Temporomandibular joint syndrome treatment with peripheral nerve stimulation

A. Arévalo-Sáenz, F. Rascón-Ramírez, M. Pedrosa Sánchez
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Abstract

Introduction: Temporomandibular joint syndrome is defined by a triad of intense joint pain together with restriction of mouth opening and jaw clicking. The objective of this study is to evaluate the efficacy and safety of peripheral nerve stimulation for the treatment of this pathology. Material and Methods: A retrospective study was conducted. All patients met selection criteria that include prior resistance to medical or surgical treatment and completion of a series of pre-surgical tests. An octopolar electrode was implanted in the affected preauricular region. The results were measured using the Analog Pain Scale, a short questionnaire on pain, improvement of restriction in mouth opening and reduction of analgesic medication.Results: A total of 10 patients with 14 performed procedures were included. The mean reduction in pain measured by VAS was 86.2% at one month and 79% at one year after surgery. All patients experienced a drastic improvement in pain and its impact according to the Brief Pain Inventory, the mean improvement being 90% at 4 weeks and 82% at one year. There was an improvement in the mean oral opening of 10.14 mm (minimum of 4 and maximum of 13 mm). One case was excluded due to the complication demanding the system removal.Conclusions: Patients with temporomandibular joint syndrome who do not respond to conventional treatments are ideal candidates for peripheral nerve stimulation, showing improvement in pain, oral restriction, and quality of life with a low percentage of serious complications.
周围神经刺激治疗颞下颌关节综合征
简介:颞下颌关节综合征是由三种强烈的关节疼痛以及张嘴受限和下颌咔咔声定义的。本研究的目的是评估周围神经刺激治疗这种病理的有效性和安全性。材料与方法:回顾性研究。所有患者均符合选择标准,包括先前对药物或手术治疗的抵抗力以及完成一系列手术前检查。在受影响的耳前区植入一个八爪电极。结果采用模拟疼痛量表,一份简短的疼痛问卷,改善张嘴限制和减少镇痛药物。结果:共纳入10例患者,14例手术。术后1个月VAS测量的疼痛平均减轻率为86.2%,术后1年为79%。根据简短疼痛量表,所有患者的疼痛及其影响均有显著改善,4周时平均改善90%,1年时平均改善82%。平均口开度提高10.14 mm(最小4 mm,最大13 mm)。1例因并发症需要移除系统而被排除。结论:对常规治疗无效的颞下颌关节综合征患者是周围神经刺激的理想选择,可以改善疼痛、口腔限制和生活质量,严重并发症发生率低。
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