Kalaitsidou Ioanna, Gass Mathieu, Tatsis Dimitris, Khalil Sherin, Schedeit Christian, Marjanowski Simon David, Wiegner Sarah, Schaller Benoît
Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Diagnostics (Basel). 2025 May 28;15(11):1360. doi: 10.3390/diagnostics15111360.
: Trismus, or restricted mouth opening, can present significant challenges in oral and maxillofacial surgery and trigger substantial functional and psychosocial disabilities. Intra-articular causes, such as temporomandibular joint ankylosis and arthritis, are thoroughly described; however, extra-articular pathologies like neoplastic, traumatic, infectious, and fibrotic conditions of adjacent soft and hard tissues are less frequently reported and present distinct diagnostic complexities and therapeutic hurdles. This retrospective study aims to investigate the difficulties encountered in diagnosis and surgical interventions associated with rare extra-articular causes of trismus. : This article describes five rare causes of extra-articular trismus. The cases range from benign pathologies like coronoid hyperplasia and osteomas to more complex diagnoses of myositis ossificans, external auditory canal abscess, and chronic osteomyelitis. A thorough diagnostic workup was performed for each patient, and specific surgical interventions were administered based on their pathology. : All five patients showed significant improvements in mouth opening after surgery. Diagnostic accuracy was ensured with advanced imaging modalities and innovative surgical techniques, and adequate postoperative care translated the favorable outcome. : Although based on individual case descriptions, this study emphasizes the potential importance of early diagnosis, a multidisciplinary approach, and individualized treatment planning in managing rare extra-articular causes of trismus. These cases suggest a basis for a more organized system for the timely identification and treatment of such conditions. Additional research is needed to improve diagnostic accuracy, optimize surgical management, and develop evidence-based aftercare treatment to improve patient care and quality of life.
牙关紧闭，即张口受限，在口腔颌面外科手术中会带来重大挑战，并引发严重的功能和心理社会障碍。关节内病因，如颞下颌关节强直和关节炎，已有详尽描述；然而，诸如相邻软硬组织的肿瘤性、创伤性、感染性和纤维化病症等关节外病变的报道较少，且存在独特的诊断复杂性和治疗障碍。这项回顾性研究旨在调查与罕见的关节外牙关紧闭病因相关的诊断和手术干预中遇到的困难。本文描述了五种罕见的关节外牙关紧闭病因。病例涵盖从喙突增生和骨瘤等良性病变到骨化性肌炎、外耳道脓肿和慢性骨髓炎等更复杂的诊断。对每位患者都进行了全面的诊断检查，并根据其病理情况实施了特定的手术干预。所有五名患者术后张口情况均有显著改善。先进的成像方式和创新的手术技术确保了诊断准确性，而充分的术后护理促成了良好的结果。尽管基于个别病例描述，但本研究强调了早期诊断、多学科方法和个性化治疗计划在处理罕见的关节外牙关紧闭病因方面的潜在重要性。这些病例为建立一个更有组织的系统以及时识别和治疗此类病症提供了基础。需要进一步研究以提高诊断准确性、优化手术管理并制定循证的术后护理治疗方案，以改善患者护理和生活质量。
