Temporomandibular joint involvement in malignant otitis externa: a case report

In-Young Byun; Jin-Hong Kim; Sang-Hoon Kang; Moon-Key Kim

doi:10.5125/jkaoms.2011.37.6.535

Journal List > J Korean Assoc Oral Maxillofac Surg > v.37(6) > 1032516

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Byun, Kim, Kang, and Kim: Temporomandibular joint involvement in malignant otitis externa: a case report

Original Article

J Korean Assoc Oral Maxillofac Surg 2011;37(6):535-538.

Published online: 10 January 2011

DOI: https://doi.org/10.5125/jkaoms.2011.37.6.535

Temporomandibular joint involvement in malignant otitis externa: a case report

In-Young Byun, Jin-Hong Kim, Sang-Hoon Kang, Moon-Key Kim

Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

Moon-Key Kim Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital 100, Ilsan-ro, Ilsandong-gu, Goyang 410-719, Korea TEL: +82-31-900-0623 FAX: +82-31-900-0622 E-mail: ilsanoms@gmail.com

Received 31 August 2011 Revised 2 November 2011 Accepted 23 November 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malignant otitis externa (MOE) originates as inflammation of the epidermis in the external auditory canal, and spreads to the surrounding structures and neck, leading to abscess formation. MOE is associated with an immunosuppressive condition and diabetes. Patients with MOE suffer from otalgia, otorrhea and hearing loss. According to the literature, surgery to the temporomandibular joint is controversial as the treatment of choice.

Keywords: Otitis externa, Temporomandibular joint

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Fig. 1.

Preoperative T1-weighted magnetic resonance image (MRI). MRI shows thick soft tissue surrounding right condylar head. In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 2.

Preoperative T2-weighted magnetic resonance image. Right mastoid air cells were filled with fluid contents (arrows). In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 3.

Preoperative gadolinium-enhanced magnetic resonance image. Mass-like lesion (arrow) in right temporal bone invaded skull base. In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 4.

Preoperative panoramic image. Cortical discontinuity in posterior border of right condylar head was note (arrow). In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 5.

Preoperative temporomandibular joint magnetic resonance images. A. Left temporomandibular joint: normal structure. B. Right temporomandibular joint: joint cavity was filled with thick soft tissue (arrows). In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 6.

Intraoperative photographs. A. Joint cavity was filled with inflammatory tissue. B. After inflammatory tissue removal: posterior surface of the condylar head was eroded. In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

Fig. 7.

Postoperative T2-weighted magnetic resonance image. Mastoiditis (arrow) was newly developed in left mastoid air cell compared to previous study. In-Young Byun et al: Temporomandibular joint involvement in malignant otitis externa: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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