Mandible dislocation: Difference between revisions

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[[Category:ENT]]
[[Category:ENT]]


[[File:Mandible dislocation.jpg|thumb]]
[[File:Mandible dislocation.jpg|thumb|Posterior position]]

Revision as of 23:34, 13 September 2011

Background

  • Anterior dislocation of mandibular condyle(s) in relation to fossa
  • Risk factors include prior dislocation,weak capsule, and torn ligaments
  • Yawning, "popping" ears, or laughing may predispose


Diagnosis

  • Clinical diagnosis, but XR/CT if fracture suspected in setting of trauma
  • Pt unable to open mouth with locked jaw
    • Unilateral or bilateral
    • Jaw deviates to contralateral side if unilateral
  • Palpation of TMJ reveals anterior condyle(s)
    • Palpate with fingers in the auditory canal


Treatment

  • Analgesia
  • Benzodiazepines for muscle relaxation
  • Wrap physician's thumbs circumferentially with 4x4's and tape
    • Thumbs will be placed intra-orally and may be bitten upon relocation
  • Can stand anterior or posterior to patient (see image below)
    • First, downward pressure is applied to release condyles
    • Second, move chin posteriorly to seat condyles in fossa
    • Posterior position is easier in this author's opinion
      • Allows for increased leverage, less patient anxiety
  • Soft diet for one week
  • Avoid wide opening of mouth, Barton's bandage may be helpful
  • Refer recurrent dislocations

Disposition

  • Outpatient management as above
  • ENT or OMFS referral with recurrent dislocations
Posterior position