Repair of the foramen of Huschke using an extended endaural approach.

INTRODUCTION The foramen of Huschke develops due to an ossification defect of the anteroinferior part of the temporal bone in the first 5 years of life and is an anatomic variation of the tympanic portion of the temporal bone. A small-sized (mean 2.7 mm in length and 2.0 mm in width) persistent foramen is commonly observed in 9% to 27% of adult temporal bone and varies with age and sex. However, spontaneous temporomandibular joint (TMJ) herniation that requires surgical intervention is rare. A persistent foramen of Huschke may result in complications, such as TMJ herniation and salivary fistula formation, and facilitate ear injury during TMJ arthroscopy. Previous studies have reported successful preauricular approaches to surgery in these cases. We herewith report two cases with a patent foramen of Huschke that presented with TMJ herniation and otalgia. We repaired this defect using an extended endaural method and we herewith discuss the advantages of our approach.