Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T09:22:00.252Z Has data issue: false hasContentIssue false
  • English
  • Français

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: [email protected]
Get access Rights & Permissions [Opens in a new window]

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

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

1Lacout, A, Marsot-Dupuch, K, Smoker, W, Lasjaunias, P. Foramen tympanicum, or foramen of Huschke: pathologic cases and anatomic CT study. AJNR Am J Neuroradiol 2005;26:1317–23Google ScholarPubMed
2Hawke, M, Kwok, P, Mehta, W, Wang, R. Bilateral spontaneous temporomandibular joint herniation into the external auditory canal. J Otolaryngol 1987;16:387–9Google ScholarPubMed
3Wang, R, Bingham, B, Hawke, M. Persistence of the foramen of Huschke in the adult: an osteological study. J Otolaryngol 1991;20:251–3Google ScholarPubMed
4Heffez, L, Anderson, D, Mafee, M. Developmental defects of the tympanic plate: case reports and review of the literature. J Oral Maxillofac Surg 1989;47:1336–40CrossRefGoogle ScholarPubMed
5Moriyama, M, Kodama, S, Suzuki, M. Spontaneous temporomandibular joint herniation into the external auditory canal: a case report and review of the literature. Laryngoscope 2005;115:2174–7CrossRefGoogle ScholarPubMed
6Saeed, SR, Saeed, NR, Brooke, GB. Temporomandibular joint capsule prolapse: a technique of repair using autograft cartilage. J Laryngol Otol 1994;108:30–2CrossRefGoogle ScholarPubMed
7Merritt, RM, Bent, JP, Porubsky, ES. Temporomandibular joint dehiscence after mastoid surgery: a case report. Otolaryngol Head Neck Surg 1995;113:293–4CrossRefGoogle ScholarPubMed
8Annand, VT, Latif, MA, Smith, WP. Defects of the external auditory canal: a new reconstructive technique. J Laryngol Otol 2000;114:279–82CrossRefGoogle Scholar