Temporomandibular joint disorder from skull-base osteomyelitis: a case report
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Updated: Mar 30, 2026
Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
Published on: August 22, 2022
Suck-Chul Lee1, Jae-Hyung Kim1, Chul-Hoon Kim1
1Department of Oral and Maxillofacial surgery, Dong-a University Hospital, Daesingongwon-ro 26, Seo-gu, Busan, 602-715 Korea.
Abstract:
Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.
Insights
Diabetic patients with skull-base osteomyelitis experienced jaw pain and limited mouth opening. Effective diabetes control and treatment, including arthrocentesis, significantly improved symptoms and function.
Area of Science:
- Otorhinolaryngology
- Osteomyelitis Research
- Diabetology
Background:
- Skull-base osteomyelitis is a rare, severe infection affecting cranial bone marrow, often stemming from malignant external otitis.
- Elderly diabetic patients are a primary demographic, with uncontrolled diabetes being a significant risk factor.
- This case highlights the potential link between poor glycemic control and the development of osteomyelitis.
Observation:
- A 58-year-old male presented with left jaw pain and restricted mouth opening (27 mm), with deflection.
- Imaging (Panoramic, CT, CBCT) confirmed left condyle bone resorption.
- The patient had a history of poorly controlled diabetes.
Findings:
- Multimodal treatment including diabetes management, medication, arthrocentesis, and occlusal appliance therapy was initiated.
- Significant improvement was observed: mouth opening increased to 45 mm, and jaw pain resolved.
- This demonstrates a successful outcome in a complex case of skull-base osteomyelitis secondary to uncontrolled diabetes.
Implications:
- Effective diabetes mellitus management is crucial in preventing and treating skull-base osteomyelitis.
- Arthrocentesis with lavage may be a beneficial adjunctive therapy, warranting further investigation.
- This case underscores the importance of a comprehensive approach to managing patients with comorbidities like diabetes presenting with rare infections.
