PDF(Pubmed)
Abstract：
A patient presenting with a history of restricted mouth opening and deflection of the mandible after a prolonged dental procedure raises a suspicion of temporomandibular joint disorder (TMD) due to its estimated high prevalence of 29%. Muscle relaxants and routine active physiotherapy established normal range of movement and pain reduction was achieved through TENS therapy and analgesics. However, the non-subsidence of deflection prompted an initial suspicion of TMD which was overturned by MRI. The MRI evaluation revealed left side medial pterygoid abscess. It is imperative to understand that despite strong history and relevant clinical features, for the definitive diagnosis radiographic evaluation is highly contributory. Misdiagnosing TMD due to its similar presentation can have significant implications for the patient\'s well-being and quality of life. The clinical features of medial pterygoid abscess including restricted mouth opening and pain can be similar to that of TMD. These abscesses are most commonly caused by odontogenic infections but can also occur as a result of septic inferior alveolar nerve block techniques. Limited literature reports of pterygoid space abscess have been described, but intramuscular and medial pterygoid abscess is an absolute rarity. Causal relationship to septic inferior alveolar nerve block further makes this case report an interesting read.
摘要：
长期牙科手术后出现张口受限和下颌骨偏转病史的患者，由于估计其患病率高29％，因此怀疑颞下颌关节紊乱病（TMD）。肌肉松弛剂和常规的积极物理治疗建立了正常的运动范围，并且通过TENS疗法和镇痛药可以减轻疼痛。然而,偏转的非沉降引发了最初对TMD的怀疑,该怀疑被MRI推翻.MRI评估显示左侧内侧翼状脓肿。必须理解，尽管有很强的病史和相关的临床特征，对于明确的诊断，影像学评估具有很高的贡献。TMD由于其相似的表现而误诊可能对患者的健康和生活质量有重大影响。内侧翼状脓肿的临床特征，包括张口受限和疼痛，与TMD相似。这些脓肿最常见的原因是牙源性感染，但也可能是败血症下牙槽神经阻滞技术的结果。翼状体间隙脓肿的文献报道有限，但是肌内和内侧翼状脓肿是绝对罕见的。与败血症下牙槽神经阻滞的因果关系进一步使该病例报告成为有趣的阅读。
