颞下颌关节强直是被忽视的儿童髁状突骨折的后遗症

Pub Date : 2024-01-05 DOI:10.1155/2024/5101486
Manel Gharbi, R. Kammoun, I. Chaabani, Touhami Ben Alaya
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引用次数: 0

摘要

颞下颌关节强直是牙科医生和颌面外科医生应该了解的一种重要疾病。其临床表现为下颌骨活动永久受限,张口低于 3 厘米。这种严重的病变会带来严重的功能性影响,如咀嚼问题、语言障碍、进食障碍和下颌发育障碍,此外,在日常生活中应对这种病症也会带来心理上的困难。在此,我们以放射学和时间顺序的方式来说明被忽视的下颌骨髁状突外伤骨折后颞下颌关节强直的演变过程。本病例报告涉及一名 8 岁患者,因车祸后逐渐出现张口受限而转诊。断层扫描显示左侧颞下颌关节面之间有一个骨块,显示出关节强直。进行了创伤后脑部计算机断层扫描。结果显示左侧髁状突骨折未被发现。本文旨在说明,如果对创伤后立即进行的计算机断层扫描的判读给予足够的重视,创伤性强直是可以避免的。一旦重要的紧急情况结束,必须进行全面的牙科检查。颞下颌关节外伤的早期诊断是预防并发症(如强直和随之而来的口腔功能障碍)的关键因素。当儿童有头部外伤史,尤其是下颌骨外伤史时,牙医必须自动怀疑髁突骨折。本病例提醒我们,虽然颞下颌关节在患者的首次生命急救检查中经常被忽略,但颞下颌关节/它们仍然是一个非常重要的结构,如果出现病变,忽略颞下颌关节会导致功能障碍,从而导致不可忽视的医疗法律后果/在患者的首次生命急救检查中应考虑颞下颌关节,因为如果出现病变,忽略颞下颌关节会导致功能障碍,从而导致不可忽视的医疗法律后果。
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Temporomandibular Joint Ankylosis as a Sequel of an Overlooked Condylar Fracture in a Child
Temporomandibular joint ankylosis is an important entity that dentists and maxillofacial surgeons should know about. It clinically manifests through a permanent limitation of mandibular movements coupled with mouth opening inferior to 3 cm. This serious pathology can have serious functional repercussions, such as mastication problems, speech troubles, eating disorders, and jaw growth hindrance, in addition to the psychological difficulties in coping with such a condition in daily life. Herein, we present a radiological and chronological illustration of the evolution of temporomandibular joint ankylosis following an overlooked traumatic fracture of the mandibular condyle. The present case report involves an 8-year-old patient referred for a gradually evolving mouth opening limitation following a car accident. Tomodensitometry was helpful as it revealed an osseous block between the left temporomandibular joint surfaces, showing an ankylosis. Posttraumatic cerebral computed tomography scan was performed. It revealed an undetected fracture of the left condyle. The aim of this paper was to show how a traumatic ankylosis could have been avoided if enough attention was paid to the interpretation of immediate posttraumatic computed tomography scans. A thorough dental examination must be carried out once vital emergency is over. Early diagnosis of temporomandibular joint trauma is a crucial factor in preventing complications, such as ankylosis and its consequent oral dysfunctions. The dentist must automatically suspect condylar fracture when a child presents a history of head trauma, especially a mandibular trauma. This case should be a reminder that although temporomandibular joints are very often left out in patients’ vital emergency first examination, temporomandibular joints/they are still a highly important structure which omission, and thus, dysfunction, if lesions are present, can lead to nonnegligible medico-legal consequences/that temporomandibular joints should be taken into account during patients’ vital emergency first examination because if they are neglected, in the presence of lesions, they cause dysfunction, thus leading to nonnegligible medico-legal consequences.
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