Malignant (invasive) otitis externa involving the temporomandibular joint

2005 ◽  
Vol 119 (1) ◽  
pp. 61-63 ◽  
Author(s):  
L Dobbyn ◽  
C O’Shea ◽  
P McLoughlin
Keyword(s):  
Temporomandibular Joint ◽  
Otitis Externa ◽  
External Auditory Meatus ◽  
Posterior Wall ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Glenoid Fossa ◽  
Cranial Neuropathies ◽  
The Right

Malignant (invasive) otitis externa (MOE) is an infection involving the external auditory meatus (EAM), most often found in elderly diabetics, which carries a high morbidity and mortality. In advanced cases it may give rise to osteomyelitis and cranial neuropathies. This is a case of MOE, which invaded the posterior wall of the right temporomandibular joint (TMJ), resulting in severe trismus and pain. Subsequently, this required treatment by replacement of the glenoid fossa with a Silastic® prosthesis.

Temporomandibular joint fistula into the external ear canal

2012 ◽  
Vol 126 (8) ◽  
pp. 837-839 ◽  
Author(s):  
J Ajduk ◽  
M Ries ◽  
D Vagic ◽  
A Batos-Tripalo
Keyword(s):  
Temporomandibular Joint ◽  
Rare Case ◽  
Normal Skin ◽  
Rare Condition ◽  
External Auditory Meatus ◽  
External Ear ◽  
Clear Fluid ◽  
The Right ◽  
Foramen Of Huschke ◽  
Otoscopic Examination

AbstractBackground:Temporomandibular joint fistula into the external auditory canal is a very rare condition. We report a case of spontaneous fistula which presented with repeated episodes of clear fluid otorrhoea and ear infection.Case report:A 53-year-old woman complained of occasional episodes of clear fluid otorrhoea from the right ear followed by infection. Otoscopic examination showed a normal tympanic membrane and normal skin in the external auditory meatus. Otomicroscopy showed a small punctum on the anteroinferior part of the meatus. Computed tomography identified a foramen of Huschke. Surgery revealed a fistula between the meatus and the temporomandibular joint, which was successfully resolved.Conclusion:This report presents a rare case of a fistula between the temporomandibular joint and the external auditory meatus, associated with Huschke's foramen. Such a defect can be quite difficult to detect. It should be suspected in cases of chronic otorrhoea when neither middle nor external ear disease is apparent. Surgery is usually successful, and is advised in cases with repeated complications.

scholarly journals Study of ectopic pregnancy in a tertiary care centre

2019 ◽  
Vol 9 (1) ◽  
pp. 212
Author(s):  
Nitesh Meena ◽  
Radheshyam Bairwa ◽  
Savitri Sharma
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
Mortality Incidence ◽  
Ectopic Pregnancies ◽  
The Right

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.

Osteomyelitis of the temporomandibular joint in patients with malignant otitis externa

1999 ◽  
Vol 113 (5) ◽  
pp. 451-453 ◽  
Author(s):  
Katie I. Midwinter ◽  
Kanwar S. Gill ◽  
John A. Spencer ◽  
Iain D. Fraser
Keyword(s):  
Temporomandibular Joint ◽  
Otitis Externa ◽  
Cranial Neuropathy ◽  
Diabetic Patients ◽  
High Morbidity ◽  
External Ear ◽  
Resonance Imaging ◽  
Malignant Otitis Externa ◽  
Magnetic Resonance Imaging Mri

AbstractMalignant (invasive) otitis externa is an infection involving the external ear canal, often in elderly diabetic patients, which carries a high morbidity and mortality. It may involve widespread areas of soft tissue around the skull base, and in more advanced cases, may give rise to osteomyelitis and cranial neuropathy. We describe two patients who were treated for malignant otitis externa complicated by destructive osteomyelitis of the temporomandibular joint (TMJ). For both patients, diagnosis was made using magnetic resonance imaging (MRI), and repeat scans were employed during follow-up. Improved scan appearances mirrored improvements in clinical condition in both cases.

scholarly journals MORPHOMETRIC CHARACTERISTICS OF TEMPOROMANDIBULAR JOINT IN HUMAN DURING THE SECOND TRIMESTER OF INTRAUTERINE DEVELOPMENT

2018 ◽  
Vol 17 (2) ◽  
pp. 23-26
Author(s):  
D. B. Stoliar ◽  
L. P. Lavriv
Keyword(s):  
Connective Tissue ◽  
Temporomandibular Joint ◽  
Synovial Membrane ◽  
Back Surface ◽  
Glenoid Fossa ◽  
Second Trimester ◽  
Intrauterine Development ◽  
Articular Capsule ◽  
Articular Disk ◽  
The Right

The article provides data on the anatomical features of temporomandibular joint in the second trimester of fetal development, certain methods of anatomy, morphometry and craniometry. The glenoid fossa in fetuses aged 4-6 months was found to be flat. The bone substance in the glenoid fossa is thin. One can see the development of the elements of the synovial membrane in the articular capsule. In the lower and upper parts of the articular cavity, the folds and ligaments of the connective tissue plate are identified, and the capillaries grow into the synovial membrane. In some places there are connective tissue membranes between the surfaces of the temporal bone and the articular disk, the articular disk and the head of mandible. Macroscopically, the articular disk has a dense structure, it is arranged between the articular surfaces, from the back surface of the articular disk to the inner surface of the articular capsule the taenia of the connective tissue is identified. Anteriorly, the articular disk is attached in the area of the future articular tubercle. The right and lefts temporomandibular joint are of the same size. In the dynamics of the second trimester of intrauterine development, the temporomandibular joint is characterized by the presence of a flat glenoid fossa and the absence of an articular tubercle. An increase in all craniometric indices is observed, indicating an increase in the total bone mass of the skull and an increase in the size of the temporomandibular joint.

