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Effat KG, Berty A. Otological symptoms in patients with rheumatoid arthritis of the temporomandibular joint. Cranio 2023:1-8. [PMID: 37747112 DOI: 10.1080/08869634.2023.2260281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The aim of the current study was to describe the pattern of otological symptoms in patients with rheumatoid arthritis (RA), having clinical temporomandibular joint (TMJ) involvement. This issue had not been previously addressed. METHODS A questionnaire and examination findings protocol was applied for 141 patients with RA and 141 control subjects. RESULTS Otological symptoms (otalgia, hearing loss, tinnitus, and vertigo), all had a significantly higher incidence in RA patients, compared to control subjects (P = .001). CONCLUSION The onset and maintenance of otological symptoms in patients with TMJ involvement by RA probably result from peripheral, as well as central nervous system alterations in sensory stimuli programming.
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Affiliation(s)
- Kamal G Effat
- Consultant Otolaryngologist, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Consultant Rheumatologist, St. Mark Rheumatology Center, Cairo, Egypt
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García Martín I, Cariati P, Martínez-Sauquillo Rico A, Cabello Serrano A, García Medina B. Arthroscopic osteoplasty of the medial and anteromedial wall of temporomandibular joint: surgical technique and anatomical considerations. Br J Oral Maxillofac Surg 2023; 61:72-77. [PMID: 36535863 DOI: 10.1016/j.bjoms.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
The anterior displacement of the articular disc is the most frequent cause of pathological alterations in the TMJ. Although it is an extremely common pathology, there is no certainty about the aetiopathogenesis of this disease. The main aim of the present report is to describe new anatomical findings that could help clarifying the aetiopathogenesis of this disease and determine a typology of treatment based on the cause of the disease. All the operative records of patients who underwent arthroscopic osteoplasty of the medial TMJ wall in our centre from January 2021 to September 2021 were reviewed and analysed to identify specific anatomical features observed in every procedure. Fifty-two joints were included for analysis in this study. Twenty-two joints were classified as Wilkes stages II-III and 30 as Wilkes stages IV-V. The most common complication observed in our sample was the dysaesthesias found in the temporal and preauricular regions. Other complications observed were frontal branch paresis (n = 2), intraoperative bleeding (n = 1), and postoperative malocclusion (n = 1). The compression of the superior head of pterygoid lateral muscle (SPLM) on the medial bony wall and the consequent muscle atrophy could be key for the aetiology of the anterior TMJ disc displacement. Therapeutic actions on the osseous and muscular component in this anatomical area could improve the outcomes of patients affected by TMJ internal derangement. A meticulous dissection of the fascia of the superior fascicle of the lateral pterygoid muscle allows a remodelling of the bone surfaces with minimal complications.
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Affiliation(s)
- Irene García Martín
- Department of Oral and Maxillofacial Surgery, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Paolo Cariati
- Hospital General Universitario de Albacete, Departamento de Cirugía Oral y Maxilofacial, Albacete, Spain.
| | | | - Almudena Cabello Serrano
- Hospital Universitario Virgen de las Nieves de Granada, Departamento de Cirugía Oral y Maxilofacial, Granada, Spain
| | - Blas García Medina
- Hospital Universitario Virgen de las Nieves de Granada, Departamento de Cirugía Oral y Maxilofacial, Granada, Spain
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Effat KG. Temporomandibular disorder: A previously unreported complication of chronic suppurative otitis media. Cranio 2022:1-6. [PMID: 36538022 DOI: 10.1080/08869634.2022.2157525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of the current clinical study was to test the hypothesis that chronic suppurative otitis media (CSOM) might be significantly associated with signs of temporomandibular joint (TMJ) internal derangement. METHODS The study involved 79 patients with CSOM and 79 control subjects. The TMJ was clinically examined in both groups. RESULTS Signs of internal derangement of the TMJ(s) were found in 67.1% of CSOM patients versus 26.6% of control subjects (p = .001). CONCLUSION CSOM may be associated with the extension of the inflammatory process into the TMJ, thereby predisposing to internal derangement of the joint.
