The Anterior Wall Sign

Abstract

Diagnosis of temporomandibular disorder (TMD) in patients with otalgia is based on the medical history and physical examination, which is based on deep palpation of the joint area, however, palpation will often cause discomfort in healthy patients. Ninety-nine patients with otological symptoms in relationship with TMD were studied. We palpated with a blunt curette, the skin lining the anterior wall of the bony auditory canal located above the temporomandibular joint. We only consider a positive sign if palpation unequivocally evokes pain or discomfort identical to what the patient feels or has felt before. The positivity of the anterior wall sign was 99% in the TMD group. We found a significant difference between the control and TMD groups regarding the sign of the anterior wall (P < 0.005). The anterior wall sign could be an effective tool to detect temporomandibular dysfunction.