解开十年的误诊和痛苦:在多年的多学科方法失败后,解决慢性口腔下颌肌张力障碍的开创性诊断和治疗突破。

IF 1 4区 医学 Q3 SURGERY
Mohammed Rhael Ali, Basim Ali Qasim, Elham Hazeim Abdulkareem
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引用次数: 0

摘要

口腔肌张力障碍(OMD)是一种罕见的影响下颌肌肉的运动障碍,可引起言语、吞咽、t、t等口腔运动困难。患者最初诊断为颞下颌关节紊乱或神经痛,平均4年未接受充分治疗。该研究旨在评估通过A型肉毒杆菌毒素(Botox)注射治疗最初多学科治疗失败的慢性OMD患者的结果。在2021年10月至2024年5月期间,对12名对其他治疗无反应的OMD患者进行了一项干预性前瞻性抗ret研究。肉毒杆菌毒素注射到LP和MM使用标准化的模式和剂量。可测量的评估目标包括张嘴和进食和说话的功能方面,这些评估时间长达1年。治疗效果评价采用配对t检验进行重复测量方差分析。观察到预期较早结果的有利变化;预处理后平均口开度由1.2 cm增加至3.6 cm (P < 0.001)。在饮食和说话方面的功能改善达到75%。66.7%的患者在12个月时持续获益,尽管复发率为25%。精确注射肉毒杆菌素导致显著的临床改善和持久的影响,最大的病人与OMD。尽管大多数患者获得了长期的积极结果,但一些患者的复发要求进一步的持续随访。通过尽早正确识别症状并进行后续治疗,可以大大提高OMD管理的总体有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unraveling a Decade of Misdiagnosis and Suffering: A Pioneering Diagnostic and Therapeutic Breakthrough in Resolving Chronic Oromandibular Dystonia After Years of Failed Multidisciplinary Approaches.

Oromandibular dystonia (OMD) is a rare movement disorder affecting the jaw muscles, causing speech, swallowing, t, T, and other oral movement difficulties. Patients are initially diagnosed with temporomandibular joint disorders, or neuralgias, and receive no adequate treatment for an average of 4 years. The study aims to assess the management outcome through botulinum toxin type A (Botox) injection in patients with chronic OMD who failed initial multidisciplinary approaches. An interventional prospective anti-RET study was set between October 2021 and May 2024 with 12 OMD patients who did not respond to other treatments. Botox was injected into the LP and MM using a standardized pattern and dosage. The measurable evaluation goals included mouth opening and functional aspects of eating and speaking, which were evaluated at times up to 1 year. The treatment efficacy was assessed based on paired t tests as repeated measures ANOVA. Favourable changes were observed that anticipated the earlier results; the mean pretreated mouth opening augmented from 1.2 to 3.6 cm (P < 0.001) after treatment. Functional improvements were observed in eating and speaking at a level of 75%. In 66.7% of the patients, a sustained benefit was reported at 12 months, although had a 25% relapse rate. Precise injections of Botox lead to striking clinical improvement and lasting effects in the greatest patients with OMD. Although most enjoyed long-term positive outcomes, some patients' relapses assert further constant follow-up. The overall effectiveness of OMD management may be greatly enhanced by properly identifying symptoms as early as possible and the subsequent treatment.

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来源期刊
CiteScore
1.70
自引率
11.10%
发文量
968
审稿时长
1.5 months
期刊介绍: ​The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial surgery, maxillofacial surgery and pediatric plastic surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The journal publishes original articles, scientific reviews, editorials and invited commentary, abstracts and selected articles from international journals, and occasional international bibliographies in craniofacial surgery.
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