Fracture Dislocation of the Temporomandibular Joint

Mandibular Condyle Dislocation Into the Middle Cranial Fossa: A Case Report and Review of Literature

“…13,15,16 In addition to that, mortality because of intracranial damage from a displaced condyle or from other concomitant cranial injuries might explain the low number of cases reported. 17 Intracranial hematomas, 16,18,19 facial nerve paralysis or paresis 9,12,15,20 -22 combined with a unilateral and bilateral cranial base fracture, 9,21 damages of the eighth cranial nerve with ipsilateral hearing loss, 1,9,12,16,21 hematorrhoea, 1,11,15 leakage of cerebrospinal fluid, 9,16,21,22 and cerebral injuries as contusion or concussion 12,19,21,22 are some of the other findings reported in literature.…”

“…29 In some reported cases, cerebral concussion with total amnesia, 12,19,21,22,30 as well as significant brain injuries, 9,21 have been described. If the temporal lobe is affected by a compound, depressed skull fracture epilepsy may occur as a sequela in Ͼ50% of cases.…”

“…Possible concomitant neurological signs, including loss of consciousness, nausea, facial nerve paralysis 9,12,15,20 -22,28 with or without skull-base fractures, 9,15,20,21 ipsilateral hearing loss because of eighth cranial nerve damage, 1,9,12,16,21,28 and cerebrospinal fluid leakage, 9,21,22 may indicate intracranial injuries. 29 In some reported cases, cerebral concussion with total amnesia, 12,19,21,22,30 as well as significant brain injuries, 9,21 have been described.…”

“…4,17,25,32 The overall aim of any treatment is the reduction of the condyle to minimize permanent cerebral complications 10 and to restore occlusion without temporomandibular ankylosis. 2,3,5,6,9,[11][12][13]15,16,18,19,21,29 According to Melugin et al, 14 the treatment of this injury, as with all trauma, should be individualized and should take into account the age of injury, the growth potential of the patient, the degree of glenoid fossa destruction, the risk of ankylosis, the risk of additional intracranial injury, the restoration of the posterior facial height, and the restoration of function. Condylar entrapment because of superiorly displaced bony fragments of the glenoid fossa may occur during attempted forced reduction of the condyle.…”

“…If the temporal lobe is affected by a compound, depressed skull fracture epilepsy may occur as a sequela in Ͼ50% of cases. 21 Steinhauser,6 mentioned in his article that, because of the anatomic relations between the glenoid fossa and the middle meningeal artery, ??? may be torn resulting in an epidural hematoma.…”