Spontaneous Temporomandibular Joint Herniation Into the External Auditory Canal Through a Persistent Foramen Tympanicum (Huschke)

Nakasato, Tatsuhiko; Nakayama, Tetsuo; Kikuchi, Kazuko; Ehara, Shigeru; Ohtsuka, Hisashi; Fukuda, Katsunori; Sato, Hiroaki

doi:10.1097/rct.0b013e318272ef04

Cited by 23 publications

(19 citation statements)

References 14 publications

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“…19,21,23 Several studies of detection of this anatomical variation, using conventional CT and cadaver studies, have been published. 1,2,10,26 However, only 1 study has been conducted on CBCT imaging, 1 but to our knowledge, no attempt has been made to study the visualization of foramen tympanicum according to orthodontic malocclusions using CBCT imaging. Hence, it was considered worthwhile to assess the occurrence and location of the foramen tympanicum according to orthodontic malocclusions and sex in a Turkish sample using CBCT.…”

mentioning

confidence: 94%

Evaluation of Foramen Tympanicum Using Cone-Beam Computed Tomography in Orthodontic Malocclusions

Akbulut

Kurşun²,

Aksoy³

et al. 2014

Journal of Craniofacial Surgery

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The foramen tympanicum is a persistent anatomic formation of the temporal bone due to a defect in ossification normal bone physiology in neonatal or postnatal period. This study determined the occurrence and location of the foramen tympanicum in a Turkish sample using cone-beam computed tomography. Scans of 370 sites in 185 patients were retrospectively analyzed to determine foramen tympanicum occurrence, sizes, and locations according to their orthodontic malocclusions. Measurements were done on axial and sagittal sections to identify the dimensions. Differences in foramen tympanicum incidence by measurements, sex, side, malocclusions, and location were statistically evaluated. Foramen tympanicum was determined in 42 (22.7%) of 185 patients. No statistical difference was found considering location and sex (P > 0.05), but it was found more bilaterally in female patients within significance level at P = 0.024. Mean sizes did not differ significantly by sex but were found to be greater in females. In axial diameter, the average measurement was found wider on the right side of all patients (P = 0.017). The findings showed a greater foramen tympanicum dimension among class II than among class I and III subjects (P < 0.05). Knowledge about these structures is helpful for the interpretation of imaging (especially cone-beam computed tomography) and provides valuable information especially before orthognathic surgery to avoid intraoperative reconstruction and complications.

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mentioning

confidence: 94%

Evaluation of Foramen Tympanicum Using Cone-Beam Computed Tomography in Orthodontic Malocclusions

Akbulut

Kurşun²,

Aksoy³

et al. 2014

Journal of Craniofacial Surgery

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“…19 Surgical treatment includes hernia resection and bone defect repair. Various materials have been used to close this type of defect, such as fascia, 20 cartilage, 6,21–23 autologous bone chips, 11 polypropylene plate, collagen mesh, 24 and titanium mesh. 25 …”

Section: Discussionmentioning

confidence: 99%

“…The PFH is a zone of reduced mechanical resistance that can be associated with significant complications, such as STMJH, the spread of infection or tumours between the EAC and TMJ, and ear injury. 4,5 STMJH is extremely rare; there were some case report in the literature, however, the features and diagnostic strategy were not well described, 6 we retrospectively studied 15 cases to explore the otoscopy and radiological features.…”

Section: Introductionmentioning

confidence: 99%

Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal

Liu

Huang

et al. 2020

BJR|Open

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Objective: To explore the otoscopy, CT and MRI features of spontaneous temporomandibular joint(TMJ）herniation(STMJH) into the external auditory canal (EAC) through the persistent foramen of Huschke (PFH). Methods: 15 cases diagnosed STMJH were collected. The otoscopy, CT data of 15 cases and MRI data of 6 cases were retrospectively reviewed. Results: Otoscopy revealed a mass located in the anterior wall of the bony EAC that moved forwards and backwards during mouth opening and closing, respectively. CT showed a soft mass with bony defect in the anterior wall of the EAC, with no enhancement; the bony defect margin was well defined in all cases. The bone adjacent to the PFH was pressed and partially wrapped around the soft mass, as if “holding a ball,” in seven cases. Pseudobone shell around the soft mass was observed in eight cases. Six cases included MRI scans, which showed TMJ soft tissue herniated into the EAC. Conclusion: STMJHs have unique otoscopic, CT and MRI features. The examination strategy recommended is dynamic otoscopy and conventional CT, MRI can be chosen when the herniation is complicated by infection or otitis externa or when the patient has TMJ dysfunction; conservative management and follow-up observations are the main treatment strategy recommended. Advances in knowledge: Mechanical stress of TMJ on the EAC is thought to cause herniation and the special CT features, the location and size of the PFH, especially the location, are the major risk factors for TMJ herniation in patients with FH.

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“…TMJ herniation as was seen in this case was also reported by other authors. [5][6][7] Other complications include ear injury following TMJ arthroscopy, [8] salivary gland fistula. [1] Infection and tumoral spread could occur from the ear to the infratemporal fossa and vice versa.…”

Section: Discussionmentioning

confidence: 99%

Foramen of Huschke (tympanicum) in a Nigerian male with articular soft-tissue herniation into the external auditory meatus

2014

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The protrusion of articular soft-tissue from the temporomandibular joint (TMJ) into the external ear in the absence of trauma, neoplasm or inflammation is rare. We present below a Nigerian adult male with retrodiscal herniation of soft-tissues of the TMJ into the external auditory meatus through a persistent foramen of Huschke. We are not aware of any reports of this developmental defect or its prevalence in the Nigerian medical literature. Therefore, this case is presented to heighten the index of suspicion of physicians when managing patients with otorrhea and otalgia; which is often primarily diagnosed or misdiagnosed as otitis externa. This will help avoid complications associated with the anomaly, some of which could be very serious.

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Spontaneous Temporomandibular Joint Herniation Into the External Auditory Canal Through a Persistent Foramen Tympanicum (Huschke)

Cited by 23 publications

References 14 publications

Evaluation of Foramen Tympanicum Using Cone-Beam Computed Tomography in Orthodontic Malocclusions

Evaluation of Foramen Tympanicum Using Cone-Beam Computed Tomography in Orthodontic Malocclusions

Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal

Foramen of Huschke (tympanicum) in a Nigerian male with articular soft-tissue herniation into the external auditory meatus

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