scholarly journals 1425 Surgical Management of a Long-Standing Temporomandibular Joint Dislocation: A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Dunphy ◽  
H Quach ◽  
G A Ghaly
Keyword(s):  
Temporomandibular Joint ◽  
Closed Reduction ◽  
Infratemporal Fossa ◽  
Maxillofacial Surgery ◽  
Oral Intake ◽  
General Anaesthetic ◽  
Range Of Movement ◽  
Muscle Fibrosis ◽  
Tmj Dislocation ◽  
History Of

Abstract Background Temporomandibular joint (TMJ) dislocation is a common presentation to Oral & Maxillofacial Surgery. In most cases, the condylar head is displaced anterior to the articular eminence and can be relocated by closed reduction. Severe dislocation into the infratemporal fossa is uncommon. Long-standing dislocation is rare and makes closed reduction difficult to achieve. Presentation A 60-year-old female presented to the outpatient clinic with long-standing bilateral TMJ dislocation which onset months prior following a seizure. Both condylar heads could be palpated superior to the zygomatic arches and could not be reduced under local anaesthetic. Mandibular range of movement was severely limited and creating an oral seal was not possible, affecting speech function. There was a history of discomfort and declining oral intake. Computed tomography revealed both condyles were displaced into the infratemporal fossa. Management The patient and family expressed a desire to avoid risk of damage to the facial nerve and therefore surgery was limited to an intra-oral approach only. Closed reduction was impossible due to the degree of muscle fibrosis present. Bilateral coronoidectomies were performed under a short general anaesthetic which immediately improved range of movement. Full articulation and occlusion were achieved by performing bilateral condylotomies. Outcome The patient was reviewed by video consultation 2 weeks later and had recovered well. They reported good masticatory function and improved dietary intake. No additional physiotherapy or surgical input was required, and they have been discharged from further review.

scholarly journals Serial kasus berbagai metode perawatan dislokasi sendi temporomandibula berdasarkan jenis dislokasinyaCase series of various temporomandibular joint dislocation treatment methods based on the dislocation type

2021 ◽  
Vol 33 (2) ◽  
pp. 91
Author(s):  
Dina Novianti ◽  
Endang Syamsudin ◽  
Winarno Priyanto
Keyword(s):  
Temporomandibular Joint ◽  
Case Reports ◽  
Maxillofacial Surgery ◽  
Case Series ◽  
Facial Asymmetry ◽  
Oral And Maxillofacial Surgery ◽  
Delayed Treatment ◽  
Tmj Dislocation ◽  
Joint Dislocations ◽  
Dislocation Type

Pendahuluan: Dislokasi sendi temporomandibula (TMJ) merupakan suatu keadaan dimana kondilus keluar dari fosa glenoidalis ke arah superior, posterior atau anterior melewati eminentia artikularis dan seringkali disertai dengan spasme otot-otot pengunyahan. Penanganan yang terlambat dapat menimbulkan komplikasi berupa asimetri wajah dan menggangu pengunyahan. Tujuan penulisan kasus ini adalah menyampaikan serial kasus perawatan dislokasi sendi temporomandibular berdasarkan jenis dislokasinya. Laporan kasus: Empat tipe kasus dislokasi TMJ datang ke IGD dan Poli Bedah Mulut dan Maksilofasial Rumah Sakit Hasan Sadikin Bandung dengan riwayat dislokasi yang berbeda. Pasien berjenis kelamin dua laki-laki dan dua perempuan, berusia 33 hingga 66 tahun dengan faktor predisposisi menguap. Klasifikasi dislokasi yaitu akut dan kronis. Perawatan keempat kasus berupa reduksi manual, menggunakan metode Hippocrates dan wrist pivot, hingga pembedahan dengan miotomi. Simpulan: Keadaan dislokasi yang berbeda memerlukan perawatan yang berbeda. Kasus akut dapat segera dilakukan reduksi manual, sedangkan kasus kronis memerlukan pembedahan. Keterlambatan penanganan yang tepat dapat membuat keadaan menjadi lebih berat sehingga memerlukan penanganan yang lebih kompleks dan biaya yang lebih besar. ABSTRACTIntroduction: Temporomandibular joint (TMJ) dislocation is a condition in which the condyle exits the glenoid fossa superiorly, posteriorly, or anteriorly through the articular eminence and is often accompanied by mastication muscle spasm. Delayed treatment can cause complications in the form of facial asymmetry, thus interfere with mastication. The purpose of the case series was to present a case series of temporomandibular joint dislocations treatment based on the dislocation type. Case reports: Four different patients with four types of TMJ dislocation cases came to the ER and the Oral and Maxillofacial Surgery Clinic of Hasan Sadikin Hospital Bandung, with different dislocation histories. The patients were two males and two females, aged 33 to 66 years, with predisposing factors of yawning. Classifications of dislocations were acute and chronic. The four cases’ treatments were manual reduction, each using the Hippocrates method and wrist pivot, up to surgery with myotomy. Conclusions: Different dislocation conditions require different treatments. Acute cases can be directly reduced manually, while chronic cases require surgery. Delay in proper handling will severe the situation, requiring more complex treatment with higher costs.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

