Dislocation of the mandible: a case report

Dislocation of the mandible is a possible complication of direct tracheal laryngoscopy. The temporomandibular joint (TMJ) is unique in that any movement of the bone always causes movement in both joints simultaneously. The entire TMJ is surrounded by a ligamentous capsule and is stabilized by 3 ligaments. Four muscles of mastication move the mandible with great power. The lateral pterygoid muscle has nearly horizontal muscular fibers and is chiefly responsible for dislocating the mandibular condyle and articular disc past the articular eminence into the infratemporal fossa, causing the patient great pain and distress. If mandibular dislocation should occur, prompt recognition and treatment of the dislocation is recommended. There are steps, used by dentists, which can be employed by the nurse anesthetist to relocate the mandible. The technique for intraoral bimanual relocation of the mandible is described.