Kodama Yasumitsu, Seo Kenji, Hayashi Takafumi, Kobayashi Takanori, Niwano Masahiro, Koyama Takahiro, Murayama Masaaki, Takagi Ritsuo
Division of Oral and Maxillofacial Surgery, Niigata Graduate School of Medical and Dental Sciences 5274, 2-Banchou, Gakkouchoudoori, chuuouku, Niigata, 951-8514 Japan.
Cranio. 2012 Jul;30(3):183-7. doi: 10.1179/crn.2012.028.
The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. However, sonography indicated the location of the suspected lesion. Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ.
