Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1601862
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Delayed Management of Unrecognized Bilateral Temporomandibular Joint Dislocation: A Case Report

Siok Yoong Chin1, Nazer Bin Berahim1, Khairulzaman Bin Adnan1, Sundrarajan Naidu Ramasamy1
  • 1Department of Oral and Maxillofacial Surgery, Ministry of Health Malaysia, Temerloh, Pahang, Malaysia
Further Information

Publication History

30 December 2015

18 December 2016

Publication Date:
12 April 2017 (eFirst)


Temporomandibular joint (TMJ) dislocation is a common occurrence, but diagnosis can be missed if patients do not complain. Delayed presentation complicates the management of a straightforward reduction. We present a case of a 24-year-old man who had bilateral TMJ dislocation of unknown duration after motor vehicle accident. The accident left him bedridden with speech difficulty. He was totally dependent on Ryles' and percutaneous endoscopic gastrotomy tubes for feeding. Computed tomography revealed dislocation of condyles anterior to articular eminences. The bilateral TMJ dislocations were reduced surgically via bicoronal with preauricular extension approaches. However, the surgery was challenging due to tissue changes around the joint accompanied by masticatory muscles atrophy. Postoperatively, he was placed on intermaxillary fixation for 2 weeks followed by elastics training. Three months later, the patient's mastication returned completely to function. Delayed management of bilateral TMJ dislocation is undoubtedly challenging and somewhat frustrating; nevertheless, we manage to achieve satisfactory outcome in improving the patient's quality of life.