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Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal

OBJECTIVE: To explore the otoscopy, CT and MRI features of spontaneous temporomandibular joint(TMJ)herniation(STMJH) into the external auditory canal (EAC) through the persistent foramen of Huschke (PFH). METHODS: 15 cases diagnosed STMJH were collected. The otoscopy, CT data of 15 cases and MRI dat...

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Autores principales: Liu, Jun-Hua, Huang, Wen-Hu, Xu, Jiang Hong, Liu, Yin, Sha, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Institute of Radiology. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7594893/
https://www.ncbi.nlm.nih.gov/pubmed/33178972
http://dx.doi.org/10.1259/bjro.20200005
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author Liu, Jun-Hua
Huang, Wen-Hu
Xu, Jiang Hong
Liu, Yin
Sha, Yan
author_facet Liu, Jun-Hua
Huang, Wen-Hu
Xu, Jiang Hong
Liu, Yin
Sha, Yan
author_sort Liu, Jun-Hua
collection PubMed
description OBJECTIVE: To explore the otoscopy, CT and MRI features of spontaneous temporomandibular joint(TMJ)herniation(STMJH) into the external auditory canal (EAC) through the persistent foramen of Huschke (PFH). METHODS: 15 cases diagnosed STMJH were collected. The otoscopy, CT data of 15 cases and MRI data of 6 cases were retrospectively reviewed. RESULTS: Otoscopy revealed a mass located in the anterior wall of the bony EAC that moved forwards and backwards during mouth opening and closing, respectively. CT showed a soft mass with bony defect in the anterior wall of the EAC, with no enhancement; the bony defect margin was well defined in all cases. The bone adjacent to the PFH was pressed and partially wrapped around the soft mass, as if “holding a ball,” in seven cases. Pseudobone shell around the soft mass was observed in eight cases. Six cases included MRI scans, which showed TMJ soft tissue herniated into the EAC. CONCLUSION: STMJHs have unique otoscopic, CT and MRI features. The examination strategy recommended is dynamic otoscopy and conventional CT, MRI can be chosen when the herniation is complicated by infection or otitis externa or when the patient has TMJ dysfunction; conservative management and follow-up observations are the main treatment strategy recommended. ADVANCES IN KNOWLEDGE: Mechanical stress of TMJ on the EAC is thought to cause herniation and the special CT features, the location and size of the PFH, especially the location, are the major risk factors for TMJ herniation in patients with FH.
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spelling pubmed-75948932020-11-10 Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal Liu, Jun-Hua Huang, Wen-Hu Xu, Jiang Hong Liu, Yin Sha, Yan BJR Open Original Research OBJECTIVE: To explore the otoscopy, CT and MRI features of spontaneous temporomandibular joint(TMJ)herniation(STMJH) into the external auditory canal (EAC) through the persistent foramen of Huschke (PFH). METHODS: 15 cases diagnosed STMJH were collected. The otoscopy, CT data of 15 cases and MRI data of 6 cases were retrospectively reviewed. RESULTS: Otoscopy revealed a mass located in the anterior wall of the bony EAC that moved forwards and backwards during mouth opening and closing, respectively. CT showed a soft mass with bony defect in the anterior wall of the EAC, with no enhancement; the bony defect margin was well defined in all cases. The bone adjacent to the PFH was pressed and partially wrapped around the soft mass, as if “holding a ball,” in seven cases. Pseudobone shell around the soft mass was observed in eight cases. Six cases included MRI scans, which showed TMJ soft tissue herniated into the EAC. CONCLUSION: STMJHs have unique otoscopic, CT and MRI features. The examination strategy recommended is dynamic otoscopy and conventional CT, MRI can be chosen when the herniation is complicated by infection or otitis externa or when the patient has TMJ dysfunction; conservative management and follow-up observations are the main treatment strategy recommended. ADVANCES IN KNOWLEDGE: Mechanical stress of TMJ on the EAC is thought to cause herniation and the special CT features, the location and size of the PFH, especially the location, are the major risk factors for TMJ herniation in patients with FH. The British Institute of Radiology. 2020-05-21 /pmc/articles/PMC7594893/ /pubmed/33178972 http://dx.doi.org/10.1259/bjro.20200005 Text en © 2020 The Authors. Published by the British Institute of Radiology This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Research
Liu, Jun-Hua
Huang, Wen-Hu
Xu, Jiang Hong
Liu, Yin
Sha, Yan
Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title_full Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title_fullStr Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title_full_unstemmed Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title_short Otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
title_sort otoscopy and imaging features of spontaneous temporomandibular joint herniation into the external auditory canal
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7594893/
https://www.ncbi.nlm.nih.gov/pubmed/33178972
http://dx.doi.org/10.1259/bjro.20200005
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