Abstract
Active and passive mouth opening exercises are a very common practice in oral and maxillofacial surgery especially for various conditions causing limited mouth opening like space infections, trauma, and ankylosis. But most of the practitioners do not follow basic principles while advocating these active mouth opening exercises and also take it for granted that it would benefit the patient in the long run. Because of this, the mouth opening physiotherapy by itself can at times lead to unwanted complications. We report a case wherein due to active physiotherapy, the patient had complications leading to persistent temporal space infection which required surgical intervention and hospitalization. This could have been because of hematoma formation during physiotherapy which got infected due to anchoretic infection of unknown etiology and resulted in temporal space infection. Hence, our conclusion is that whenever mouth opening exercises are initiated, it should be done gradually under good antibiotic coverage to avoid any untoward complications and for optimum results. According to the current English literature, such a complication has not been documented before.
Highlights
The term “Trismus” is derived from a Greek word “Trismos” meaning squeaking, whistling, or whizzing [1]
In children fibrous ankylosis especially following injury to temporomandibular joint can manifest as trismus
We present an unusual case report of a patient who had temporal space infection as a result of vigorous mouth opening physiotherapy for trismus due to fibrous ankylosis
Summary
The term “Trismus” is derived from a Greek word “Trismos” meaning squeaking, whistling, or whizzing [1]. The principal manifestation of trismus is restricted jaw movement that can severely affect nutrition, oral hygiene, and speech and in some cases can result in airway compromise. It is one of the most common complications which can occur due to infection, trauma, temporomandibular joint disorders, MPDS, submucous fibrosis, and so forth. This condition is usually managed conservatively with analgesics, muscle relaxants, hot fomentations, and mouth opening physiotherapy. We present an unusual case report of a patient who had temporal space infection as a result of vigorous mouth opening physiotherapy for trismus due to fibrous ankylosis. According to our present knowledge such a case has not been documented anywhere in the literature
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