Congenital Temporomandibular Joint Ankylosis: Clinical Characterization and Natural History of Four Unrelated Affected Individuals

2005 ◽  
Vol 42 (6) ◽  
pp. 694-698 ◽  
Author(s):  
Vera Lúcia Gil-da-Silva-Lopes ◽  
Daniela Varela Luquetti
Keyword(s):  
Natural History ◽  
Temporomandibular Joint ◽  
Clinical Aspects ◽  
Temporomandibular Joint Ankylosis ◽  
History Of ◽  
Joint Ankylosis

The objective of this study was to describe four unrelated patients affected by congenital temporomandibular joint ankylosis. Clinical delineation, natural history, and possible etiologies are discussed. Clinical aspects that are important for follow-up are outlined.

scholarly journals Midline Mandibulotomy for Reduction of Long-Standing Temporomandibular Joint Dislocation

2013 ◽  
Vol 6 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Vidya Rattan ◽  
Sachin Rai ◽  
Amit Sethi
Keyword(s):  
Temporomandibular Joint ◽  
Indirect Reduction ◽  
Joint Dislocation ◽  
Related Literature ◽  
Reduction Techniques ◽  
Tmj Dislocation ◽  
Direct Exposure ◽  
Uncommon Condition ◽  
Temporomandibular Joint Dislocation

Long-standing temporomandibular joint (TMJ) dislocation is an uncommon condition, and due to its rarity, no definitive guidelines have been developed for its management. Various reduction techniques ranging from indirect traction techniques to direct exposure of the TMJ have been used. Indirect traction techniques for reduction may fail in long-standing dislocation. Management of two cases of long-standing TMJ dislocation with midline mandibulotomy is discussed in which other indirect reduction techniques had failed. Midline osteotomy of the mandible can be used for reduction in difficult TMJ dislocations. An algorithm for the management of long-standing TMJ dislocation is proposed and related literature is reviewed.

1239 Postoperative Complication Rate of Facial Injury Repairs Treated by Maxillofacial On-Call Team: Surgical Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
General Anaesthetic ◽  
Facial Injury ◽  
Postoperative Complication Rate ◽  
Female Ratio ◽  
Facial Injuries

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.

A Case Report of Delirium Induced by Herbal Laxative Senna

2021 ◽  
Vol 11 (6) ◽  
pp. 231-233
Author(s):  
Nimitha K J ◽  
Porimita Chutia ◽  
Pooja Misal
Keyword(s):  
Case Report ◽  
Serum Sodium ◽  
Elderly Population ◽  
Oral Intake ◽  
Mental Illnesses ◽  
Electrolyte Imbalance ◽  
Normal Limits ◽  
Icd 10 ◽  
Current Scenario ◽  
History Of

Constipation is one major complaint in elderly population. It may be due to physiological and anatomical reasons of aging, but it can be also due chronic medical and mental illnesses and due to use of multiple medications. Constipation itself is a precipitating factor for delirium. Drugs used for constipation can also be the culprit. A 64-year-old female who had a history of hypertension and chronic constipation presented with symptoms of confused and altered behavior, decreased oral intake, decreased sleep. On history taking it was known that she was using Herbal medication containing senna glycoside and other compounds since 8-9months. On examination she had signs of dehydration, disoriented and attention was impaired. On investigation her serum sodium was 122.6 mmol/ and other investigations were within normal limits. She was diagnosed as a case of Delirium according to ICD-10 criteria. Her dehydration was corrected by giving intravenous fluids and serum sodium level was corrected using salt capsules 2 tablets thrice daily. For disturbed sleep she was prescribed Tab Melatonin 10mg at bedtime and constipation was treated with per rectal enema and syrup lactulose 30ml at bedtime. Patient improved in 1 week time. Senna a herbal laxative used to treat constipation. It can alter intestinal electrolyte transportation and irritates intestinal mucosa. It is due to increased peristalsis and increased defecation and even diarrhea Prolonged use can cause dehydration, electrolyte imbalance and delirium. Senna, an over-the-counter laxative with FDA approval is a matter of concern in the current scenario. This case report warns into the judicious use of laxatives containing senna in elderly population. Key words: Delirium, Herbal Laxative, Senna, Constipation.

scholarly journals Aspiração de Corpo Estranho no Idoso

2016 ◽  
Vol 29 (5) ◽  
pp. 340
Author(s):  
Cátia Oliveira Matos ◽  
Manuel Mário Sousa
Keyword(s):  
Oral Intake ◽  
The Elderly ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Clinical Suspicion ◽  
Chronic Obstructive ◽  
History Taking ◽  
Therapeutic Procedure ◽  
Obstructive Pulmonary Disease ◽  
History Of

