Steigerwald D P, Verne S V, Young D
Cranio. 1996 Jan;14(1):46-54. doi: 10.1080/08869634.1996.11745949.
Forty-three patients who underwent arthroscopic surgery for arthrogenous TMD were polled concerning the effect of surgery on the symptoms of headache, neck pain, shoulder pain, dizziness and tinnitus. Statistically significant levels of symptom reduction were recorded for all symptoms polled. This indicates that a substantial number of significant symptoms are produced by the influence of temporomandibular joint pathology on central neural processes. A model for the affect of temporomandibular joint pathology on cervical and masticatory musculature is proposed. This data implies that we cannot use muscle tenderness, hypertonicity and/or pain to differentiate arthrogenous from myogenous temporomandibular disorders. The characteristics of a population of whiplash onset TMD patients were compared to other TMD populations. The results indicate that whiplash induced TMD may differ from insidious onset TMD and even other trauma onset TMDs by prevalence of neck pain, intensity of neck pain and probability of concurrence of neck pain, shoulder pain, headache and jaw pain. These symptoms resolved within 24 hours of arthroscopic temporomandibular joint surgery indicating that the temporomandibular joint pathology was the perpetuating force behind, if not the cause of, these symptoms.
对43例行关节镜手术治疗关节源性颞下颌关节紊乱病（TMD）的患者进行了调查，询问手术对头痛、颈部疼痛、肩部疼痛、头晕和耳鸣症状的影响。所有调查症状的减轻程度均具有统计学意义。这表明大量明显症状是由颞下颌关节病理改变对中枢神经过程的影响所致。提出了颞下颌关节病理改变对颈部和咀嚼肌影响的模型。该数据表明，我们不能用肌肉压痛、张力亢进和/或疼痛来区分关节源性和肌源性颞下颌关节紊乱病。将一组挥鞭样损伤引发的TMD患者的特征与其他TMD患者群体进行了比较。结果表明，挥鞭样损伤引发的TMD在颈部疼痛的发生率、颈部疼痛的强度以及颈部疼痛、肩部疼痛、头痛和颌部疼痛并发的可能性方面，可能与隐匿性发病的TMD甚至其他创伤性发病的TMD不同。这些症状在关节镜颞下颌关节手术后24小时内得到缓解，这表明颞下颌关节病理改变即便不是这些症状的病因，也是其背后的持续作用力。
