# The calcified Sphenomandibular ligament: case report, surgical management and literature review

## TL;DR

A rare case of calcification in the Sphenomandibular ligament is reported, with successful surgical treatment improving jaw function.

## Contribution

This is the fourth documented case of Sphenomandibular ligament calcification, providing new clinical insights and management strategies.

## Key findings

- Calcification of the Sphenomandibular ligament was confirmed through imaging and surgery.
- Surgical excision significantly improved the patient's mandibular function.
- The case highlights the importance of considering rare ligamentous pathologies in persistent trismus.

## Abstract

Calcification of the Sphenomandibular ligament (SML) is an extremely rare condition, with only three previously documented cases worldwide. This report presents the fourth known case of SML calcification in a 32-year-old male patient with a 17-year history of progressive trismus. Following a dental procedure involving a mandibular nerve block, the patient gradually developed limited mouth opening, which was resistant to conservative treatments. Imaging revealed calcification of the SML, which was confirmed intraoperatively. Surgical excision led to a significant improvement in mandibular function. This report discusses clinical presentation, diagnostic workup, surgical management, and a comprehensive literature review, emphasizing the importance of considering rare ligamentous pathologies in cases of persistent trismus.