TMJ arthritis is a frequent complication of otomastoiditis.
BACKGROUND
Septic arthritis of the temporomandibular joint (TMJ) is a rare condition known to result in significant morbidity if diagnosis is delayed. Acute otomastoiditis is a typical complication of acute otitis media but few cases of acute otomastoiditis complicated with TMJ arthritis have been reported in the international literature. Furthermore, otomastoiditis reports and studies rarely analyzed TMJ CT scans. The aim of this study was to determine the incidence of TMJ arthritis in acute otomastoiditis, based on the analysis of CT scans.


METHODS
We conducted a prospective study from 2014 to 2015, including all consecutive pediatric patients admitted to the Pediatric Otolaryngology department for acute otomastoiditis. A craniofacial injected CT scan was performed in all patients. The imagery was prospectively blind analyzed by two independent investigators screening for the criteria of TMJ arthritis. Finally, during the long-term follow-up we noted the number of patients presenting a clinical TMJ ankylosis.


RESULTS
We included 45 patients. The analysis showed 15 patients with TMJ effusion. Of those, 6 (13.33%) had an abscess and 2 clinical ankyloses.


CONCLUSIONS
This study showed a high rate of TMJ arthritis complicating otomastoiditis. Our results demonstrate that systematic TMJ analysis in the CT scan of patients with otomastoiditis is essential.
APHP, Necker Enfants Malades, Service d'ORL et Chirurgie Cervico-faciale, 75015 Paris, France.
Romain
R
Luscan
APHP, Necker Enfants Malades, Service d'imagerie Médicale Pédiatrique, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France.
Kahina
K
Belhous
APHP, Necker Enfants Malades, Service d'ORL et Chirurgie Cervico-faciale, 75015 Paris, France.
Francois
F
Simon
APHP, Necker Enfants Malades, Service d'imagerie Médicale Pédiatrique, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; INSERM U1000 and UMR 1163, Institut Imagine, 750015 Paris France.
Nathalie
N
Boddaert
APHP, Necker Enfants Malades, Service d'ORL et Chirurgie Cervico-faciale, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France.
Vincent
V
Couloigner
Université Paris Descartes, 75005 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, 75015 Paris, France.
Arnaud
A
Picard
Université Paris Descartes, 75005 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, 75015 Paris, France. Electronic address: natacha.kadlub@aphp.fr.
Natacha
N
Kadlub
D000208:Acute Disease; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000150:complications* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D014057:Tomography, X-Ray Computed
Ankylosis; Arthritis; Otomastoiditis; Temporomandibular joint