[Delayed diagnosis of a postanaesthesia temporomandibular joint dislocation].
Temporomandibular joint (TMJ) dislocation during anaesthesia is a rare occurrence. Patients with a history of prior dislocations or TMJ dysfunction, and patients with mandibular retrognathism are at risk of this complication. This is a case report of delayed diagnosis of TMJ dislocation after a general anaesthesia for aortic valvular replacement surgery in a predisposed patient. Considering this unusual presentation, TMJ evaluation should be performed during preoperative anaesthetic assessment. In at-risk patients, one should not worry about TMJ dislocation during intubation but concentrate on glottic exposure. However, afterwards, one should be highly aware of this possible complication in order to detect it early, allowing an immediate simple manual reduction. This manoeuver may be performed with or without sedation by a practitioner, familiar with this way of resetting a dislocated jaw.
Département d'anesthésie-réanimation, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France. astrid.quessard@chru-strasbourg.fr
A
A
Quessard
P
P
Barrière
F
F
Levy
A
A
Steib
P
P
Dupeyron
D000769:Anesthesia, Inhalation / Q000379:methods*; D001021:Aortic Valve / Q000601:surgery; D004198:Disease Susceptibility; D004630:Emergencies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D004204:Joint Dislocations / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008312:Malocclusion, Angle Class II / Q000150:complications*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D010197:Pancuronium / Q000494:pharmacology; D011292:Premedication; D013314:Stress, Mechanical; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology; D013997:Time Factors
D003473:Neuromuscular Nondepolarizing Agents; D010197:Pancuronium
Luxation de l'articulation temporomandibulaire diagnostiquée au décours d'une anesthésie générale.