Trismus caused by scarring from refractory major recurrent aphthous stomatitis

Publication date: Available online 26 November 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Yukio Watabe, Yusuke Matsuzaki, Shiro ShigematsuAbstractTrismus can have intra- and extra-articular causes. Extra-articular trismus can be caused by head and neck cancers and associated treatments, oral submucous fibrous, odontogenic infection, trauma and so on. However, scar contracture due to major recurrent aphthous stomatitis (RAS) has not been reported previously as a cause of trismus. We performed Z-plasty for surgical treatment of severe trismus caused by acquired scar contracture from major RAS and achieved good results. A 40-year-old woman was referred to our department for a checkup of major RAS in the right buccal mucosa. Clinical examination revealed that maximum interincisal opening was 15 mm, with no increase under assisted opening and no pain in the temporomandibular joints. Intraoral examination showed major RAS on the right buccal mucosa had already resolved and a dense right retromolar scar band was seen running from the maxillary mucobuccal fold to mandibular mucobuccal fold. The diagnosis was trismus due to scarring from refractory major RAS. The patient underwent Z-plasty scar reorientation and temporal muscle tendolysis. On postoperative day 1, the patient’s mouth was opening to 30 mm and the patients was advised to keep on performing the jaw-opening exercise using a mouth-opening training apparatus. At the 6-month...
Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology - Category: ENT & OMF Source Type: research