Abstract

CEBRIAN CARRETERO, J.L.; DEMARIA MARTINEZ, G.  and  RIVAS VILA, S.. Functional Alteration of the temporomandibular joint: Infrequent clinical Presentation for external otitis. Rev Esp Cirug Oral y Maxilofac [online]. 2009, vol.31, n.6, pp.376-380. ISSN 2173-9161.

Introduction: Infectious pathology of the external ear is quite frequent in small children and sometimes appears as an alteration of the temporomandibular joint function. However, acute pathology of this joint is quite rare in this age group and is nearly always preceded by trauma. A complete history and thorough clinical exploration allows for good diagnosis without the need for additional studies. Patients and Methods: We present three clinical cases that were referred to the Paediatric Maxilofacial Surgery Service of the La Paz Hospital with diagnoses of acute temporomandibular joint (TMJ) pathology. The final diagnosis in all three was acute external otitis (AEO). Discussion: AEO is the second most frequent cause of otalgia after acute medial otitis. Humidity, repeated traumas and glandular obstruction can promote infection. The clinical symptoms are characterised by pain, itchiness, suppuration and, occasionally, hearing loss. Sometimes mandible movement without malocclusion is painful. The last symptom can cause confusion and lead to an erroneous diagnosis of TMJ pathology, something that is quite rare in children. Childhood TMJ pathology is characterised by painful mouth opening and dental disocclusion. An otoscopy will allow a differential diagnosis of the two clinical entities and avoid an unnecessary radiological exploration. Conclusion: Given the rarity of TMJ pathology in small children, AEO must be ruled out before subjecting the patient to radiological examination.

Keywords : Acute external Otitis; Children; Temporomandibular joint.

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