Superolateral dislocation of the intact mandibular condyle associated with panfacial fracture: a case report and literature review

Abstract – Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15‐year‐old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three‐dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well‐documented cases of SDIMC. The patients’ mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases.     

Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review

Temporomandibular joint dislocation refers to the dislodgement of mandibular condyle from the glenoid fossa. Anterior and anteromedial dislocations of the mandibular condyle are frequently reported in the literature, but superolateral dislocation is a rare presentation. This report outlines a case of superolateral dislocation of an intact mandibular condyle that occurred in conjunction with an ipsilateral mandibular parasymphysis fracture. A review of the clinical features of superolateral dislocation of the mandibular condyle and the possible techniques of its reduction ranging from the most conservative means to extensive surgical interventions is presented.     

Superolateral dislocation of the intact mandibular condyle into the temporal fossa: review of the literature and report of a case

Anterior dislocation of the mandibular condyle is common, but superolateral dislocation is quite rare. Because of its rarity, this type of dislocation is often misdiagnosed or completely overlooked. We describe an additional case of superolateral dislocation of the intact condyle into the temporal fossa. We review all of the available English literature on superolateral dislocation and discuss a causative mechanism, the diagnostic features, and clinical management.     

外伤致下颌骨髁突颅内移位：病例报告及文献复习

下颌骨髁突颈部结构薄弱,受外力作用时容易折断,从而通过缓冲创伤能量,避免颅中窝及颅脑等重要解剖部位受到损伤,可视为人体的一种自我保护机制。本文报告1例较为少见的髁突颅内移位外伤病例,髁突在未发生骨折的情况下向上移位,突破颅中窝底进入颅内,并结合相关文献,就其发生机制、临床表现、诊断及治疗进行讨论。     

Bifid mandibular condyle: a case report

The bifid mandibular condyle is a rare anomaly. A variety of causes are implicated with its development such as developmental origin and trauma. Because of the lack of epidemiological data, there is little information about the real incidence of this malformation. The purpose of this paper is to report a case of bifid mandibular condyle in a 20-year-old woman who referred to a private radiological clinic for routine dental examination. A panoramic radiography incidentally revealed a discrete modification of the left mandibular condyle. Magnetic resonance imaging (MRI) was taken and confirmed the diagnostic proposed.     

Bifid mandibular condyle: a case report

Abstract –  A case of left bifid mandibular condyle (BMC) is reported in a 36-year-old female. The patient had a history of trauma in childhood. From the radiological examination, the left condyle was seen to have two anterioposteriorly situated heads. BMC is an extremely rare condition, where the condyle is duplicated or lobulated. The literature on BMC is reviewed, and possible cause of trauma and consequences of the anomaly are discussed.     

Trifid mandibular condyle: a case report

A suspected case of trifid mandibular condyle that was observed on a panoramic radiograph and confirmed using computed tomography (CT) is reported. No history of previous temporomandibular joint (TMJ) trauma was reported by the subject.     

Osteochondroma of the mandibular condyle: a case report

A case of osteochondroma of the right mandibular condyle in a 47-year-old woman is presented. Instead of condylectomy, surgical resection was performed, resulting in fewer functional changes and less dysfunction of the temporomandibular joint but recurrence within 12 months after surgery.     

Bifid condyle: case report

The double headed mandible condyle is a rare alteration that is frequently diagnosticated as an incidental finding in a panoramic radiograph. The different theories about its etiology are explained in this article. Symptoms described with bifid condyles vary from case to case, but in most instances are absent. Computer tomography is the ideal imaging method to evaluate the condyle morphology and to role out any degenerative process to achieve the differential diagnosis. Treatment is conservative for symptomatic patients with TMJ disorders, surgical treatment is described in literature in TMJ ankylosis that develops in bifid condyles secondary to trauma.     

Rare case of superolateral dislocation of the condyle

Background

Dislocation of the mandibular condyle occurs most commonly in the anterior direction. When there is an intracranial displacement of the condyle, it is often associated with CSF leak. Superolateral dislocation of the condyle from the glenoid fossa is a rare condition which commonly occurs following traumatic insult to the mandible. When there is a superlolateral displacement, the condyle is often lodged in the temporal fossa.

