An atypical path of the lingual nerve in the retromolar region: Incidence in oral surgery

The Lingual nerve is frequently anesthetized during oral, maxillofacial or otorhinolaryngology surgery. It originates below the oval hole in the infratemporal region, follows its path down and forward, and moves away from the medial surface of the ramus and goes just above the mylohyoid line. It approaches the lateral margin of the tongue and crosses the Wharton's canal, and divides into numerous branches. As described in the literature, some cases of temporomandibular joint syndrome or myofascial pain syndrome could be a result of its anatomical variations. Also, the jurisprudence has always tried to condemn the practitioner if he did not demonstrate that the path of the injured nerve presents an anomaly which makes his involvement inevitable. The purpose is to present one of the multiple atypical paths of the lingual nerve not described in the retromandibular trigone demonstrating that its damage constitutes a risk that cannot be controlled.

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Myofascial pain syndrome in the dysfunction of the temporomandibular joint

Zhurnal nevrologii i psikhiatrii im S S Korsakova ◽

10.17116/jnevro201911911121 ◽

2019 ◽

Vol 119 (11) ◽

pp. 21

Author(s):

J. V. Kotsiubinskaya ◽

V. A. Mikhailov ◽

G. E. Mazo ◽

I. A. Ashnokova

Keyword(s):

Temporomandibular Joint ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome

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Intra-articular biomaterials-assisted delivery to treat temporomandibular joint disorders

Journal of Tissue Engineering ◽

10.1177/2041731418776514 ◽

2018 ◽

Vol 9 ◽

pp. 204173141877651 ◽

Cited By ~ 15

Author(s):

Khandmaa Dashnyam ◽

Jung-Hwan Lee ◽

Nandin Mandakhbayar ◽

Guang-Zhen Jin ◽

Hae-Hyoung Lee ◽

...

Keyword(s):

Temporomandibular Joint ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Cartilage Degradation ◽

Current Treatment ◽

Temporomandibular Joint Disorders ◽

Assisted Delivery ◽

Joint Disorder ◽

Therapeutic Molecules

The temporomandibular joint disorder, also known as myofascial pain syndrome, is considered one of the prevalent chronic pain diseases caused by muscle inflammation and cartilage degradation in head and neck, and thus influences even biopsychosocial conditions in a lifetime. There are several current treatment methodologies relieving inflammation and preventing degradation of the joint complex. One of the promising non-surgical treatment methods is an intra-articular injection of drugs such as corticosteroids, analgesics, and anti-depressants. However, the side effects of drugs due to frequent injections and over-doses, including dizziness, dry mouth, and possible drug dependency are considered limitations. Thus, the delivery of therapeutic molecules through the use of nano/microparticles is currently considered as a promising strategy primarily due to the controlled release. This review highlights the nano/microparticle systems for effective intra-articular therapeutics delivery to prevent cartilage degradation and protect subchondral bone in a temporomandibular joint.

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Knowledge and practices of myofascial pain syndrome of the temporomandibular joint by dentists in the Greater eThekwini region

10.51415/10321/3070 ◽

2018 ◽

Author(s):

◽

Hyla Van der Colff

Keyword(s):

Temporomandibular Joint ◽

Myofascial Pain ◽

Management Strategies ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Differential Diagnoses ◽

Graduate Courses ◽

Referral Patterns ◽

Post Graduate ◽

Knowledge Utilisation

BACKGROUND: Temporomandibular disorders (TMDs) affect up to fifteen percent of adults. It produces craniofacial pain of musculoskeletal structures within the head and neck. One particular cause of TMDs is said to be myofascial pain syndrome (MFPS), which according to various research papers, if not considered and/or assessed, the general cause of a patient’s pain could be disregarded and incorrect treatment offered. Numerous studies conducted internationally on dental management of temporomandibular joint disorder (TMJD) concluded that there is a significant gap in dentists’ education and training regarding the identification and management of MFPS. Upon reviewing the current literature available in South Africa, very little research existed on dentists’ knowledge and the management strategies that they utilised regarding MFPS in TMJD patients. OBJECTIVES: To determine the dentists’ knowledge regarding MFPS of the temporomandibular joint (TMJ). What assessment and treatment/management strategies they use, and whether they make use of referral networks and if the respondents’ demographics influence their knowledge, utilisation, perception and referral patterns. METHODOLOGY: The researcher developed a research questionnaire, which was validated by both an expert and a pilot study group. This questionnaire was then used as a research tool in this cross-sectional study. General dental practitioners from the Greater eThekwini Region received an invitation to participate. The questionnaire-based survey consisted of five sections: biographical profile of respondents; topic background; perception; knowledge; utilisation and management (including referral patterns) of MFPS. RESULTS: The majority of respondents did receive basic education in MFPS, with 76.9% reporting that they received undergraduate education and 57.7% indicating that they had attended post-graduate courses/talks on MFPS. There was a 100% response from dentists indicating their willingness to attend post-graduate courses/talks on MFPS. The results indicated that the respondents, who felt that their curriculum regarding MFPS was sufficient, were more knowledgeable and more competent in diagnosing and managing MFPS. Overall, the average score for knowledge was 65.17%. Clinical features (78.85%) and the perpetuating and relieving factors (72.11%) scored the highest while causes (58.06%) and differential diagnoses (51.16%) scored the lowest knowledge levels. Respondents mostly made use of allopathic medical fields, and not of alternative medical fields, however a high number of respondents (73.1%) indicated that they would consider chiropractic co–management of patients with MFPS. CONCLUSION: This study adds new information in the South African context regarding dentists’ understanding of the myofascial component of TMDs. It also provides the dental profession with information about the knowledge and practices related to MFPS as well as information regarding the strengths and weaknesses on its educational component. It is recommended that dentists receive additional training on differential diagnoses and causes. It is also recommended that the chiropractic profession take this opportunity to offer courses/talks on MFPS and join forces with the dentistry profession on how they can assist in managing patients with MFPS.

