Claeys T, Bremerich A, Cesteleyn L, Kovacs B
Dienst Maxillo-Faciale Chirurgie, AZ St-Elisabeth, Zottegem.
Acta Stomatol Belg. 1992 Dec;89(4):239-48.
The diagnosis and treatment of facial pain remains a great challenge for oral and maxillofacial surgeons. By taking an exact anamnesis--especially a pain anamnesis--and by starting specific examinations the patient can quickly be recommended to a qualified therapist. The pain syndromes are classified according to the IASP (International Association for the Study of Pain). The pain syndromes the maxillofacial surgeon is most frequently confronted with--idiopathic trigeminal neuralgia, atypical facial pain and the temporomandibular joint--are described. The necessity of a multidisciplinary examination is emphasized and the different diagnostic investigations are illustrated, particularly in the case of myo-arthropathy. Beside the analysis of temporomandibular joint dysfunction, a radiologic examination is performed. In some cases the advise of a neurologist, ophthalmologist or otolaryngologist may be indicated.
面部疼痛的诊断和治疗对口颌面外科医生来说仍然是一个巨大的挑战。通过进行准确的问诊——尤其是疼痛问诊——并开展特定检查,可迅速为患者推荐合格的治疗师。疼痛综合征根据国际疼痛研究协会(IASP)进行分类。文中描述了颌面外科医生最常遇到的疼痛综合征——特发性三叉神经痛、非典型面部疼痛和颞下颌关节疾病。强调了多学科检查的必要性,并举例说明了不同的诊断性检查,特别是在肌骨病的情况下。除了分析颞下颌关节功能障碍外,还需进行放射学检查。在某些情况下,可能需要咨询神经科医生、眼科医生或耳鼻喉科医生的意见。