Difficult Tracheal Intubation as a Result of Unsuspected Abnormality of the Temporomandibular Joint

Liu, Yun-Hou; Wang, Jhi-Joung; Chang, Ching‐Fong; Jin, Chan-Hui

doi:10.1097/00000539-200103000-00043

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…In some instance, unsuspected temporomandibular joint (TMJ) dysfunction had been mistaken for MMR. [12] This possibility was ruled out in this case by the absence of inability to open the mouth to >1 cm and the absence of firmly approximated teeth.…”

Section: Discussionmentioning

confidence: 95%

Masseter muscle rigidity: Atypical malignant hyperthermia presentation or isolated event?

Onyeka

2010

Saudi J Anaesth

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This report describes a case of masseter muscle rigidity encountered at the start of an elective gynaecological procedure. At preoperative assessment, the patient, a 41-year old woman with a previous non-eventful surgical and anesthetic history was given a Mallampati score of 3. Following suxamethonium administration, full mouth opening proved difficult. Laryngoscopy and tracheal intubation were not possible leading to the eventual use of a laryngeal mask airway and resulting in a successful anaesthetic outcome. A number of possibilities that may account for this situation as well as viable options for airway access in such cases are discussed below.

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Section: Discussionmentioning

confidence: 95%

Masseter muscle rigidity: Atypical malignant hyperthermia presentation or isolated event?

Onyeka

2010

Saudi J Anaesth

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“…With closed locking, secondary to anterior displacement of the articular disc, reduction can be accomplished by placing the thumbs over the buccal aspect of the mandibular ridge and applying downward and forward pressure. 9 Conversely, to reduce an anteriorly displaced mandible with open locking of the TMJ, the pressure should be applied in a downward and backward direction. 10 To prevent morbidity related to the development of fibrosis and adhesions within the joint capsule, early recognition and reduction of a displaced TMJ are important.…”

Section: Discussionmentioning

confidence: 99%

Trachlight™ management of succinylcholine-induced subluxation of the temporomandibular joint: a case report and review of the literature

Ordons

Townsend

2008

Can J Anesth

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Instability of the TMJ is not uncommon, and has several implications for airway management, highlighting the importance of preoperative screening. Limited mouth opening, due to spontaneous subluxation of the TMJ following succinylcholine-induced muscle relaxation in the absence of airway manipulation, has only twice been reported in the literature. This report highlights how tracheal intubation may be accomplished using the Trachlight, in order to secure the airway prior to reduction of the subluxed joint.

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Intubation Risk Factors for Temporomandibular Joint/Facial Pain

Martin¹,

Wilson²,

Ross³

et al. 2007

Anesthesia Progress

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Endotracheal intubation has been proposed as a risk factor for temporomandibular joint dysfunction (TMD) in a limited number of published case reports and systematic studies. Symptoms may result from forces applied with the laryngoscope, or manually in an attempt to complete the intubation, and may be related to the duration in which temporomandibular joint (TMJ) structures are stressed. The objective of this study was to examine risk factors for TMD complaints associated with endotracheal intubation. One hundred twenty-two patients who underwent endotracheal intubation for surgery at the University of Washington Medical Center participated. Exclusions included surgery of the head or neck, cognitive deficit, or emergency surgery. Subjects were assessed presurgically, and at 7 and 14 days postoperatively. Gender, interincisal distance, and age were found to be significantly associated with TMD symptoms lasting as long as 14 days following intubation. For both TMD pain and TMD nonpain symptoms, the most reliable predictor of a complaint following intubation was a history of TMD complaints within a year preoperatively. Any association between endotracheal intubation and the development of short-term TMD symptoms is likely to be found in patients with prior report of such conditions, and we therefore recommend a review of TMD complaint history when planning general anesthesia.

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Difficult Tracheal Intubation as a Result of Unsuspected Abnormality of the Temporomandibular Joint

Cited by 3 publications

References 8 publications

Masseter muscle rigidity: Atypical malignant hyperthermia presentation or isolated event?

Masseter muscle rigidity: Atypical malignant hyperthermia presentation or isolated event?

Trachlight™ management of succinylcholine-induced subluxation of the temporomandibular joint: a case report and review of the literature

Intubation Risk Factors for Temporomandibular Joint/Facial Pain

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