Suzanne K Veneman, Stephanie E Veneman, Thiemo F Veneman
{"title":"Temporomandibular Joint Dislocation After Long-Term Mechanical Ventilation.","authors":"Suzanne K Veneman, Stephanie E Veneman, Thiemo F Veneman","doi":"10.12890/2025_005340","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Case description: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Learning points: </strong>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.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 4","pages":"005340"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013238/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of case reports in internal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12890/2025_005340","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
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.
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.