## Overview Temporohyoid osteoarthropathy (THO) is bony proliferation and fusion of the temporohyoid joint. Fracture or compression in this region damages cranial nerves VII (facial) and VIII (vestibulocochlear), producing facial paralysis, ear droop, reduced tear production, head tilt, and ataxia or balance loss. ## Causes Progressive osteoarthritis of the temporohyoid articulation, often culminating in fracture of the petrous temporal bone or stylohyoid. ## Diagnosis Clinical signs of facial and vestibular dysfunction plus endoscopic or computed tomographic evidence of temporohyoid thickening or fracture. Corneal ulceration from inability to blink is a common complication. ## Treatment Medical management with anti-inflammatories and antibiotics if infection is suspected; surgical ceratohyoidectomy to reduce forces on the joint. Corneal protection is essential. ## Recovery and Prognosis Guarded. Some neurologic signs improve after surgery or with time; residual deficits are common. Corneal scarring can affect vision. ## Prevention None specific. Early recognition of subtle signs may allow intervention before fracture.
facial paralysis (ear and lip droop); reduced blinking and tear production; head tilt; ataxia; corneal ulceration
## Overview Temporohyoid osteoarthropathy (THO) is bony proliferation and fusion of the temporohyoid joint. Fracture or compression in this region damages cranial nerves VII (facial) and VIII (vestibulocochlear), producing facial paralysis, ear droop, reduced tear production, head tilt, and ataxia or balance loss. ## Causes Progressive osteoarthritis of the temporohyoid articulation, often culminating in fracture of the petrous temporal bone or stylohyoid. ## Diagnosis Clinical signs of facial and vestibular dysfunction plus endoscopic or computed tomographic evidence of temporohyoid thickening or fracture. Corneal ulceration from inability to blink is a common complication. ## Treatment Medical management with anti-inflammatories and antibiotics if infection is suspected; surgical ceratohyoidectomy to reduce forces on the joint. Corneal protection is essential. ## Recovery and Prognosis Guarded. Some neurologic signs improve after surgery or with time; residual deficits are common. Corneal scarring can affect vision. ## Prevention None specific. Early recognition of subtle signs may allow intervention before fracture.
facial paralysis (ear and lip droop); reduced blinking and tear production; head tilt; ataxia; corneal ulceration