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Affiliation(s)
- Kamal G Effat
- Department of Otolaryngology, El- Sahel Teaching Hospital, Cairo, Egypt
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Anastasi MR, Rizzo G, Nicita F, Bramanti A, Milardi D, Macchi V, Brunetto D, Cascone P, Arco A, Nicita A, Anastasi G, Favaloro A. Microscopic reconstruction and immunohistochemical analysis of discomalleolar ligament. Heliyon 2020; 6:e04651. [PMID: 32817892 PMCID: PMC7424222 DOI: 10.1016/j.heliyon.2020.e04651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/22/2020] [Accepted: 08/04/2020] [Indexed: 11/16/2022] Open
Abstract
Discomalleolar ligament represents the vestiges of the primitive lateral pterygoid muscle which penetrates in the caudal end of Meckel's cartilage; during the development of newborn, the petrotympanic fissure close almost completely leaving inside the discomalleolar ligament. After entering in tympanic cavity, some fibers of the discomalleolar ligament insert to walls of cavity, other fibers continue with the lateral margin of the anterior ligament and insert in the neck of malleus; in contrast, other Authors demonstrated that discomalleolar ligament is an independent structure inserted in proximity of the neck of the malleus. Although the discomalleolar ligament can be considered as a structure of clinical importance, it is not described by anatomy textbooks. Moreover, it is likely that important correlations between temporomandibular diseases and otological symptoms exist. We have studied discomalleolar ligament submitting the specimens to the 3D volume rendering technique, light microscopy, reconstructing a wide light microscopic fields to analyze the real connection between retrodiscal connective tissue and middle ear, and immunofluorescence methods in order to analyze the consistence of ligament. We have shown two types of connections between TMJ and ear: first, with external acoustic meatus and, second, with middle ear through discomalleolar ligament. The different insertion represents a strong support in order to demonstrate that the TMJ disorders can determine variations of tension that are transmitted on the tympanic membrane provoking tinnitus in according to clinical features. Then, we propose that it is necessary to mention, also in anatomy textbook, the discomalleolar ligament as ligament distance of TMJ.
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Affiliation(s)
- Michele Runci Anastasi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Maxillo-Facial Surgery, "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy
| | - Giuseppina Rizzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Fabiana Nicita
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Veronica Macchi
- Institute of Human Anatomy, Department of Neurosciences, University of Padova, Italy
| | - Dario Brunetto
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Piero Cascone
- Department of Maxillo-Facial Surgery, "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy
| | - Alba Arco
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Arianna Nicita
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giuseppe Anastasi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Angelo Favaloro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
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Bordoni B. Costen's syndrome and COPD. Int J Chron Obstruct Pulmon Dis 2019; 14:457-460. [PMID: 30863046 PMCID: PMC6388777 DOI: 10.2147/copd.s200787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Bruno Bordoni
- Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific Address, Milan 20100, Italy, ,Correspondence: Bruno Bordoni, Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific Address, S Maria Nascente, Via Capecelatro 66, Milan 20100, Italy, Tel +39 02 349 630 0617, Email
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Damaskos S, Syriopoulos K, Sens RL, Politis C. An Investigation of the Morphology of the Petrotympanic Fissure Using Cone-Beam Computed Tomography. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2018; 9:e4. [PMID: 29707183 PMCID: PMC5913417 DOI: 10.5037/jomr.2018.9104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/27/2018] [Indexed: 11/16/2022]
Abstract
Objectives The purpose of the present study was: a) to examine the visibility and morphology of the petrotympanic fissure on cone-beam computed tomography images, and b) to investigate whether the petrotympanic fissure morphology is significantly affected by gender and age, or not. Material and Methods Using Newtom VGi (QR Verona, Italy), 106 cone-beam computed tomography examinations (212 temporomandibular joint areas) of both genders were retrospectively and randomly selected. Two observers examined the images and subsequently classified by consensus the petrotympanic fissure morphology into the following three types: type 1 - widely open; type 2 - narrow middle; type 3 - very narrow/closed. Results The petrotympanic fissure morphology was assessed as type 1, type 2, and type 3 in 85 (40.1%), 72 (34.0%), and 55 (25.9%) cases, respectively. No significant difference was found between left and right petrotympanic fissure morphology (Kappa = 0.37; P < 0.001). Furthermore, no significant difference was found between genders, specifically P = 0.264 and P = 0.211 for the right and left petrotympanic fissure morphology, respectively. However, the ordinal logistic regression analysis showed that males tend to have narrower petrotympanic fissures, in particular OR = 1.58 for right and OR = 1.5 for left petrotympanic fissure. Conclusions The current study lends support to the conclusion that an enhanced multi-planar cone-beam computed tomography yields a clear depiction of the petrotympanic fissure's morphological characteristics. We have found that the morphology is neither gender nor age-related.
