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颞下颌关节化脓性关节炎的关节镜治疗:病例报告。

Septic arthritis of the temporomandibular joint managed with arthroscopy: a case report.

机构信息

Instituto Português da Face, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal.

出版信息

Int J Oral Maxillofac Surg. 2023 Dec;52(12):1278-1281. doi: 10.1016/j.ijom.2023.06.008. Epub 2023 Jul 20.

Abstract

Septic arthritis of the temporomandibular joint (SATMJ) is an uncommon bacterial or fungal infection of the joint space. A 68-year-old man with underlying diabetes mellitus and a history of liver transplant, who was on immunosuppressants, presented to the oral and maxillofacial surgery department of the authors´ institution in Portugal. His main symptoms were arthralgia in the right temporomandibular joint, malocclusion, pre-auricular swelling and erythema. After clinical, laboratory, and imaging evaluations, diagnoses of chronic suppurative otitis media and SATMJ were made. The patient was managed with arthroscopy of the right temporomandibular joint, which allowed joint fluid collection for microbiological examination, lavage, and biopsy. The biopsy sample was positive for Pseudomonas aeruginosa. After surgery, targeted intravenous antibiotic treatment (amikacin) was given for 30 days. No recurrence of any complaints was reported after 12 months of follow-up.

摘要

颞下颌关节(TMJ)感染性关节炎是一种少见的关节间隙细菌或真菌感染。作者所在葡萄牙的一所机构的口腔颌面外科部门收治了一名 68 岁的男性患者,他患有糖尿病且曾接受过肝移植,目前正在服用免疫抑制剂。他的主要症状是右侧 TMJ 关节痛、咬合不正、耳前肿胀和红斑。经过临床、实验室和影像学评估,该患者被诊断为慢性化脓性中耳炎和 TMJ 感染性关节炎。患者接受了右侧 TMJ 关节镜检查,以便采集关节液进行微生物检查、冲洗和活检。活检样本中检测到铜绿假单胞菌。手术后,给予 30 天靶向静脉内抗生素治疗(阿米卡星)。在 12 个月的随访中,未报告任何症状复发。

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