The phantom earache. Temporomandibular joint dysfunction in children.

Temporomandibular joint dysfunction is a benign, relatively uncommon childhood disorder and should be considered in children who have intermittent unilateral otalgia of three to four days' duration and whose audiographic, tympanometric, and clinical otologic examinations reveal normal findings. Most of the patients in our study had undergone orthodontic therapy during the year preceding the onset of temporomandibular joint dysfunction, and the vast majority of them had received orthodontic treatment within two weeks of each episode of otalgia. The diagnosis can be confirmed clinically by reproducing the pain associated with masticatory muscle spasm by palpation of the preauricular areas, intraotic manipulation, and palpation of the pterygoid muscles. Treatment consists of administering acetaminophen, applying hot compresses to the preauricular area, and opening and closing the mouth 30 to 40 times after each compress as an effort to interrupt the muscle spasm.