Introduction of Meglumine Diatrizoate into the Middle Cranial Fossa: A Rare Fatal Complication of Temporomandibular Joint Arthrography

The authors here report a rare fatal complication of temporomandibular joint (TMJ) arthrography. A 57-year-old woman suddenly exhibited spasm and dizziness during TMJ arthrography. A multislice CT scanning of head demonstrated a defect in the roof of the glenoid fossa and unanticipated introduction of meglumine diatrizoate into the middle cranial fossa, which should account for neurotoxic symptoms of the patient and could be fatal if not appropriately treated in time. As TMJ puncture is widely performed in clinical practice and generally considered a safe technique, this case might serve as a reminder of the potential risk of the anatomical variation—a defect in the roof of the glenoid fossa—to TMJ clinical practitioners. Address correspondence and reprint requests to Yong Cheng, PhD, DDS and Bo Li, PhD, DDS, School and Hospital of Stomatology, Wuhan University, #237 Luo Yu Road, Wuhan, Hubei 430079, PR China; E-mail: wb003142@whu.edu.cn (Yong Cheng); libocn@whu.edu.cn (Bo Li). Received 5 April, 2018 Accepted 21 May, 2018 YC and BL are co-corresponding authors in this paper. This study was supported by the Fundamental Research Funds for the Central Universities (Grant No. 2042016kf0071) and the National Natural Science Foundation of China (Grant No. 81570995). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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