm. The mean bony thickness of specimens showing the eminence was 0.8 +/- 0.5 mm, whereas it was 2.3 +/- 1.2 mm in specimens without an eminence. These differences were statistically significant (P < 0.01). The osteological features we describe may be relevant to certain clinical problems. Traumatic dislocation of mandibular condyle, for example, might relate to a weakness of the glenoid fossa.
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Affiliation(s)
- Atsunobu Tsunoda
- Department of Otolaryngology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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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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30
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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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31
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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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