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Affiliation(s)
- Spyros Damaskos
- Department of Oral Radiology, Academic Centre for Dentistry Amsterdam, AmsterdamThe Netherlands.,Department of Oral Diagnosis and Radiology, School of Dentistry, NKUA, AthensGreece
| | - Konstantinos Syriopoulos
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, Katholieke Universiteit Leuven, LeuvenBelgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, LeuvenBelgium
| | - Rogier L Sens
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, Katholieke Universiteit Leuven, LeuvenBelgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, LeuvenBelgium
| | - Constantinus Politis
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of Medicine, Katholieke Universiteit Leuven, LeuvenBelgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, LeuvenBelgium
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Alvez CS, Carvalho de Moraes LO, Marques SR, Tedesco RC, Harb LJC, Rodríguez-Vázquez JF, Mérida-Velasco JR, Alonso LG. Analysis by Light, Scanning, and Transmission Microscopy of the Intima Synovial of the Temporomandibular Joint of Human Fetuses during the Development. ANATOMY RESEARCH INTERNATIONAL 2014; 2014:732720. [PMID: 24527214 PMCID: PMC3914572 DOI: 10.1155/2014/732720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/25/2013] [Indexed: 11/18/2022]
Abstract
Objective. To characterize morphologically and ultrastructurally using light microscopy, the scanning electron microscopy and transmission electron microscopy the intima synovial of the temporomandibular joint (TMJ) of human fetuses between the 10th and the 38th week of development. Materials and Methods. The TMJ was dissected bilaterally in 37 human fetuses belonging to the Institute of Embryology of the University Complutense of Madrid and of the Federal University of São Paulo. Results. The outcome by light microscopy showed the morphology of the TMJ and that the formation of inferior joint cavity precedes the superior joint cavity and the presence of blood vessels in the synovial. Conclusion. By scanning and transmission electron microscopy we observed the presence of two well-defined cell types in the intima layer of synovial of the TMJ of human fetuses, macrophage-like type A cell and fibroblast-like type B cell, and the presence of the a third cell type, defined by the name of intermediate lining cell in the intima layer of the synovial.
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Affiliation(s)
- Carlos Sabu Alvez
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, 04023-900 São Paulo, SP, Brazil
- Departamento de Morfologia, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil
| | | | - Sergio R. Marques
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, 04023-900 São Paulo, SP, Brazil
| | - Roberto C. Tedesco
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, 04023-900 São Paulo, SP, Brazil
| | - Leandro J. C. Harb
- Departamento de Morfologia, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil
| | | | - Jose R. Mérida-Velasco
- Departamento de Anatomía y Embriología II, Universidad Complutense of Madrid, 28040 Madrid, Spain
| | - Luis Garcia Alonso
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, 04023-900 São Paulo, SP, Brazil
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