Herniation of the temporomandibular joint into the external auditory meatus secondary to benign necrotising otitis externa

The temperomandibular joint (TMJ) is intimately related to the external auditory meatus (EAM). Herniation of the joint into the EAM occurs secondary to neoplasia. trauma, inflammation and developmental problems [Conover GL, Crammond RJ. Tympanic plate fracture from mandibular trauma. J Oral Maxillofac Surg 1985:43:292-4: Ali TS, Rubinstein JT. Rheumatoid arthritis of the temporomandibular joint with herniation into the external auditory canal. Ann Otol Rhinol Laryngol 2000:109:177-9]. Benign necrotising otitis externa ((BNOE) is an uncommon condition characterized by avascular necrosis of the tympanic plate that has been described as a sequence of simple otitis externa [Wormald P.J. Surgical management of benign necrotizing otitis externa. J Laryngol Otol 1994-108:101-5.] We present it case of BNOE that resulted in a posterior herniation of the TMJ capsule into the EAM. (C) 2008 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.