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Diagnostics and treatment of myofascial syndrome in the ENT-clinic: analysis of ﬁve-year experience of L. I. Sverzhevskiy Otorhinolaryngology Research Clinical Institute

Russian Osteopathic Journal ◽

10.32885/2220-0975-2018-1-2-28-37 ◽

2018 ◽

pp. 28-37

Author(s):

M. V. Tardov ◽

N. L. Kunelskaya ◽

A. V. Boldin ◽

L. G. Agasarov ◽

E. V. Baybakova ◽

...

Keyword(s):

Temporomandibular Joint ◽

Myofascial Pain ◽

Collaborative Work ◽

Interdisciplinary Approach ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Pathogenetic Therapy ◽

Loss Of Hearing ◽

Myofascial Syndrome

Goal of research - to evaluate the role of myofascial syndrome developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders. The myofascial syndrome manifests itself in the development of pain phenomena, cochlear and vestibular symptoms similar to the symptoms of the diseases of the ENT organs.Materials and methods. We have analyzed the results of several studies conducted in 2012-2017 at L. I. Sver-zhevsky Otorhinolaryngology Research Clinical Institute, which involved more than 3 000 people with neck and head pain and/or cochleovestibular symptoms in combination with myofascial pain syndrome (MFPS), developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders.Results. Patterns of development of the MFPS in head and neck regions, as well as peculiarities of diagnostics of trigger points with pain and non-pain manifestations (buzzing in ears, ear fullness, loss of hearing, dizziness) were deﬁ ned. The principles of MFPS treatment with pain and non-pain manifestations and therapy options used in L. I. Sverzhevsky Otorhinolaryngology Research Clinical Institute were described. The effect of pathogenetic therapy is shown in the collaborative work of doctors of different specialties: ENT specialist, neurologist, physiotherapist and dentist.Conclusion. Myofascial syndrome of the pericranial muscles can be one of the causes of face and neck pain imitating diseases of ENT organs and dental pathologies. Treatment of such clinical forms should be the subject of an interdisciplinary approach. It should include pharmaceutical and non-pharmaceutical methods: analgesia, relaxation and stretching of the corresponding muscles.

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A cadaveric study: the morphometric differences in the levator scapulae muscle

Anatomy Journal of Africa ◽

10.4314/aja.v8i2.187580 ◽

2019 ◽

Vol 8 (2) ◽

pp. 1504-1514

Author(s):

Jan H.T. Smit ◽

Matthew R.H. Todd

Keyword(s):

Shoulder Pain ◽

Myofascial Pain ◽

Cervical Vertebra ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Anatomical Variations ◽

First Report ◽

Levator Scapulae ◽

Neck And Shoulder Pain ◽

Levator Scapulae Muscle

Although the levator scapulae are surrounded in the deep cervical fascia, it can be separated into a number of muscle slips at the proximal attachment. Originally the muscle was described as having 3 muscle slips at its origin. More recent texts have now adopted 4 slips of origin. Each slip coming from a different cervical vertebra. Levator scapulae is important with myofascial pain syndrome which is one of the leading causes of neck and shoulder pain. Surgically it can also be used to overcome trapezius paralysis. Anatomical variations of the levator scapulae are important and therefore clinically relevant. In this dissection study, we have investigated the morphometric differences in 46 levator scapulae muscles from 23 cadavers. Measurements of the proximal- and distal attachments and the total length of the muscles were taken. Between 3 and 6 muscle slips were reported at the proximal attachment. Differences were also observed between sides. The first report of a levator scapula muscle with 6 muscle slips at the proximal attachment, is described in this study.Keywords: Origin (proximal attachment); insertion (distal attachment); muscle slips

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