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Temporomandibular joint herniation and the foramen of Huschke: an unusual external auditory canal mass

Published online by Cambridge University Press:  13 September 2011

S J Prowse ,
G Kelly  and
F Agada
S J Prowse*
Affiliation:
Department of ENT Surgery, The General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, UK
G Kelly
Affiliation:
Department of ENT Surgery, The General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, UK
F Agada
Affiliation:
Department of ENT Surgery, The General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, UK
*
Address for correspondence: Mr Simon Prowse, Department of ENT Surgery, The General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK Fax:  + 44 (0)113 3923165 E-mail: sjprowse@me.com
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Abstract

Objectives:

We describe a rare case of spontaneous temporomandibular joint herniation into the external auditory canal, and we also review the presentation, aetiology and management of such cases.

Case report:

An 87-year-old woman presented with a four-month history of left-sided otorrhoea and otalgia. Examination revealed a soft, polypoid mass in the left ear canal. When the patient opened her mouth the lesion disappeared. Subsequent computed tomographic imaging of the patient's temporal bones confirmed an 8.6 mm defect in the antero-inferior portion of the left ear canal, with herniation of retrodiscal soft tissues.

Conclusion:

The external auditory canal is intimately related to the temporomandibular joint, separated only by its bony anterior wall. Neoplasm, trauma or inflammation in this area can result in displacement of the temporomandibular joint into the ear canal; however, spontaneous herniation is rare. Persistence of the primitive foramen of Huschke can result in dehiscence of the anterior canal wall, allowing articular tissue to prolapse into the ear canal. Surgical closure of these defects is known to be effective in ameliorating symptomatic cases.

Keywords

Ear, ExternalTemporo-Mandibular JointEmbryologyHerniaDiagnosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 12 , December 2011 , pp. 1279 - 1281
Copyright
Copyright © JLO (1984) Limited 2011

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References

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