J Oral Med Pain.  2021 Dec;46(4):161-164. 10.14476/jomp.2021.46.4.161.

Symptomatic Temporomandibular Joint Herniation through the Foramen of Huschke: A Case Report

• Song HJ
• Lee Y
• Choi HM
• Kim YJ
• Kim C
• Park MS

• KMID: 2552224
• DOI: http://doi.org/10.14476/jomp.2021.46.4.161

Abstract

The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient’s symptom level and the patient’s general health status. If the clinical symptoms are not severe, no treatment is required.

Keyword

External auditory canal; Foramen of Huschke; Herniation