Foreign body aspiration is common in children and in the elderly, who may present with subtle symptoms. Clinical suspicion is crucial and bronchoscopy is the main diagnostic and therapeutic procedure available. This is the case of a man, 78 years old, with a history of chronic obstructive pulmonary disease, who presented with respiratory distress following oral intake of tablets. History taking and physical examination raised suspicion. The diagnosis was confirmed with flexible bronchoscopy and rigid bronchoscopy was carried out for treatment. The patient’s condition is stable and he is under investigations for dysphagia.

scholarly journals A Morphometric Analysis of Intra-articular Disc of Temporomandibular Joints in Cadavers

2021 ◽  
Author(s):  
Pratik Ashokkumar Agrawal ◽  
Navin S Shah ◽  
Ramnarayan A Gandotra ◽  
Karan Vasantray Panchal ◽  
Rishabh Navin Shah
Keyword(s):  
Temporomandibular Joint ◽  
Anatomic Variation ◽  
Maxillofacial Surgery ◽  
Temporomandibular Joint Disorders ◽  
Research Centre ◽  
Oral And Maxillofacial Surgery ◽  
Articular Disc ◽  
Chi Square ◽  
Temporomandibular Joints ◽  
Human Cadavers

Introduction: Temporomandibular Joint (TMJ) has been a controversial topic in Oral and Maxillofacial Surgery speciality especially regarding temporomandibular joint disorders and internal derangement of articular disc. The aetiology behind it has been related to the anatomic variations of the disc and its impact on the functioning of the articular disc. To understand such anatomic variation, the study has been conducted that will help future maxillofacial surgeon’s in designing accurate prosthetic articular disc that will improve the overall mechanics of the functioning of the prosthetic disc. Aim: To analyse the morphometric variations of the intra-articular disc in terms of circumference of the disc, perforations and their thickness within the disc in cadavers. Materials and Methods: The present observational study was carried out on cadavers in the Department of Anatomy. SBKS Medical College and Research Centre, Sumandeep Vidyapeeth University, Gujarat, India. The study was done from January 2017 to October 2018. Temporomandibular joints were dissected bilaterally from 10 human cadavers, i.e., 20 articular discs. The disc was removed and was measured with the help of thread, vernier callipers and standardised metallic scale and the circumference and thickness in the disc were evaluated. Descriptive statistical test was used and Chi-square test was applied. Results: Mean thickness of disc, both in males as well as females ranged from 1.4-2.0 mm in the Posterio-Medial (PM) and Posterio- Lateral (PL) region, while in Anterio-Medial (AM) and Anterio- Lateral (AL) region it ranged from 1.6-1.8 mm. Maximum length of disc ranged from 12-13 mm in anterio-posterio dimension while in Medio-Lateral (ML) it was 22-23 mm. Conclusion: The study gives an indepth knowledge about the various morphometric variations of articular disc and also shows its impact on the functioning of the disc. The study also directs maxillofacial surgeons to design prosthetic articular disc with greater accuracy and anatomical knowledge so that the procedures like surgical replacement of the disc can be carried out with greater potency and efficacy for the betterment of the patient.

scholarly journals PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

2016 ◽  
Vol 3 (3) ◽  
pp. 124-129
Author(s):  
Prakash B Billakanti
Keyword(s):  
Infratemporal Fossa ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Anatomical Variations ◽  
Clinical Implications ◽  
Maxillary Artery ◽  
Foramen Ovale ◽  
Anesthetic Agents ◽  
Male Cadaver ◽  
Anatomical Area

La fosa infratemporal es un área anatómica clínicamente importante para la administración de agentes anestésicos locales en odontología y cirugía maxilofacial. Fueron estudiadas variaciones en la anatomía del nervio alveolar inferior y la arteria maxilar en la disección infratemporal. Durante la disección rutinaria de la cabeza en el cadáver de un varón adulto, fue observada una variación excepcional en el origen del nervio alveolar inferior y su relación con las estructuras circundantes. El nervio alveolar inferior se originaba en el nervio mandibular por dos raíces y la primera parte de la arteria maxilar estaba incorporada entre ambas. El origen embriológico de esta variación y sus implicaciones clínicas es debatido. Dado que la arteria maxilar transcurría entre las dos raíces del nervio alveolar inferior, y el nervio estaba fijado entre el foramen oval y el foramen mandibular, el atrapamiento vásculo-nervioso pudo causar entume-cimiento o dolor de cabeza e interferir con la inyección de anestésicos locales en la fosa infratemporal.  Variaciones anatómicas en esta región deben ser tenidas en cuenta, especialmente en casos de tratamiento fallido de neuralgia del trigémino. Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originated from the mandibular nerve by two roots and the first part of the maxillary artery was incorporated between them. An embryologic origin of this variation and its clinical implications is discussed. Because the maxillary artery runs between the two roots of the inferior alveolar nerve, and the nerve was fixed between the foramen ovale and mandibular foramen, neurovascular entrapment may cause pain numbness or headache and may interfere with the injection of local anesthetics into the infratemporal fossa. Anatomical variations in this region should be kept in mind, particularly in cases of failed treatment of trigeminal neuralgia.

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