Temporomandibular disorder or not? A case report.

OBJECTIVES: The purpose of this case study is to show the need for a good differential diagnosis of suspected temporomandibular disorder (TMD) with otologic symptoms.

METHODS/RESULTS: This study is a clinical case referring to a patient seeking treatment for pain in the right maxilla. The usual Medical History for diagnosis of a TMD was applied. Anamnesis revealed the patient had had a right maxillary pain for 1 month, a slight hearing loss and dizziness for the past 5-6 months, and two implants placed in the upper jaw 2 years previously. Clinical examination showed right temporomandibular joint (TMJ) clicking and tenderness in the lateral pterygoid muscles and in the right masseter muscle. Temporomandibular disorder and orofacial pain were diagnosed, and the appropriate treatment was initiated. In addition, a cranial magnetic resonance imaging (MRI) evaluation was requested and revealed acoustic neuroma.

CONCLUSION: The coexistence of TMD with otovestibular symptoms suggests the need for a cranial MRI evaluation, especially if the dental or TMD treatment has not been positive.