El Bouazzaoui Abderrahim, Labib Smael, Derkaoui Ali, Adnane Berdai Mohammed, Bendadi Azzeddine, Harandou Mustapha
Department of Anesthesia and Resuscitation, Mother and Child Hospital, University Hospital Hassan II, Fez, Morocco.
Pan Afr Med J. 2010 Jun 25;5:23.
Dislocation of temporo-mandibular joint (TMJ) is an infrequent disease but still spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occur in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin). We report a case of TMJ occurring in an uncommon circumstance: vaginal delivery. A woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800 g and 2400 g. During labour, and due to efforts of crying, the patient developed a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened and with the chin lowered and thrown forward. The examination found an empty glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ was established. A CT scan of facial bones was done, objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation.
颞下颌关节脱位是一种罕见但仍较为引人注目的疾病。这种疾病表现为颞下颌关节在一定程度上的永久性完全破坏。这些脱位常发生在打哈欠时，较少见的情况是在一阵大笑或相对轻微的面部创伤（耳光、下巴受拳击）之后。我们报告一例在不寻常情况下发生的颞下颌关节脱位病例：经阴道分娩。一名24岁、无特殊既往病史的初产妇因双胎妊娠即将分娩入住非斯哈桑二世大学医院妇产科。入院十分钟后，患者行会阴切开术经阴道分娩。她产下了体重分别为2800克和2400克的双胞胎。在分娩过程中，由于哭闹用力，患者突然出现颞下颌关节功能立即丧失，说话困难，嘴巴一直张开，下巴低垂并向前突出。检查发现双侧颞下颌关节的关节窝空虚。确诊为颞下颌关节脱位。进行了面部骨骼CT扫描，证实为双侧颞下颌关节脱位。在手术室镇静下对该脱位进行了复位。
