Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Unit of Oral and Maxillofacial surgery, Ca'Foncello Hospital, Treviso, Italy.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103599. doi: 10.1016/j.amjoto.2022.103599. Epub 2022 Aug 12.
Temporomandibular joint (TMJ) arthritis and ankylosis represent unusual but potential complications of ear suppuration, especially in children. We performed a review of the literature of pediatric otogenic TMJ arthritis and ankylosis, discussing their clinical and radiological features, their mechanism of infection spread, and the importance of a prompt diagnosis and treatment. We additionally describe a case of TMJ ankylosis following acute mastoiditis in a 4-year-old female patient.
A search of English literature from January 1, 1980 to December 31, 2021 was performed on the electronic databases (PubMed, Web of Science and Scopus) in order to identify studies concerning TMJ complication after ear suppuration.
Seventeen articles were considered eligible for the review. Eight and nine studies described otogenic TMJ ankylosis and arthritis, respectively. A total of 17 children affected by ankylosis consequent to ear infection and a total of 31 cases of TMJ arthritis concurrent to otomastoiditis were identified. Mean time elapsed between ear infection and diagnosis of TMJ ankylosis was 4.8 years (range 0.5-13).
TMJ involvement during complicated otitis media should be kept in mind. Its prompt recognition is mandatory to set up appropriate treatment and follow-up and reduce the risk of ankylosis with its functional and psychological complications.
颞下颌关节(TMJ)关节炎和强直是耳化脓性疾病的罕见但潜在的并发症,尤其是在儿童中。我们对小儿耳源性 TMJ 关节炎和强直的文献进行了回顾,讨论了其临床和影像学特征、感染传播机制以及及时诊断和治疗的重要性。我们还描述了一例 4 岁女性患者在急性乳突炎后发生 TMJ 强直的病例。
在电子数据库(PubMed、Web of Science 和 Scopus)上对 1980 年 1 月 1 日至 2021 年 12 月 31 日的英文文献进行了搜索,以确定有关耳化脓性疾病后 TMJ 并发症的研究。
共考虑了 17 篇符合审查标准的文章。其中 8 篇和 9 篇研究分别描述了耳源性 TMJ 强直和关节炎。总共发现 17 例儿童因耳部感染而发生强直,31 例 TMJ 关节炎并发乳突炎。从耳部感染到 TMJ 强直诊断的平均时间为 4.8 年(范围为 0.5-13 年)。
在复杂的中耳炎中应考虑 TMJ 受累。及时识别对于制定适当的治疗和随访计划以及降低强直及其功能和心理并发症的风险至关重要。