Rosèn Annika, Helgeland Espen, Pedersen Torbjørn Ø
Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
Dent Clin North Am. 2023 Jan;67(1):61-70. doi: 10.1016/j.cden.2022.07.005. Epub 2022 Oct 28.
This article describes a woman in her forties who spontaneously developed facial pain 19 years after double-jaw orthognathic surgery. The focus of her pain was the left side of the face, including the temporomandibular joint (TMJ). Conservative treatment was initiated, including several occlusal splints, in addition to injections with local anesthesia, botulinum toxin, and corticosteroids, with limited effects. Surgical treatments with arthroscopy and discectomy, and ultimately a TMJ prosthesis, improved the patient's joint function but did not reduce pain. The question is whether the degenerated joint was due to progression of the original disease process or to multiple surgical procedures.
本文描述了一位四十多岁的女性，她在双颌正颌手术后19年自发出现面部疼痛。她疼痛的重点在面部左侧，包括颞下颌关节（TMJ）。开始了保守治疗，包括使用几种咬合夹板，此外还进行了局部麻醉、肉毒杆菌毒素和皮质类固醇注射，但效果有限。关节镜检查和椎间盘切除术等手术治疗，以及最终的TMJ假体植入，改善了患者的关节功能，但并未减轻疼痛。问题在于退变的关节是由于原发病进程的进展还是多次外科手术所致。
