Vázquez Bouso Olga, Forteza González Gabriel, Mommsen Jens, Grau Víctor Gumbao, Rodríguez Fernández Javier, Mateos Micas Mario
Maxillofacial Surgical Department, Joan XXIII Hospital, Tarragona, Spain.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):e33-7. doi: 10.1016/j.tripleo.2009.10.046.
Many patients suffer recurrent episodes of temporomandibular joint (TMJ) dislocation due to an excess of muscle contraction or spasticity in the depressor muscles of the jaw. The manual repositioning using the Nelaton maneuver is the first treatment. Occasionally, it may be necessary to use sedation or general anesthesia to achieve the desired muscle relaxation. In case of recurrence, surgical treatment is indicated. One nonsurgical method of treatment is the local infiltration of botulinum toxin type A. We present 4 cases of recurrent TMJ dislocation in patients suffering from conditions of neurologic origin, with considerable motor deterioration, treated with local infiltration of botulinum toxin type A. In conclusion, the injection of botulinum toxin type A is an effective method in cases of neurogenic TMJ dislocation, with low morbididty and side effects, improving patients' quality of life.
许多患者因下颌降肌过度收缩或痉挛而反复出现颞下颌关节（TMJ）脱位。使用内拉通手法进行手动复位是首选治疗方法。偶尔，可能需要使用镇静剂或全身麻醉以达到所需的肌肉松弛效果。若出现复发，则需进行手术治疗。一种非手术治疗方法是局部注射A型肉毒杆菌毒素。我们报告了4例患有神经源性疾病且伴有明显运动功能减退的复发性TMJ脱位患者，采用局部注射A型肉毒杆菌毒素进行治疗。总之，注射A型肉毒杆菌毒素是治疗神经源性TMJ脱位的有效方法，具有低发病率和副作用，可改善患者生活质量。
