A 4 year-old boy with the chief complaint of trismus was referred to the Department of Oral Surgery, Gunma University, on June 1, 1985. The trismus occurred during effective treatment with irradiation at the Department of Neurosurgery, after partial resection of a brain stem tumor for diagnosis on April 22, 1985. Histopathological findings revealed medulloblastoma.
On the first visit he showed right side V, VI, VII cranial nerve paresis and trunkal ataxia, and the maximal jaw opening value between the interincisal spaces was only 2 mm. A jaw opening exercise with a Heister's mouth gag was prescribed for ten minutes to or more times a day.
Good results were obtained using this treatment, the maximal jaw opening value increased to 24 mm on April 19, 1988.
The authors propose that the trismus in this case brought on the V, VIi cranial nerve paresis and that the effect of irradiation included part of the TMJ.
Cases like the above are infrequent in oral surgery.