AM was a 25-year-old female trader who\ndiscovered that she could no longer close her mouth\nafter yawning a day before presentation. She also had\npain in the preauricular region. This was her first\nexperience of such, and she had no comorbid\nconditions. On examination, it was noticed that she\nhad limitation in mouth opening and closure, her lip\nseal was incompetent and there was bilateral tenderness\nin the preauricular regions. TMJ movement\ntransmission was not detected bilaterally. Radiologic\ninvestigations revealed an anterior displacement of the\ncondylar head beyond the articular eminence. No other\nabnormality was seen. Patient had Hippocrates\nmanouvre done to reposition the head of the condyle\nback in the glenoid fossa and this was successful. Barrel\nbandage was applied to immobilize the joint. The\noutcome as at two (2) days post reduction was a\nsuccessful restoration of TMJ movement
OO was a 40-year-old female fashion\ndesigner who presented with a 1 day history of inability\nto close her mouth following a fall during an epileptic\nfit during which she hit her face on the floor. This was\nthe seventh episode, the first episode having occurred\n13 years prior to presentation. She is known epileptic\nof twenty eight years on Epanutin and Phenobarbitone.\nOn examination, patient had obvious facial asymmetry,\nwith flattening of the left side of the face, elongation\nof the face and a depressed hollow in the preauricular\nareas bilaterally. There was also enamel fracture of 11.\nDiagnosis made was that of bilateral anterior TMJ\ndislocation. The dislocation was successfully treated\nusing the Hippocrates manouvre. No complication\nwas recorded.