Maxillofac Plast Reconstr Surg.  2015 Oct;37(10):39. 10.1186/s40902-015-0041-1.

Temporomandibular joint disorder from skull-base osteomyelitis: a case report

• Lee SC
• Kim JH
• Kim CH
• Kim BJ

• KMID: 2381865
• DOI: http://doi.org/10.1186/s40902-015-0041-1

Abstract

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

Keyword

Malignant external otitis; Skull-base osteomyelitis; Arthrocentesis with lavage

MeSH Terms

Aged
Bone Resorption
Ear Canal
Humans
Jaw
Joints
Middle Aged
Mouth
Occipital Bone
Osteomyelitis*
Otitis Externa
Rare Diseases
Temporomandibular Joint Disorders*
Temporomandibular Joint*
Therapeutic Irrigation