Temporomandibular Joint Dislocation After Long-Term Mechanical Ventilation.

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2025-03-26 eCollection Date: 2025-01-01 DOI:10.12890/2025_005340
Suzanne K Veneman, Stephanie E Veneman, Thiemo F Veneman
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引用次数: 0

Abstract

Introduction: Dislocations of the temporomandibular joints (TMJ) are relatively common and occur in as many as 7% of the entire population at some point in their lives. Anterior dislocations are the most common and are defined as the excessive forward movement of the mandibular condyle out of the glenoid fossa beyond the articular eminence with complete separation of the articular surfaces. However, anterior bilateral TMJ dislocation after intubation described in this case report, is a very uncommon complication.

Case description: A 43-year-old woman with an unremarkable medical history presented to the emergency department with respiratory distress. She was admitted to the intensive care unit for non-invasive ventilation and intubated on the same day. After 10 days she was extubated. Post-extubation, the patient was unable to close her mouth, speak, or swallow, causing severe drooling. A computed tomography scan revealed a bilateral dislocation of the TMJ. An ear, nose and throat specialist successfully and easily repositioned the mandible under 5 ml of propofol, restoring normal jaw anatomy and function.

Discussion: Endotracheal intubation is a predisposing factor for TMJ dislocation. Other risk factors include female sex, interincisal distance, and age. Early recognition and management are imperative, since delay scan cause difficult repositioning due to muscle spasms. Longer delays can cause long-lasting dysfunctions and pain.

Conclusion: Bilateral anterior TMJ dislocation is a known but rare complication of endotracheal intubation. Swift recognition and treatment are imperative in order to prevent long-lasting anatomical and functional defects.

Learning points: Bilateral temporomandibular dislocation is a rare complication after intubation.Swift repositioning of anatomical structures is important to prevent long term complications.Long-term complications of prolonged dislocation of the temporomandibular joint include persistent disfunction and/or pain.

长期机械通气后颞下颌关节脱位。
颞下颌关节(TMJ)脱位是相对常见的,在整个人群中有多达7%的人在他们生命中的某个阶段发生过脱位。前脱位是最常见的,被定义为下颌髁过度向前运动,超出关节隆起的关节窝,关节面完全分离。然而,本病例报告中描述的插管后双侧颞下颌关节前脱位是一种非常罕见的并发症。病例描述:一名43岁女性,病史一般,因呼吸窘迫就诊于急诊科。患者于同日入住重症监护室进行无创通气并插管。10天后,她拔管。拔管后,患者无法闭上嘴、说话或吞咽,导致严重流口水。计算机断层扫描显示双侧TMJ脱位。一位耳鼻喉科专家在5毫升异丙酚的作用下成功且轻松地将下颌骨重新定位,恢复了正常的颌骨解剖和功能。讨论:气管插管是诱发TMJ脱位的一个因素。其他危险因素包括女性性别、内脏距离和年龄。早期识别和处理是必要的,因为延迟扫描导致肌肉痉挛难以重新定位。更长时间的延迟会导致长期的功能障碍和疼痛。结论:双侧颞下颌关节前位脱位是一种已知但罕见的气管插管并发症。为了防止长期的解剖和功能缺陷,迅速识别和治疗是必不可少的。学习要点:双侧颞下颌关节脱位是插管后罕见的并发症,快速定位解剖结构是防止长期并发症的重要因素。长期的颞下颌关节脱位的并发症包括持续的功能障碍和/或疼痛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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