Two Cases of Masticator Space Abscess Initially Diagnosed as Temporomandibular Joint Disorder

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Diseases causing trismus or pain of the temporomandibular joint (TMJ) includetemporomandibular joint disorders (TMJD), trauma, tumors and an inflammation.This report describes two cases of masticator space abscesses causing trismus and TMJpain, which were initially diagnosed as TMJD. The first case was a 62-year-old femalesuffering from trismus and right-TMJ pain without swelling or redness, which wasdiagnosed as TMJD with MRI (TMJ region) findings of bilateral anterior discdisplacement without reduction. However, five days later the right-TMJ pain becamemore severe and MRI (maxillofacial region) revealed a right masticator space abscess.She was treated with antibiotics and underwent an intraoral incision followinghospitalization. She recovered well and was discharged from the hospital on the 15thday. The second case was a 68-year-old female having trismus and left-TMJ pain,which was diagnosed as TMJD at another hospital. She received instructions for jawopening training, but visited our hospital because her symptoms were not improved. Atthe first visit, the mouth opening range was 18 mm and an anterior dislocation of theleft condylar process was found by X-ray imaging. CT-scan revealed an abscess in theleft masticator space. Therefore an intraoral incision was performed under generalanesthesia and antibiotics were administered. She recovered well and was dischargedfrom hospital on the 12th day.When we treat TMJD, we must keep in mind the possibility of inapparent of thepresence of some unseen inflammation, especially an abscess formation in themasticator space.

Two Cases of Masticator Space Abscess Initially Diagnosed as Temporomandibular Joint Disorder

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