肉毒杆菌毒素治疗翼外肌严重颞下颌关节弹响伴关节盘前移位2例报告
Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement.
作者信息
Bakke Merete, Møller Eigild, Werdelin Lene M, Dalager Torben, Kitai Noriyuki, Kreiborg Sven
机构信息
Department of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, School of Dentistry, University of Copenhagen, Denmark.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Dec;100(6):693-700. doi: 10.1016/j.tripleo.2004.11.019.
A novel treatment procedure is introduced for severe clicking of the temporomandibular joint (TMJ) associated with anterior disc displacement (ADD), using injections with botulinum toxin (BTX-A) in the lateral pterygoid muscle (LP). It has been suggested that ADD may be caused, precipitated, or maintained by LP activity, but the role of the LP in the dynamics of the TMJ clicking is uncertain. The case report includes 2 women, followed with clinical examinations, TMJ imaging, and electromyography (EMG), in whom local anesthetics in the LP could abolish the clicking for several days. BTX-A block of the LP (30 U Botox, given twice under EMG guidance with 6-month interval) temporarily reduced the action of the muscle, but the clicking was permanently eliminated and did not return during the observation period of 1 year, and a small but distinctive positional improvement in the disc-condyle relationship was obtained. However, the precise mechanisms behind the favourable treatment outcome are unclear.
本文介绍了一种针对与关节盘前移位（ADD）相关的颞下颌关节（TMJ）严重弹响的新型治疗方法，即向翼外肌（LP）注射肉毒杆菌毒素（BTX-A）。有研究表明，ADD可能由LP活动引起、诱发或维持，但LP在TMJ弹响动态过程中的作用尚不确定。该病例报告包括2名女性，她们接受了临床检查、TMJ影像学检查和肌电图（EMG）检查，在这些患者中，向LP注射局部麻醉剂可使弹响消失数天。对LP进行BTX-A阻滞（30 U保妥适，在EMG引导下分两次注射，间隔6个月）可暂时减弱肌肉的作用，但弹响被永久消除，且在1年的观察期内未复发，同时在盘-髁关系上获得了微小但显著的位置改善。然而，良好治疗效果背后的确切机制尚不清楚。
Zotero 插件