JMO was a 48-year-old married female\nteacher who was a victim of assault. She was attacked\nby armed robbers on her way to work 5 days earlier.\nShe was stifled by her assailants to prevent her from\nshouting for help. She subsequently discovered she\ncould not close her mouth after the incident. Attempt\nat a private clinic and a teaching hospital in Lagos was\nunsuccessful. On examination, patient had bilateral\npreauricular depression and marked tenderness.\nSince the patient had previously had several failed\nattempts at close reduction using Hippocrates\nmaneuver while alert, Hippocrates maneuver was\nattempted under general anaethesia, this was also\nunsuccessful, and was abandoned after a second\nattempt. The patient was placed in a class III\nmaxillomandibular wires for gradual traction with daily\nadjustment which also did not produce the desired\neffect and was abandoned after 5 days. Patient was\neventually planned for open reduction under general\nanesthesia. She had open reduction under general\nanaesthesia which was successful. The outcome was a\nlimited mouth opening which was managed with jaw\nexercises using acrylic screws.\nShe had multiple reviews up till 6 weeks after surgery\nwith a gradual restoration of jaw movements.
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.