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A case is reported of a foreign body in the left parotid gland, which presented in an unusual manner following a trivial injury and posed a difficult diagnostic problem, trismus being the most prominent clinical feature. The importance of having a high index of suspicion for retained foreign bodies is stressed.
A case is reported where long standing trismus was the presenting factor in a case of catatonic schizophrenia. The investigations and treatment are described.
A 63 year-old man who had had an operation for adenocarcinoma of the left parotid gland presented with worsening trismus after the completion of radiotherapy. None of the treatments given were successful so he resorted to a "home-made" approach, and succeeded in improving his mouth-opening by 18 mm.
OBJECTIVE: This study compared kinesiologic taping (KT) with conventional elastic adhesive bandaging in managing postoperative morbidity following open reduction and internal fixation. STUDY DESIGN: In this prospective, randomized controlled trial conducted at KLE Dr Prabhakar Kore Hospital, 26 patients with unilateral mandibular fractures were allocated into two groups: Group 1 received an elastic adhesive bandage (n = 13) and Group 2 used KT (n = 13). Pain (Visual Analog Scale), facial swelling (standardized linear measurements), and maximum interincisal distance were recorded at baseline and on postoperative Days 2 and 5. Data were analyzed using repeated measures ANOVA and independent t tests (p < .05). RESULTS: The KT group showed significantly lower pain scores and reduced facial edema at Days 2 and 5 compared with controls (P < .05). Trismus improved in both groups without significant intergroup differences. No adverse effects were observed. CONCLUSIONS: KT is a safe and effective adjunct for reducing early postoperative pain and edema after mandibular fracture fixation.
Tetanus is a life-threatening infection that is rare in the developed world. Trismus and dysphagia are the most common presenting symptoms, and thus oral and maxillofacial surgeons may be involved in the early stages of evaluation of the patient. Early diagnosis helps initiate prompt management and referral for intensive therapy. This article is a case report of severe generalized tetanus with a discussion of its diagnosis, pathophysiology, and management.
A 21-year-old female patient presented with trismus, initially diagnosed as related to pericoronitis. Computed tomography demonstrated heterotopic soft tissue ossification involving both medial pterygoids which was later followed by similar features in the submandibular muscles and right quadriceps. A variant of fibrodysplasia ossificans progressiva was considered the likeliest diagnosis. The computed tomographic features of the condition and the importance of early diagnosis are stressed.
A double-blind randomised placebo-controlled study of the value of systemic penicillin in preventing pain, swelling and trismus following the removal of impacted mandibular third molars and indicates that penicillin may be used justifiably in the more difficult cases.
We present a 62-year-old patient with a chronic organized abscess of the right masseter muscle that developed following parotidectomy. This patient's chronic abscess originated from an infection in the masticator space from the second molar. Cases of repeated parotitis should lead one to suspect a masticator space infection. In this case, the cicatricical masseter muscle produced severe trismus. Total eradication of the abscess and myotomy of the masseter resolved the problem completely. We should pay attention to the dental condition in case of masticator space infection, especially in case of masseter muscle infection mimicking parotitis.
This investigation compared the results of 2 types of wound closure after mandibular third molar removal. In both the test group and the control group, the molars were removed using a mucoperiosteal flap as described by Szmyd; a wedge of tissue distal to the second molar was removed before closure to secure self-irrigation of the empty socket. The test group received a gauze drain partially submerged into the socket to secure more drainage and to prevent primary wound healing. Examinations were performed 2 days and 7 days after surgery, and pain, swelling, trismus and wound condition were recorded. Analyses of variance indicated that there was no significant difference between the 2 types of wound closure.
A unique case of delayed trismus secondary to an infratemporal foreign body is presented. The pathophysiology and treatment options are discussed.
We describe a patient with trigeminal neurinoma whose main presenting symptom was trismus. This has not previously been reported in the literature. We review the previously described symptoms and signs of trigeminal neurinoma.
At one time the incidence of broken hypodermic needles was a fairly common occurrence in general dental practice. Fortunately the routine use of modern stainless steel needles has all but eliminated this emergency. Occasionally a patient may make a sudden movement during administration of local anaesthetic, particularly in the provision of an inferior dental block. A case is described where this occurred with subsequent fracture of the hypodermic needle. The patient experienced sudden trismus and dysphagia as the needle fragment became deeply impacted in the surrounding soft tissues.
Endotracheal intubation of patients with limited bite opening is a serious task for the caring physician. Blind intubation can be frustrating and, very often, unsuccessful. Tracheostomy, even under ideal conditions, can create serious complications. Fiberoptic bronchoscopy has opened up a new era in intubation of patients with trismus. In this article, we discuss an organized illustrated procedure for intubation of such patients. We have used this procedure successfully in 16 patients over the last sixteen months in our craniofacial unit, with no complications and no failures.
A female with congenital microgastria, Pierre Robin sequence and partial trismus is described. This is a previously undescribed association and the etiology of the association is discussed.
Hecht syndrome is a rare condition that is also known as trismus pseudocamptodactyly syndrome. Short muscle and tendon units limiting the range of motion of upper and lower extremities and mouth characterize this disorder of muscle development. There is no consensus on the optimal treatment of temporomandibular joint (TMJ) ankylosis in this patient population. Endoscopic release in one patient resulted in early postoperative recurrence. The authors present a 28-month old boy who had a limited mouth opening of 6 mm. CT scan showed no bony ankylosis. The range of mouth opening did not to improve with physical therapy. The patient underwent extensive subperiosteal dissection of the mandible, bilateral coronoidectomy, and TMJ exploration. An intraoperative opening of 18 mm was achieved. The patient remained intubated until postoperative swelling resolved. He was extubated in the operating room 6 days later. The patient continued to improve with physical therapy. He had a 25-mm mouth opening at 12 months of follow-up.
A family in which five individuals through three generations were affected with trismus-pseudocamptodactyly syndrome is reported. The propositus, an 8-year-old boy, had a right embedded ear, inability to open the mouth fully, pseudocamptodactyly and soft tissue syndactyly of the toes. His paternal grandmother, father, paternal uncle and his paternal cousin had pseudocamptodactyly. The occurrence of the syndrome in this Japanese family indicates that the syndrome is not exclusively of Dutch origin.
The trismus-pseudocamptodactyly syndrome (TPS) is a rare condition inherited as an autosomal dominant trait with variable expressivity. Clinically the syndrome is characterized by decreased ability to open the mouth and curvature of the fingers at the level of interphalangic joints while attempting dorsiflexion of the wrist (pseudocamptodactyly). A 6-year-old male patient from Guatemala with this syndrome is presented. The surgical treatment consisted of bilateral coronoid amputation to resolve the pseudotrismus. The procedure was successful and the patient achieved normal function.
Clinical and EMG findings in 10 cases of intrinsic brainstem lesions are reported with paradoxical activity of jaw closing muscles during jaw opening, with and without trismus. In five cases with trigeminal anaesthesia, the inverse activity of jaw closers is interpreted as a manifestation of disturbance in the central programming of mastication in the motor trigeminal area of the brainstem. Stretch reflex mechanisms and disinhibition of the trigeminal motor neurones play no part in the origin of inverse activity. The distinct brainstem syndrome can only be detected by EMG and the special clinical features.