Malignant disease as temporomandibular joint dysfunction: review of the literature and report of case

Article Abstract:

Temporomandibular joint (TMJ) disorders are being diagnosed with increasing frequency in recent years, but correct identification of the condition is still difficult because of the lack of physical signs. A misdiagnosis of TMJ disorder in patients who actually have malignant disease is of particular concern. A 48-year-old woman complained of pain and a full feeling on the right side of her face, and clicking and pain in her TMJ. Her symptoms had worsened over a period of several months. A working diagnosis of TMJ dysfunction was made and the patient was advised to eat a soft diet, take nonprescription anti-inflammatory agents, and reduce gum chewing. When her symptoms persisted, X-ray pictures indicated that she had a malignancy which was eventually diagnosed as malignant schwannoma. Radiation and surgery were not effective and she died one and one-half years later of lung metastasis (spreading of the cancer). Malignant tumors that can mimic temporomandibular dysfunction can arise in tissues of the joint or nearby regions, or can result from metastasis to the joint. Signs and symptoms that may signal the presence of a malignancy are discussed. Swelling, sensory change, auditory disturbances, and sudden occlusal change are important warning signs; pain is not a symptom of this type of malignancy. Medical literature has recorded the cases of 40 people with cancer who were misdiagnosed as having TMJ dysfunction; of these, 14 had metastatic spread from a nearby site. Examination of the nasopharynx is important in ruling out nearby cancers. Computed axial tomography or magnetic resonance imaging should be used if a malignancy is even remotely suspected. Follow-up of patients diagnosed with temporomandibular joint dysfunction should be performed to make sure symptoms are not progressing, which could indicate the presence of cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Tumors

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Facial pain treated by temporomandibular joint arthroscopy and styloidectomy: report of case

Article Abstract:

A case is reported of a 38 year-old-woman with Eagle syndrome in which the styloid process of the temporal bone of the skull can be palpated through the tonsillar fossa in the oral cavity (upper region of the throat) and causes pain. This patient also had bilateral internal derangement of the temporomandibular joint (TMJ), which is formed at the junction of the jaw bone and the skull. Her symptoms included bilateral pain and clicking in the TMJ region when she opened and closed her mouth, and pain on the right side of her throat. She underwent two separate surgical procedures. For correction of the Eagle syndrome, the styloid bone was removed. Arthroscopic surgery was performed on the TMJ. A special endoscope was used to allow examination of the joint. Bands of tissue were cut and the discs of the joint, which had been displaced forward, were properly repositioned. Following surgery a jaw stabilizing appliance was fitted and the patient received physical therapy. Approximately two weeks after surgery the patient had no pain on head or tongue movements or in the tonsilar fossa region. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Surgery, Facial pain, Arthroscopy, Temporomandibular joint

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Delayed temporomandibular joint pain and dysfunction induced by whiplash trauma: a controlled perspective study

Article Abstract:

Sixty patients with neck symptoms after being involved in rear-end car accidents were examined in Sweden. One in three people exposed to whiplash trauma is at risk of developing delayed temporomandibular joint pain and dysfunction.

Sweden, Complications and side effects, Risk factors, Whiplash injuries, Whiplash, Clinical report

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