Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse

Abstract

A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the surgical procedure and the gelding’s clinical signs resolved. Arthroscopy of the TMJ can be accomplished in the standing horse and should be considered when arthroscopic exploration or debridement of this joint is indicated. This is also the first case report of concurrent otitis media, TMJ sepsis, and THO; due to their close anatomic relationship, it is possible that septic otitis media could lead to pathology in the TMJ and temporohyoid joint, as described in humans.