[Delayed diagnosis of a postanaesthesia temporomandibular joint dislocation]

Ann Fr Anesth Reanim. 2008 Oct;27(10):846-9. doi: 10.1016/j.annfar.2008.07.095. Epub 2008 Oct 2.
[Article in French]

Abstract

Temporomandibular joint (TMJ) dislocation during anaesthesia is a rare occurrence. Patients with a history of prior dislocations or TMJ dysfunction, and patients with mandibular retrognathism are at risk of this complication. This is a case report of delayed diagnosis of TMJ dislocation after a general anaesthesia for aortic valvular replacement surgery in a predisposed patient. Considering this unusual presentation, TMJ evaluation should be performed during preoperative anaesthetic assessment. In at-risk patients, one should not worry about TMJ dislocation during intubation but concentrate on glottic exposure. However, afterwards, one should be highly aware of this possible complication in order to detect it early, allowing an immediate simple manual reduction. This manoeuver may be performed with or without sedation by a practitioner, familiar with this way of resetting a dislocated jaw.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia, Inhalation / methods*
  • Aortic Valve / surgery
  • Disease Susceptibility
  • Emergencies
  • Heart Valve Prosthesis Implantation
  • Humans
  • Intraoperative Complications / diagnosis*
  • Intraoperative Complications / etiology
  • Intraoperative Complications / therapy
  • Intubation, Intratracheal / adverse effects*
  • Joint Dislocations / diagnosis*
  • Joint Dislocations / etiology
  • Joint Dislocations / therapy
  • Laryngoscopy / adverse effects*
  • Male
  • Malocclusion, Angle Class II / complications*
  • Middle Aged
  • Musculoskeletal Manipulations
  • Neuromuscular Nondepolarizing Agents / pharmacology
  • Pancuronium / pharmacology
  • Premedication
  • Stress, Mechanical
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / etiology
  • Temporomandibular Joint Disorders / therapy
  • Temporomandibular Joint Dysfunction Syndrome / etiology
  • Time Factors

Substances

  • Neuromuscular Nondepolarizing Agents
  • Pancuronium