OS, a 65-year-old female trader presented\nwith a one year history of clicking sounds in the right\ntemporomandibular joint area on mastication. There\nwas no history of trauma, pain, swelling or any other\nsymptoms. Background medical history revealed that\nshe was a known hypertensive on medications. On\nexamination, it was discovered that the patient had\nbilateral TMJ clicking sounds on mandibular excursion.\nThere were no areas of swelling/depression or\ntenderness. Plain X-ray (TMJ views) showed anterior\ndislocation of the right mandibular condyle on opening.\nA diagnosis of chronic recurrent right TMJ dislocation\nwas made. She was treated with intraarticular injection\nof triamsinolone 40mg weekly for six weeks alongside\nphysiotherapy. There was improvement of symptoms\nand she did not present for follow up or with\nreoccurrence.
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.