超声引导下牙槽神经阻滞用于牙科治疗期间牙关紧闭：一例报告
Ultrasound-guided inferior alveolar nerve block for trismus during dental treatment: a case report.
作者信息
Kojima Yuki, Sendo Ryozo, Ohno Sachi, Sugimura Mitsutaka
机构信息
Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
出版信息
JA Clin Rep. 2020 Dec 2;6(1):94. doi: 10.1186/s40981-020-00400-0.
BACKGROUND
Temporomandibular disorder (TMD) is a broad term that encompasses pain and/or dysfunction of the masticatory musculature and TM joints (TMJs). When TMD becomes a chronic condition, the symptoms are extremely difficult to manage and require multiple interventions.
CASE PRESENTATION
A woman in her 50s developed TMD after a traffic accident 30 years ago. The patient presented with severe trismus due to TMJ pain and a maximum mouth opening of 20 mm. Ultrasound-guided inferior alveolar nerve block (IANB) was performed with ropivacaine. After IANB, the pain during mouth opening subsided and the maximum mouth opening improved to 40 mm. Dental treatment could be performed without difficulty and the patient could keep her mouth open throughout the treatment.
CONCLUSIONS
Treatments for chronic TMD are limited and it is necessary to identify the precise etiology before choosing a treatment option. In this patient, ultrasound-guided IANB proved to be effective in relieving TMD-related trismus.
背景
颞下颌关节紊乱病（TMD）是一个广义术语，涵盖咀嚼肌和颞下颌关节（TMJ）的疼痛和/或功能障碍。当TMD发展为慢性疾病时，症状极难控制，需要多种干预措施。
病例报告
一名50多岁的女性在30年前的一次交通事故后患上了TMD。患者因颞下颌关节疼痛出现严重牙关紧闭，最大开口度为20毫米。使用罗哌卡因进行超声引导下的下牙槽神经阻滞（IANB）。IANB后，开口时的疼痛减轻，最大开口度改善至40毫米。牙科治疗能够顺利进行，患者在整个治疗过程中能够保持张口。
结论
慢性TMD的治疗方法有限，在选择治疗方案之前有必要确定确切病因。在该患者中，超声引导下的IANB被证明对缓解TMD相关的牙关紧闭有效。
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