[Temporomandibular osteomyelitis secondary to progressive necrotizing otitis externa]

Osteomyelitis of the temporomandibular joint is a rare complication of invasive external otitis, often occurring after inappropriate initial treatment of the causal affection.

A 65-year-old diabetic man was treated for invasive otitis externa complicated by destructive osteomyelitis of the ipsilateral temporomandibular joint. The diagnosis was suspected clinically and confirmed by imaging. The course was favorable with medical treatment.

Osteomyelitis is an extremely unusual complication of invasive otitis externa. Diffusion of the infection toward the temporomandibular joint can be secondary to an osteitis of the bony canal or spread via congenital dehiscences of the external auditory canal. Pain, limitation of mouth opening and auricular swelling are the main clinical signs. Treatment is essentially medical, based on adapted antibiotic therapy.