TMJ ankylosis after neonatal septic arthritis: literature review and two case reports

Abstract

Ankylosis of the temporomandibular joint (TMJ) can be a result of several causes such as trauma, degenerative changes, infection, and space-occupying lesion. When occurring during early childhood, it can result in severe functional disability and facial deformity. Septic arthritis is an uncommon disease associated with systemic and local factors being most commonly caused by Staphylococcus aureus, Neisseria gonorrhoeae, and Haemophilus influenzae. This paper presents two unusual cases of TMJ ankylosis following neonatal infections treated surgically and does a literature review about the topic.

Otogenic Temporomandibular Arthritis in Children

“…To our knowledge, only 5 cases of pediatric SATMJ complicating MEI (otogenic SATMJ) have been published so far . Besides MEI, other causes of pediatric SATMJ have been reported in the literature, including blunt trauma, neonatal sepsis, systemic infectious disease, and juvenile idiopathic arthritis .…”

“…To our knowledge, only 5 cases of pediatric SATMJ complicating MEI (otogenic SATMJ) have been published so far. [1][2][3][4][5] Besides MEI, other causes of pediatric SATMJ have been reported in the literature, including blunt trauma, 6 neonatal sepsis, [7][8][9] systemic infectious disease, [10][11][12] and juvenile idiopathic arthritis. 13,14 The aim of this study was to better describe the symptoms, imaging characteristics, natural course, and treatment of otogenic SATMJ in children.…”

Ankylosis of the temporomandibular joint secondary to neonatal group B streptococcal sepsis

“…None of the children had any documented examination of the TMJ during their initial illness. There are seven similar cases of TMJ ankylosis secondary to neonatal sepsis in the literature, indicating that the incidence may be higher than previously recognised …”

Temporomandibular Joint Septic Arthritis

“… 16 , 18 Causative organisms in TMJ septic arthritis include Staphylococcus aureus , Streptococcus species, Pseudomonas aeruginosa, E. coli, Neisseria , and Haemophilus influenza. 21 – 23 Aspiration of intrasynovial fluid is essential for decompression, elimination of inflammatory contents, and to facilitate synovial fluid analysis to guide antibiotic therapy. 24 Additional options of arthroscopy and arthrotomy allow direct joint visualization and additional lavage, lysis of adhesions, or debridement.…”