A Jaw out of joint: Uncovering a rare infectious dislocation of temporo-mandibular junction: A case report

Abstract

Septic involvement of the temporomandibular joint (TMJ) resulting in dislocation is an exceptionally rare entity and is most often associated with contiguous spread from deep cervicofacial infections. Early recognition and coordinated multidisciplinary management are essential to avoid severe functional and infectious complications. We describe the case of a 48-year-old woman with a background of chronic otitis media who presented with progressive left-sided facial swelling, trismus, and local signs of inflammation. Laboratory investigations demonstrated marked inflammatory response. Contrast-enhanced computed tomography of the head and neck revealed a left parapharyngeal abscess with extension to the masticator space, complicated by dislocation of the left TMJ. The patient was treated with surgical drainage combined with broad-spectrum intravenous antibiotic therapy. Clinical outcome was favorable, with resolution of the infectious process and gradual recovery of mandibular mobility. Although rare, TMJ dislocation secondary to deep cervicofacial infection should be considered in patients presenting with facial swelling and trismus, particularly when imaging demonstrates deep neck space abscesses. Prompt imaging assessment and multidisciplinary care play a pivotal role in achieving optimal outcomes.