Temporomandibular joint involvement as a positive clinical prognostic factor in necrotising external otitis

2016 ◽  
Vol 130 (5) ◽  
pp. 435-439 ◽  
Author(s):  
E Yeheskeli ◽  
R Abu Eta ◽  
H Gavriel ◽  
S Kleid ◽  
E Eviatar
Keyword(s):  
Prognostic Factor ◽  
Temporomandibular Joint ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Otitis Externa ◽  
Oxygen Therapy ◽  
Case Series ◽  
Joint Involvement ◽  
High Morbidity ◽  
Gradual Improvement

AbstractObjective:Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy.Methods:A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy.Results:Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment.Conclusion:Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.

Management of oesophageal anastomosis dehiscence after oesophagectomy for oesophageal cancer

2020 ◽  
Vol 99 (5) ◽  
pp. 200-206
Keyword(s):  
Oesophageal Cancer ◽  
Surgical Procedure ◽  
Anastomotic Dehiscence ◽  
Gastric Conduit ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Therapeutic Algorithm

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.

ASSESSMENT OF PHYSIOLOGICAL PARAMETERS OF THE TRIGEMINAL AND COCHLEOVESTIBULAR SYSTEMS IN TEMPOROMANDIBULAR JOINT PAIN DYSFUNCTION

2020 ◽  
Vol 17 (2) ◽  
pp. 110-120
Author(s):  
N.D. Sorokina ◽  
◽  
L.R. Shahalieva ◽  
S.S. Pertsov ◽  
L.V. Polma ◽  
...  
Keyword(s):  
Nervous System ◽  
Evoked Potentials ◽  
Temporomandibular Joint ◽  
Differential Diagnostics ◽  
Autonomous Nervous System ◽  
Dental Diseases ◽  
Grade Ii ◽  
The Right ◽  
Distal Occlusion ◽  
The Brain

One of the most common causes of chronic pain in the facial region, including in the trigeminal nerve link, which is not associated with dental diseases, is pain dysfunction of the temporomandibular joint. At the same time, there is evidence in the literature that there are relationships between pain dysfunction of the temporomandibular joint, abnormal occlusion, cervical-muscular tonic phenomena, postural disorders, dysfunction of the Autonomous nervous system and cochleovestibular manifestations. At the same time, neurophysiological indicators of functional disorders in the maxillofacial region and intersystem interactions in pain dysfunction of the temporomandibular joint are insufficiently studied.Goal. The aim of the work is to evaluate the neurophysiological features of trigeminal afferentation in terms of trigeminal somatosensory evoked potentials (TSWP) and the auditory conducting system of the brain in terms of acoustic stem evoked potentials (ASVP) in distal occlusion of the dentition with pain dysfunction of the temporomandibular joint (TMJ) in comparison with physiological occlusion in students 18-21 years old. Material and methods. The main study included 41 students with distal occlusion (21 girls and 20 boys), (grade II Engl, symmetrically right and left in 14 people, and grade II Engl on the left and grade I on the right in 12 people, grade I on the left and grade II on the right in 15 people). All respondents with distal occlusion and who were practically healthy signed an informed consent to participate in the study. We used complex orthodontic methods of examination, subjective degree of severity and intensity of pain in the TMJ, assessment of the Autonomous nervous system (samples and tests), and neurophysiological methods for assessing TSVP and ASVP. Results. Significant differences in ASEP parameters were found in the group of respondents with distal occlusion in the form of a decrease in the latency period of peak I, III, and V compared to physiological occlusion, that correlated with the subjective assessment (in points) of cochleovestibular disorders. According to the TSVP study, a decrease in the duration of latent periods was found, which indicates an increased excitability of non-specific brain stem structures at the medullo-ponto-mesencephalic level compared to the control group. Conclusions. The results obtained are supposed to be used for differential diagnostics, including such dental diseases as TMJ pain dysfunction, occlusion abnormalities accompanied by pain syndrome. Additional functional diagnostics of multi-modal VP of the brain (acoustic evoked potentials, trigeminal evoked potentials) can be performed in conjunction with indicators of autonomic nervous system dysfunction, with parameters of severity of clinical symptoms of cochleovestibular disorders, musculoskeletal dysfunction the maxillofacial area, with indicators of pain, which will determine the tactics and effectiveness of subsequent treatment.

Mitral Re-Repair and Right Coronary Fistula Closure Advantage of Minimally Invasive Approach

2010 ◽  
Vol 5 (6) ◽  
pp. 456-459 ◽  
Author(s):  
Vincenzo Giordano ◽  
Jan G. Grandjean
Keyword(s):  
Mitral Valve ◽  
Right Atrium ◽  
Mild Hypothermia ◽  
Posterior Wall ◽  
Coronary Arteriography ◽  
Coronary Fistula ◽  
Invasive Approach ◽  
Concomitant Procedure ◽  
Echocardiographic Images ◽  
The Right

A 51-year-old man developed severe mitral regurgitation 10 years after previous mitral valve repair; the echocardiographic images showed a remarkable eccentric jet toward posterior wall of left atrium associated with a high degree of pulmonary vein retrograde flow. The coronary arteriography pointed out no pathologic lesions but a coronary fistula from the proximal right coronary to the right atrium. The standard approach was avoided, and a right anterolateral minithoracotomy was chosen, providing an excellent view. Under cardiopulmonary bypass and mild hypothermia, the mitral valve was re-repaired, and a new ring was implanted. After aortic cross-clamp release, the right coronary fistula was closed through the right atrium. The postoperative course was uneventful, and the patient was discharged on the fourth postoperative day. In such a high-risk reintervention and concomitant procedure, we think that this different approach may represent a feasible and reliable alternative.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

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