Alvarez-Arenal Angel, Gonzalez-Gonzalez Ignacio, Moradas Estrada Marcos, deLlanos-Lanchares Hector, Costilla-Garcia Serafin
a Department of Prosthodontics and Occlusion , School of Dentistry, University of Oviedo , Spain.
b Department of Radiodiagnostic , Central Universitary Hospital of Asturias , Spain.
Cranio. 2016 Jul;34(4):264-9. doi: 10.1179/2151090315Y.0000000018. Epub 2016 Mar 24.
The purpose of this case study is to show the need for a good differential diagnosis of suspected temporomandibular disorder (TMD) with otologic symptoms.
METHODS/RESULTS: This study is a clinical case referring to a patient seeking treatment for pain in the right maxilla. The usual Medical History for diagnosis of a TMD was applied. Anamnesis revealed the patient had had a right maxillary pain for one month, a slight hearing loss and dizziness for the past five to six months, and two implants placed in the upper jaw two years previously. Clinical examination showed right temporomandibular joint (TMJ) clicking and tenderness in the lateral pterygoid muscles and in the right masseter muscle. Temporomandibular disorder and orofacial pain were diagnosed, and the appropriate treatment was initiated. In addition, a cranial magnetic resonance imaging (MRI) evaluation was requested and revealed acoustic neuroma.
The coexistence of TMD with otovestibular symptoms suggests the need for a cranial MRI evaluation, especially if the dental or TMD treatment has not been positive.
本病例研究的目的是表明对疑似患有耳科症状的颞下颌关节紊乱病（TMD）进行良好鉴别诊断的必要性。
方法/结果：本研究是一个临床病例，涉及一名因右上颌疼痛寻求治疗的患者。采用了诊断TMD的常规病史采集方法。问诊发现患者右上颌疼痛一个月，过去五到六个月有轻微听力损失和头晕，两年前在上颌植入了两颗种植体。临床检查显示右侧颞下颌关节（TMJ）有弹响，翼外肌和右侧咬肌有压痛。诊断为颞下颌关节紊乱病和口面部疼痛，并开始了适当的治疗。此外，还要求进行头颅磁共振成像（MRI）评估，结果显示患有听神经瘤。
TMD与耳前庭症状并存表明需要进行头颅MRI评估，特别是在牙科或TMD治疗效果不佳的情况下。
