Thukral Himanshu, Nagori Shakil Ahmed, Rawat Aditi, Jose Anson
Department of Oral and Maxillofacial Surgery, Army Dental Centre (Research & Referral).
303 Field Hospital, Delhi, India.
J Craniofac Surg. 2019 Oct;30(7):e643-e645. doi: 10.1097/SCS.0000000000005700.
Pterygoid hamular bursitis is a rare craniofacial pain syndrome used to describe palatal and pharyngeal pain due to an enlarged pterygoid hamulus. The pterygoid hamulus is a hook-shaped bony process located bilaterally on each medial pterygoid plate of the sphenoid bone, posterior and medial to each maxillary tuberosity. These processes project downward and anterolaterally; serve as attachment for ligaments and a network of muscles. It can be palpated in patients with a finger palpating the posteromedial to maxillary tuberosity. The pathogenesis is elusive and varies from bursitis of tensor veli palatine, elongated pterygoid hamulus, persistent trauma to the mucosa overlying the pterygoid hamulus. The clinical features include strange chronic sensation, burning, swelling, and erythema of the pterygoid hamulus region. The pain often radiates to pharynx, ipsilateral face and sometimes radiating to temporal region making it difficult to diagnose from headache, temporomandibular disorders, and dental infections like pericoronitis. The anatomical neighboring structures in relation to oropharyngeal region may give a misleading diagnosis to dentist in case of pterygoid hamulus bursitis. The understanding of pterygoid hamulus anatomy and its relation to surrounding structures is necessary to get the correct diagnosis of the inflammatory or traumatic pain in oropharyngeal region.
翼钩滑囊炎是一种罕见的颅面部疼痛综合征，用于描述因翼钩增大引起的腭部和咽部疼痛。翼钩是位于蝶骨两侧翼突内侧板上、上颌结节后方和内侧的钩状骨质突起。这些突起向下和向前外侧突出；作为韧带和肌肉网络的附着点。在患者中，用手指触诊上颌结节后内侧时可触及该部位。其发病机制尚不明确，可能源于腭帆张肌滑囊炎、翼钩过长、翼钩上方黏膜的持续性创伤等。临床特征包括翼钩区域奇怪的慢性感觉、灼痛、肿胀和红斑。疼痛常放射至咽部、同侧面部，有时还放射至颞部，这使得它难以与头痛、颞下颌关节紊乱以及像智齿冠周炎这样的牙齿感染相鉴别诊断。在翼钩滑囊炎的情况下，与口咽区域相关的解剖学相邻结构可能会给牙医造成误诊。了解翼钩的解剖结构及其与周围结构的关系对于正确诊断口咽区域的炎性或创伤性疼痛是必要的。
