Surgical treatment of chronic otitis media with temporomandibular joint involvement

We report a case of chronic otitis media with spread of the infection into the temporomandibular joint (TMJ), causing displacement of the joint and malocclusion. Chemotherapy of the malignant disease caused activation of the chronic ear infection with a temporomandibular joint involvement. The patient was operated twice to eradicate the infection from the mastoid, middle ear and temporomandibular joint. A radical cavity with musculoperiosteal flap obliteration was created. The joint was isolated from the radical cavity with a thin vascularized temporomyofascial flap. No restriction in the movements of the temporomandibular joint could be noted in the follow-up. After the surgeries chemotherapy could continue without signs of inflammation in the temporomandibular joint or mastoid region. Prompt surgical intervention is indicated when temporomandibular joint symptoms arise in cases of chronic otitis media.