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Masticatory diplopia.

Oleg Militsakh1, J David Kriet

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City 66160, USA.

Ear, Nose, & Throat Journal
|March 25, 2008
PubMed
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Chewing worsened double vision (diplopia) in a patient with facial fractures from a motorcycle accident. Surgical correction resolved the masticatory diplopia, a rare complication of facial trauma.

Area of Science:

  • Ophthalmology
  • Trauma Surgery
  • Maxillofacial Surgery

Background:

  • Facial fractures, particularly those resulting from high-impact trauma like motorcycle accidents, can lead to complex ocular and functional complications.
  • Temporomandibular joint dysfunction and associated symptoms are recognized sequelae of facial trauma.
  • Ocular motility disorders following trauma often require specialized diagnosis and management.

Observation:

  • A patient presented with diplopia that significantly worsened during mastication (chewing).
  • The diplopia was directly linked to the patient's history of severe facial fractures sustained in a motorcycle crash.
  • Physical examination revealed no immediate cause for the masticatory exacerbation of diplopia.

Findings:

  • The diplopia was attributed to the adhesion of the temporalis muscle to the periorbita, a previously unreported complication.

Related Experiment Videos

  • This adhesion restricted ocular movement during jaw excursion, causing the characteristic exacerbation of double vision during chewing.
  • Surgical intervention, performed one year post-trauma, successfully addressed the temporalis muscle adhesion.

    • Implications:

    • This case highlights a novel mechanism of masticatory diplopia secondary to facial trauma.
    • It underscores the importance of considering unusual etiologies for ocular motility disturbances in trauma patients.
    • The findings suggest that surgical release of specific muscular adhesions can effectively treat complex post-traumatic diplopia.