Bilateral temporomandibular joint dislocation in a 26-month-old child: A rare emergency

Muhammad Faisal Khilji,Aftab Khalid Malik

doi:10.5339/jemtac.2015.9

Abstract

Bilateral temporomandibular joint (TMJ) dislocation is very rare in children with only three cases previously reported in the literature. We report a case of a 26-month-old female child who presented to the emergency department of a tertiary care hospital with complaints of inability to close her mouth and drooling of saliva for the last two hours. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved with the Hippocratic method after giving analgesia and procedural sedation. The child was able to close her mouth post-reduction, and was discharged with post-TMJ reduction instructions given to the mother and with maxillofacial clinic follow up. Our report is the first case of a child presenting to the emergency department with bilateral TMJ dislocation.

Highlights

A case of a 26-month-old child presenting to the Sultan Qaboos University Hospital Emergency Department (ED) with bilateral temporomandibular joint (TMJ) dislocation is reported here
Cases previously reported were of children aged 10, 23 and 24 months old, our case is the fourth report of bilateral TMJ dislocation in a child but the first case presenting to an emergency department.[1,2]
The incidence of spontaneous TMJ dislocation is 5.3 per 100,000 adult patients presenting to an ED, it has never been reported in a child presenting to the ED.[3]

Summary

INTRODUCTION

CASE REPORT A 26-month-old female child, with no known familial or genetic disorder, was brought by an anxious mother to the Emergency Department with complaint of the child not being able to close her mouth and drooling of saliva for the last two hours. She fed her child two hours earlier and at the time the child was normal. As the condition was acute, TMJ X-ray, transcranial view at the open mouth position was performed to rule out any injury (Figure 1) It showed an empty glenoid fossae and anteriorly displaced condylar heads.

DISCUSSION

CONCLUSION