Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-23T14:57:03.263Z Has data issue: false hasContentIssue false

Temporomandibular joint fistula into the external ear canal

Published online by Cambridge University Press:  29 June 2012

J Ajduk*
Affiliation:
Department of ENT Head and Neck Surgery, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
M Ries
Affiliation:
Department of ENT Head and Neck Surgery, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
D Vagic
Affiliation:
Department of ENT Head and Neck Surgery, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
A Batos-Tripalo
Affiliation:
Department of Radiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
*
Address for correspondence: Dr Jakov Ajduk, Department of ENT Head and Neck Surgery, Sestre Milosrdnice University Hospital Center, Vinogradska c 29, HR-10000 Zagreb, Croatia Fax: +385 1 3768293 E-mail: jakov.ajduk@gmail.com

Abstract

Background:

Temporomandibular joint fistula into the external auditory canal is a very rare condition. We report a case of spontaneous fistula which presented with repeated episodes of clear fluid otorrhoea and ear infection.

Case report:

A 53-year-old woman complained of occasional episodes of clear fluid otorrhoea from the right ear followed by infection. Otoscopic examination showed a normal tympanic membrane and normal skin in the external auditory meatus. Otomicroscopy showed a small punctum on the anteroinferior part of the meatus. Computed tomography identified a foramen of Huschke. Surgery revealed a fistula between the meatus and the temporomandibular joint, which was successfully resolved.

Conclusion:

This report presents a rare case of a fistula between the temporomandibular joint and the external auditory meatus, associated with Huschke's foramen. Such a defect can be quite difficult to detect. It should be suspected in cases of chronic otorrhoea when neither middle nor external ear disease is apparent. Surgery is usually successful, and is advised in cases with repeated complications.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Miller, RS, Jahrsdoerfer, RA, Hashisaki, GT, Kesser, BW. Diagnosis and management of salivary fistula after surgery for congenital aural atresia. Otol Neurotol 2006;27:189–92CrossRefGoogle ScholarPubMed
2 Hutchinson, IL, Ryan, D. A parotid fistula and sialocele complicating temporomandibular joint surgery. Br J Oral Maxillofac Surg 1989;27:203–8CrossRefGoogle Scholar
3 Yavuzer, R, Unal, S, Ozmen, S, Latifoglu, O, Celebi, MC. An unusual complication of microtia repair. Plast Reconstr Surg 2000;105:1896CrossRefGoogle ScholarPubMed
4 Rushton, VE, Pemberton, MN. Salivary otorrhoea: a case report and a review of the literature. Dentomaxillofac Radiol 2005;34:376–9CrossRefGoogle Scholar
5 Wang, RG, Bingham, B, Hawke, M, Kwok, P, Li, JR. Persistence of the foramen of Huschke in the adult: an osteological study. J Otolaryngol 1991;20:251–4Google ScholarPubMed
6 Lacout, A, Marsot-Dupuch, K, Smoker, WR, Lasjaunias, P. Foramen tympanicum, or foramen of Huschke: pathologic cases and anatomic CT study. AJNR Am J Neuroradiol 2005;26:1317–23Google ScholarPubMed
7 Anson, BJ, Donaldson, JA. Surgical Anatomy of the Temporal Bone, 3rd edn. Philadelphia: W B Saunders, 1981;122–3Google Scholar
8 Hawke, M, Kwok, P, Shankar, L, Wang, RG. Spontaneous temporomandibular joint fistula into the external auditory canal. J Otolaryngol 1988;17:2931 Google ScholarPubMed
9 Toyama, C, da Silva, CJ, Fugita, DY, Scapini, F. Temporomandibular joint herniation into the external auditory canal. Otol Neurotol 2009;30:426–7CrossRefGoogle ScholarPubMed
10 Psillas, G, Guyot, JP. Spontaneous temporomandibular joint herniation into the external auditory canal. Ann Otolaryngol Chir Cervicofac 2007;124:305–8CrossRefGoogle ScholarPubMed
11 De Zoysa, N, Vasani, S, Kaniyur, S, Frosh, A. Gustatory otorrhoea: a rare case of congenital external ear salivary fistula. J Laryngol Otol 2009;123:1371–4CrossRefGoogle ScholarPubMed
12 Fusconi, M, Benfari, G, Franco, M, Deriu, D, Dambrosio, F, Antonio, G et al. Foramen of Huschke: case report and experimental procedure for diagnosis of spontaneous salivary fistula. J Oral Maxillofac Surg 2009;67:1747–51CrossRefGoogle ScholarPubMed