[Multidisciplinary treatment of orofacial pain and dysfunction after a transoral condylectomy: the role of pain, sleep, and psychotrauma].

Abstract

A 45-year-old woman continued to suffer from an open bite, pain in the left temporomandibular joint, jaw muscle tightness, and ringing in both ears 6 months after an unilateral left condylectomy. A recovery surgery was planned to treat the open bite and she was referred to the department for Orofacial Pain and Dysfunction for treatment of the pain complaints, muscle tightness, and ringing in the ears. At this department she was diagnosed with temporomandibular disorders. Muscle tension, oral behaviors, and anxiety were expected to play a role in the etiology. Fear for the recovery surgery contributed to the onset and maintenance of the complaints. A multidisciplinary treatment was started, including counseling, exercise therapy, psychological treatment, and stabilization splint therapy that would take place after the replacement of the temporomandibular joint. After completion of the treatment, the anxiety had disappeared, and the pain and muscle tension were reduced significantly. The remaining pain and muscle tension resolved following a successful recovery surgery and further orofacial physiotherapy.