Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-21T20:43:50.433Z Has data issue: false hasContentIssue false
  • English
  • Français

An unusual presentation: temporomandibular tissue herniation through congenital foramen of Huschke

Published online by Cambridge University Press:  15 January 2024

Sachin Tushar Patel Open the ORCID record for Sachin Tushar Patel [Opens in a new window] ,
Keli Dusu ,
Tamir Moharrum  and
Mohammed Salem
Sachin Tushar Patel*
Affiliation:
Department of Otorhinolaryngology, Leicester Royal Infirmary, Leicester, UK
Keli Dusu
Affiliation:
Department of Otorhinolaryngology, Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, UK
Tamir Moharrum
Affiliation:
Department of Otorhinolaryngology, Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, UK
Mohammed Salem
Affiliation:
Department of Otorhinolaryngology, Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, UK
*
Corresponding author: Sachin Tushar Patel; Email: s.patel28@nhs.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The herniation of temporomandibular tissue through the foramen of Huschke into the external auditory canal is a rare clinical anomaly. This paper describes one such case and provides an overview of the relevant literature. This paper elaborates upon the aetiology, clinical assessment, management and associated complications.

Case report

A 54-year-old woman presented with a 3-month history of right ear pain and a polypoid lesion in her right ear canal. This lesion expanded during a Valsalva manoeuvre, and imaging demonstrated a defect in the antero-superior aspect of the canal with herniation of soft tissue. The patient was managed conservatively as the symptoms resided.

Conclusion

Ear canal lesions that protrude or change in size with a Valsalva manoeuvre could be due to a persistent foramen of Huschke. In symptomatic cases needing surgical intervention, a variety of materials may be used to close the defect. Titanium mesh, with or without cartilage overlay, appears to be the most popular choice.

Keywords

Embryologyear canaldiagnosisotologic surgical procedures
Type
Clinical Records
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 3
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Sachin Tushar Patel takes responsibility for the integrity of the content of the paper

*

Equal first authors

References

Hentzer, E. Histologic studies of the normal mucosa in the middle ear, mastoid cavities and eustachian tube. Ann Otol Rhinol Laryngol 1970;79:825–33CrossRefGoogle ScholarPubMed
Applebaum, EL, Kumar, A, Berg, LF, Mafee, MF. Otologic complications following temporomandibular joint arthroscopy. Ann Otol Rhinol Laryngol 1988;97:675–9CrossRefGoogle ScholarPubMed
Heffez, L, Anderson, D, Mafee, M. Developmental defects of the tympanic plate: case reports and review of the literature. J Oral Maxillofac Surg 1989;47:1336–40CrossRefGoogle ScholarPubMed
Hasani, M, Haghnegahdar, A, Khojastepour, L, Golbahar Haghighi, MJ. Determining the existence of the foramen of Huschke in patients with temporomandibular joint disorders using cone beam computed tomography: retrospective cohort study. BMC Med Imaging 2022;22:145CrossRefGoogle ScholarPubMed
Mittal, S, Singal, S, Mittal, A, Singal, R, Jindal, G. Identification of foramen of Huschke with reversible herniation of temporomandibular joint soft tissue into the external auditory canal on multidetector computed tomography. Proc (Bayl Univ Med Cent) 2017;30:92–3Google ScholarPubMed
Lacout, A, Marsot-Dupuch, K, Smoker, WRK, Lasjaunias, P. Foramen tympanicum, or foramen of Huschke: pathologic cases and anatomic CT study. AJNR Am J Neuroradiol 2005;26:1317–23Google ScholarPubMed
Lim, KH, Jung, JY, Rhee, J, Choi, J. Temporomandibular joint herniation through the foramen of Huschke with clicking tinnitus. Eur Ann Otorhinolaryngol Head Neck Dis 2019;136:497–9CrossRefGoogle ScholarPubMed
Ryu, KH, Baek, HJ, Hur, DG. Spontaneous temporomandibular joint herniation into the external auditory canal through a patent foramen of Huschke: a case report. Ann Med Surg (Lond) 2017;18:33–5CrossRefGoogle ScholarPubMed
Singh, I, Jain, A, Prasad, P, Rajpurohit, P. Spontaneous temporomandibular joint herniation: a rare case. Oral Maxillofac Surg 2017;21:87–90CrossRefGoogle ScholarPubMed
Park, YH, Kim, HJ, Park, MH. Temporomandibular joint herniation into the external auditory canal. Laryngoscope 2010;120:2284–8CrossRefGoogle ScholarPubMed
Applebaum, EL, Kumar, A, Berg, LF, Mafee, MF. Otologic complications following temporomandibular joint arthroscopy. Ann Otol Rhinol Laryngol 1988;97:675–9CrossRefGoogle ScholarPubMed
Sharma, PD, Dawkins, RS. Patent foramen of Huschke and spontaneous salivary fistula. J Laryngol Otol 1984;98:83–5CrossRefGoogle ScholarPubMed
Supplementary material: File

Patel et al. supplementary material 1

Patel et al. supplementary material
Download Patel et al. supplementary material 1(File)
File 41.6 MB
Supplementary material: File

Patel et al. supplementary material 2

Patel et al. supplementary material
Download Patel et al. supplementary material 2(File)
File 12.1 KB