SKULL BASE FRACTURES WITH TMJ INVOLVEMENT: LITERARY REVIEW AND CASE REPORT

Abstract

The authors report their experience in the treatment of middle skull base fractures with TMJ involvement of ten patients affected by fractures of the glenoid cavity and of the petrous part of the temporal bone, with TMJ disfunction and facial nerve palsy. The treatment has been based on functional rest, a liquid diet for 5 days and than a functional physiotherapy aimed at rehabilitation of the TMJ.

The efficacy of treatment has been showed after 2 months by restoring the dental occlusion and the TMJ’s function in nine out of ten cases.Three out of four patients (75%) at the same control showed a full resolution of the facial nerve palsy. At an eighth month’s follow-up all the cases had a complete resolution of the symptoms.

Finally no significant studies have been reported in literature to set standardized protocols for the treatment of glenoid cavity fractures.

According to the experience of authors the fractures of the medium cranial base involving the glenoid cavity should be treated as the current trends of intracapsular TMJ fractures.

The orthopedic-functional treatment turns out particularly efficacious when there isn’t a reduction of mandibular vertical heights.