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 is a 45 year old male shoe maker. He\nwas single. He presented with a one week history of\ninability to close the mouth following a fall from a moving bus. There was associated loss of\nconsciousness which lasted about 10 minutes. He was\npreviously treated for Tuberculosis 15 years prior to\npresentation and claimed to have completed the\nprescribed regimen. No other comorbid condition\nwas noted. On general examination, we saw middle-aged\nman who walked with a limp. There were facial\nbruises over the left supraorbital ridge and right\nzygomatic area, tip of the nose and right side of the\nupper lip, sutured laceration on right foot, but no\nobvious facial asymmetry nor bony discontinuity was\ndetected. Intraorally, there was gagging of occlusion\nposteriorly, and retained roots of 12 and 22. No other\nsignificant intraoral finding was detected. Radiological\nexamination revealed anterior dislocation of the\ntemporomandibular joint bilaterally. The patient had\nHippocrates maneuver for repositioning the condyle\nwhich was successful after four (4) attempts. Analgesia\nwas also administered and the patient discharged home.\nHowever, two days later he returned with a recurrent\nTMJ dislocation following yawning. The dislocation\nwas reduced using Hippocrates maneuver modified\nwith administration of diazepam. Barrel bandage was\napplied to limit joint mobility. The patient was seen\ntwo days later with no evidence of dislocation.