Kef Kemal
Private Kesan Hospital, Department of ENT, Edirne, Turkey.
J Pain Res. 2021 Apr 19;14:1051-1059. doi: 10.2147/JPR.S292550. eCollection 2021.
The aim of this study was to determine the effectiveness of botulinum toxin administration in patients who consulted the otolaryngology clinic with secondary otalgia caused by bruxism.
Botulinum toxin can be applied to the hypertrophic muscles in patients who suffer from facial asymmetry even though they do not experience pain. Injection intervals and the condition of the muscles should be monitored as botulinum toxin applications to the muscles may result in decreased muscle strength and chewing difficulties.
This prospective study was conducted with bruxism patients at Private Kesan Hospital otorhinolaryngology outpatient clinic between August 2019 and December 2019. The diagnosis was based on the anamnesis and physical examination of the patient. The Visual Analogue Scale was used to evaluate patients' pain levels throughout the treatment.
A total of 37 patients, between 19 and 51 years old, 22 (59.46%) females and 15 (40.54%) males, who consulted to the otolaryngology clinic in Private Kesan Hospital between August 2019 and December 2019 with a diagnosis of otalgia caused by bruxism were included in the study. Nine patients (24.3%) had facial asymmetry due to masseter muscle hypertrophy. The average age of the participants was 34.00 ± 9.13 years old. Two weeks after the application of botulinum toxin, patients' complaints subsided. In patients with facial asymmetry, it was observed that asymmetry decreased after the 2nd month and noticeably improved after the 4th month.
Bruxism should be considered in the differential diagnosis of patients with ear pain. Botulinum toxin can be applied in patients who do not respond adequately to classical treatments such as medical treatments, chewing training, neck and facial muscle relaxation techniques, psychological support, and dental splint applications.
本研究旨在确定向因磨牙症导致继发性耳痛而就诊于耳鼻喉科门诊的患者注射肉毒杆菌毒素的有效性。
肉毒杆菌毒素可应用于面部不对称但无疼痛症状患者的肥厚肌肉。由于向肌肉注射肉毒杆菌毒素可能导致肌肉力量下降和咀嚼困难，因此应监测注射间隔和肌肉状况。
本前瞻性研究于2019年8月至2019年12月在Kesan私立医院耳鼻喉科门诊对磨牙症患者进行。诊断基于患者的病史和体格检查。在整个治疗过程中，使用视觉模拟量表评估患者的疼痛程度。
共有37例年龄在19至51岁之间的患者纳入研究，其中女性22例（59.46%），男性15例（40.54%），这些患者于2019年8月至2019年12月因磨牙症导致耳痛而就诊于Kesan私立医院耳鼻喉科门诊。9例患者（24.3%）因咬肌肥大出现面部不对称。参与者的平均年龄为34.00±9.13岁。注射肉毒杆菌毒素两周后，患者的症状有所缓解。在面部不对称的患者中，观察到在第2个月后不对称情况有所减轻，在第4个月后明显改善。
在耳痛患者的鉴别诊断中应考虑磨牙症。对于对药物治疗、咀嚼训练、颈部和面部肌肉放松技术、心理支持以及牙托应用等传统治疗反应不佳的患者，可应用肉毒杆菌毒素。
