title: Dislocation of temporo-mandibular joint - an uncommon circumstance of occurrence: vaginal delivery.
abstract: Dislocation of temporo-mandibular joint (TMJ) is an infrequent disease but still spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occur in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin). We report a case of TMJ occurring in an uncommon circumstance: vaginal delivery. A woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800 g and 2400 g. During labour, and due to efforts of crying, the patient developed a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened and with the chin lowered and thrown forward. The examination found an empty glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ was established. A CT scan of facial bones was done, objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation.
authors.affiliation: Department of Anesthesia and Resuscitation, Mother and Child Hospital, University Hospital Hassan II, Fez, Morocco.
authors.forename: Abderrahim
authors.initials: A
authors.lastname: El Bouazzaoui
authors.forename: Smael
authors.initials: S
authors.lastname: Labib
authors.forename: Ali
authors.initials: A
authors.lastname: Derkaoui
authors.forename: Mohammed
authors.initials: M
authors.lastname: Adnane Berdai
authors.forename: Azzeddine
authors.initials: A
authors.lastname: Bendadi
authors.forename: Mustapha
authors.initials: M
authors.lastname: Harandou
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome