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

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

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.

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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
jkaoms-37-535f1.tif
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
jkaoms-37-535f2.tif
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
jkaoms-37-535f3.tif
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
jkaoms-37-535f4.tif
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
jkaoms-37-535f5.tif
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
jkaoms-37-535f6.tif
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
jkaoms-37-535f7.tif
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