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VOLUME 13 , ISSUE 2 ( May-August, 2021 ) > List of Articles


Temporomandibular Joint Herniation through the Huschke Foramen

Ângela Reis-Rego, Mariline Santos, Telma S Feliciano, Cecília A e Sousa

Keywords : Huschke foramen, Mass, Temporomandibular joint

Citation Information : Reis-Rego Â, Santos M, Feliciano TS, e Sousa CA. Temporomandibular Joint Herniation through the Huschke Foramen. Int J Otorhinolaryngol Clin 2021; 13 (2):61-63.

DOI: 10.5005/jp-journals-10003-1377

License: CC BY-NC 4.0

Published Online: 20-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim: To enlighten about the importance of the anatomic defect—Huschke foramen/foramen tympanicum—in the differential diagnosis of external auditory canal masses, especially when ear complaints are exacerbated by mandibular movements and when in anteroinferior configuration. Background: Most cases of persistent bony defect connecting the external acoustic meatus to the temporomandibular joint are asymptomatic. Although extremely rare, temporomandibular joint herniation through this defect may occur. This entity is not a straightforward diagnosis. Differential diagnosis with tumors involving the ear auditory canal or even cholesteatoma must be carefully excluded. A high-resolution cone-beam computed tomography is the preferred imaging modality for the evaluation of this anatomic variant. Treatment options depend on the presenting symptoms and the patient's willingness to undergo surgical correction. Case description: We report a case of symptomatic temporomandibular joint herniation through the Huschke foramen in an otherwise healthy middle-aged woman who complains of left aural plenitude and intermittent bloody otorrhea for a month. The patient was studied with temporal bone computed tomography and magnetic resonance imaging. While the patient was being studied, there was a complete self-resolution of the mass in the external auditory canal, which we treated with a topical antibiotic and corticosteroid ear drops. Imaging confirmed the existence of a Huschke foramen. Along with the patient, we decided to observe her closely as an outpatient. Conclusion and clinical significance: This report highlights the importance of studying certain external canal masses with imaging, especially in the anteroinferior location, before gross manipulation.

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