Case report

We report an unusual case of a 50-year-old male with a superolateral dislocation of the left mandibular condyle into the zygomatic arch along with a fracture of the right mandible following road traffic accident. Manual reduction of the condyle was first attempted under general anaesthesia which was futile, following which the displaced condyle was reduced by a combination of open traction and manual reduction using Keen’s approach in left maxillary vestibule. After reduction of the condyle, intermaxillary fixation (IMF) was done and X plate was used to fix the mandible fracture on the right body. Postoperatively, patient was placed on IMF for a period of 2 weeks.

Discussion

Superolateral dislocations of the condyle can be unilateral or bilateral. These types of dislocations generally occur following traumatic injury to the mandible when the mouth is open. Early diagnosis and reduction of the condyle is required to achieve satisfactory occlusion which should be followed by physiotherapy to prevent ankylosis.     

Bilateral bifid mandibular condyle: a case report

Bilateral bifid mandibular condyle is a rarely seen malformation. The aetiology of bifid condyle is not completely understood, although developmental anomaly, traumas, condylar fracture, teratogenic embryopathy and surgical condylectomy may all be causative factors. Although a few studies on human dried skulls tried to shed light on this entity it remains obscure. As most bifid condyle subjects have no complaint related to temporamandibular joint(TMJ), the cases are generally diagnosed through incidental radiographic findings. The case of a 54-year-old female is presented. In a panoramic radiograph obtained after a clinical examination, bilateral bifid mandibular condyle was observed. The open-closed lateral radiograph of the TMJ (obtained using the TMJ-specific program of the panoramic device) demonstrated duplication of the right and left condyles. In order to better evaluate the TMJ morphology and to eliminate pathologies such as fractures that might be missed with conventional radiographs, a computed tomography scan was also obtained. The joint head orientation was observed in the mediolateral direction. The case is discussed in the context of the relevant literature. Until large population-based studies are undertaken and further experimental studies are performed, bifid condyle will remain an incidental finding of anatomic variation rather than a clinically informative observation.     

Surgical correction of recurrent dislocation of a mandibular condyle in a patient with Huntington's chorea: a case report

A case report is presented describing how eminectomy proved to be successful in treating recurrent mandibular dislocation for a patient suffering from Huntington's Chorea.     

Unilateral trifid mandibular condyle: a case report

Trifid mandibular condyle is an exceptionally rare entity, diagnosed accidentally on radiographic examination. Its etiology is controversial. Dental professionals should have knowledge of this anatomic abnormality and of the problems caused by it in normal function, as well as appropriate treatment modalities. In the literature, only three such cases have been reported. The current case report (the fourth reported) is of a unilateral trifid condyle reported in a 37-year-old woman seeking treatment for a missing tooth. A panoramic radiograph accidentally revealed a discrete modification of the right mandibular condyle. Computed tomography (CT) with 3-D construction was done to confirm the diagnosis.     

Intra-articular fracture of the mandibular condyle: a case report

The authors describe a case of intra-articular fracture of the left mandibular condyle, successfully treated by the pumping technique in the upper and lower joint cavities, and show arthroscopic findings in these cavities. The patient was a 15-year-old boy whose maximum mouth opening was 30 mm. Computed tomography revealed a left intra-articular sagittal fracture of the condylar head. Aspiration of the hematoma in the upper and lower joint spaces was performed with ten pumping actions. In the upper and lower joint spaces, arthroscopic examination revealed the disappearance of the hematoma. The patient continued opening, protrusive, and lateral excursive exercises. One month after the surgery, the maximal interincisal distance was improved to 45 mm with straight opening. In the case presented, mouth-opening exercises, along with the pumping technique for treatment of an intraarticular fracture of the mandibular condyle, allowed satisfactory and stable results in the improvement of limited mouth movement.     

颏部骨折伴髁突外上方脱位的治疗体会(附10例报告)

颏部骨折合并髁突骨折伴前内侧移位临床上常见,但颏部骨折伴髁突外上方脱位非常少见,容易漏诊和误诊,治疗不当易导致关节强直等后遗症.该文回顾10例颏部骨折伴髁突外上方脱位,并结合文献讨论其发生机制,诊断特征和临床治疗.     

Posterior dislocation in intact mandibular condyle: an unusual case

Dislocation of the temporomandibular joint (TMJ) represents 3% of all reported dislocated joints. Traditionally, dislocation of the TMJ occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence. Traumatic dislocation of the condyle into the middle cranial fossa is well defined in the literature, but posterior dislocation without fracture is rarely described. This report documents a case of young male with posterior dislocation of the intact mandibular condyle after facial trauma. The clinical symptoms, diagnosis and treatment are discussed, and a critical review of the literature is provided.