Dehiscence of the anterior wall of the external auditory canal with involvement of the temporomandibular joint after exostosis surgery. Systematic review

Abstract

Introduction and objective: Carry out a systematic review to evaluate the incidence in the literature of this rare complication in otological surgery, such as the involvement of the temporomandibular joint (TMJ). Method: Iatrogenic opening of the TMJ after otological surgery attended is very unfrequent, a review of the literature about this pathology was carried out following the PRISMA method for systematic reviews evaluating the electronic databases PubMED, Web of Science and Cochrane. Results: 3 articles with published cases of EAC-TMJ fistulization and one of our own were included. All presented compatible exploration by otoscopy with or without symptoms reported by the patient and requiring surgical or conservative treatment. A total of 5 cases were found (4 women and 1 man), aged between 40 and 70, with a diagnosis of EAC-TMJ communication secondary to canaloplasty. Three of them presented cervical emphysema among the accompanying symptoms and signs. Treatment was conservative in three cases, while the other two required surgical repair. Discussion/Conclusions: Canaloplasty is a common procedure in otological surgery that requires a meticulous dissection technique to avoid damage to important structures such as the facial nerve or the TMJ. It presents a low rate of complications, being fistulization towards the temporomandibular joint very exceptional. However, we must suspect it in the presence of persistent pain, otorrhea, jaw blockage or clicking and, of course, emphysema.  
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Rodríguez-Martín, M., Corriols-Noval, P., López-Simón, E., Salvatierra-Vicario, B., Cobo-Díaz, R., García-Ibáñez, Y., & Longarela-Herrero, Y. (2022). Dehiscence of the anterior wall of the external auditory canal with involvement of the temporomandibular joint after exostosis surgery. Systematic review . Revista ORL, 14(1), e28559. https://doi.org/10.14201/orl.28559

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Minerva Rodríguez-Martín

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Hospital universitario marqués de Valdecilla
residente ORL
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