2019 Volume 40 Issue 2 Pages 174-178
In recent years, opportunities to treat elderly patients with temporomandibular joint （TMJ） dislocation complicated by systemic diseases or dementia have been increasing. Although manipulative reduction is the primary choice of treatment, patients presenting with recurrent dislocations require surgical methods. We report a case of habitual TMJ dislocation in a patient with cerebrovascular dementia treated surgically by eminectomy. A 74-year-old-male visited our department with a chief complaint of difficulty in closing the mouth. Radiographic examination showed that the head of the condyle was located anterior to the eminence and there was no evidence of morphological malformation. We first attempted manipulative reduction, however, he visited 5 days later with TMJ dislocation, and over the following 5 weeks it dislocated 9 times, each requiring manual reduction. Therefore, a surgical procedure （eminectomy） under general anesthesia was carried out. Anesthesia was induced with intravenous propofol, remifentanil and rocronium and maintained with air, oxygen and sevoflurane. He has been followed for 17 months since surgery and there have been no signs of recurrence of habitual TMJ dislocation.
