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Neonatal Temporomandibular Joint Dislocation: A Case Report and Literature Review
Tyler A Le1, Alison C Ma2, Sean Clausen2
1Medical Education, American University of the Caribbean, Cupecoy, SXM.
Insights
Neonatal temporomandibular joint (TMJ) dislocation, though rare, can occur in infants. This case highlights a transient TMJ dysfunction in a newborn, resolving within a month.
Area of Science:
- Pediatric Otolaryngology
- Neonatal Medicine
- Craniofacial Development
Background:
- Neonatal temporomandibular joint (TMJ) dislocation is an uncommon condition.
- Infantile TMJ development features joint laxity and a shallow mandibular fossa, potentially predisposing to dislocation.
- Literature review indicates most infant TMJ dislocations are fixed and associated with forceful actions like crying or vomiting.
Observation:
- A six-day-old infant presented with a dislocating jaw during breastfeeding, characterized by a clicking sound and jaw deviation.
- The infant exhibited a palpable click upon mouth opening and spontaneous reduction upon closing.
- Symptoms were observed to be asymmetrical, with the jaw deviating to the left.
Findings:
- The case describes a transient, non-fixed neonatal TMJ dislocation.
- The infant's symptoms resolved spontaneously within one month without intervention.
- This contrasts with previously reported cases of fixed TMJ dislocations in infants.
Implications:
- Transient TMJ dysfunction may be more prevalent in neonates than previously recognized.
- Understanding the biomechanics of the infantile TMJ is crucial for diagnosing and managing such conditions.
- Further research is needed to elucidate the etiology and natural history of neonatal TMJ dislocations.
Abstract:
Neonatal temporomandibular joint (TMJ) dislocation is rare. The purpose of this study is to describe a case of neonatal TMJ dysfunction and to review the literature on this topic. A six-day-old female was seen with both parents for evaluation of a dislocating jaw. Her mother had been breastfeeding successfully but noticed that there was a noticeable click every time the baby swallowed. Her jaw came out and down as she fed and then returned to the normal position. Over the last few days, her mother felt that only one side was involved as her jaw movement seemed asymmetrical. Her primary care physician had witnessed the click during the sucking reflex. The patient had a normal appearance and was otherwise healthy. The pediatric otolaryngologist observed deviation of the jaw toward the left with a palpable click upon mouth opening and spontaneous reduction with mouth closing. The symptoms resolved over the following month. The literature review showed few cases of TMJ dislocation in infants, most of which described fixed dislocation related to vomiting or crying. Due to the development of the TMJ in infancy characterized by joint laxity and a flat mandibular fossa, malfunctioning of the hinge joint mechanism could be expected to be more common early in life.
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