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1.
Ann R Coll Surg Engl ; 102(2): e20-e22, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31219307

RESUMO

We present the case of a 33-year-old man with right-sided facial pain. Clinical examination revealed an isolated mass attached to the right inferior turbinate. This was confirmed with computed tomography. Excision was achieved endoscopically and histology revealed an angioleiomyoma. Full symptomatic relief was achieved after surgical excision. Less than 1% of angioleiomyoma lesions are found within the sinonasal cavity. We describe the first documented presentation of angioleiomyoma as a cause of isolated, unilateral facial pain; a very common presentation to the otorhinolaryngology clinic. We promote consideration of angioleiomyoma as a different diagnosis in the presence of facial pain and a unilateral sinonasal lesion. Endoscopic resection provides complete symptomatic resolution.


Assuntos
Angiomioma/diagnóstico , Dor Facial/etiologia , Obstrução Nasal/etiologia , Neoplasias Nasais/diagnóstico , Adulto , Angiomioma/complicações , Angiomioma/cirurgia , Biópsia , Endoscopia , Dor Facial/cirurgia , Humanos , Masculino , Obstrução Nasal/diagnóstico por imagem , Obstrução Nasal/cirurgia , Neoplasias Nasais/complicações , Neoplasias Nasais/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Conchas Nasais/diagnóstico por imagem , Conchas Nasais/patologia
2.
Acta Odontol Scand ; 78(1): 57-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31401930

RESUMO

Background: Pain in the temporomandibular region is a main complaint causing disability and distress among temporomandibular disorders sufferers.Objectives: The aim of the study was, over an 11-year follow-up on Finnish adult population, to investigate the prevalence of clinically assessed pain-related temporomandibular disorder (TMD) signs, i.e. temporomandibular joint (TMJ) and masticatory muscles (MM) pain on palpation, and their association with sociodemographic background and denture status.Methods: The data were based on the nationally representative Finnish Health 2000 and Health 2011 Surveys (BRIF8901). The sample comprised 1210 adults who underwent clinical oral examinations including TMD signs assessment. Statistical evaluations included chi-square tests and logistic regressions.Results: The prevalence of palpatory MM pain decreased from 9.5% at baseline to 4.6% in the follow-up. Cross-sectionally, presence of palpatory MM pain significantly associated with gender (p < .001, p = .002) and educational level (p < .001, p = .001) in both years, and with age (p = .006) and denture status (p = .022) at baseline. The prevalence of palpatory TMJ pain increased from 2.1% at baseline to 3.5% in the follow-up. Presence of palpatory TMJ pain significantly associated with gender in both years (p = .012, p = .032). Female gender, lower education and palpatory MM pain at baseline predicted palpatory MM pain in the follow-up.Conclusion: Palpatory MM pain is relatively prevalent in adults, yet with a favourable prognosis. Women and people with low education are more susceptible groups. Previous experience of palpatory MM pain increases the risk of exhibiting it later in life.


Assuntos
Dor Facial/etiologia , Estresse Psicológico/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dor Facial/epidemiologia , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Masculino , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Palpação , Prevalência , Estresse Fisiológico , Transtornos da Articulação Temporomandibular/psicologia , Adulto Jovem
4.
J Int Adv Otol ; 15(3): 405-408, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31846920

RESUMO

OBJECTIVES: A lesser known after effect of harvesting temporalis fascia is the post-surgical craniofacial pain. The aim of the study was to evaluate this pain after tympanomastoid surgeries and the effectiveness of silastic sheet interpositioning to prevent this pain. MATERIALS AND METHODS: This pilot study that spanned one year, included patients who underwent tympanoplasty with or without mastoidectomy involving the harvesting of temporalis fascia. At the end of surgery, the wound was closed after silastic sheet was secured over the donor site in cases and without silastic sheet in controls. In the post-operative period, patients scored their temporal pain, tenderness and pain during opening of mouth and mastication on a visual analogue scale (VAS) on day 7, 15, 30 and 90. RESULTS: Visual analogue scale (VAS) scores of the silastic group were lower than the control group on day 7 and 15 after surgery and the difference was statistically significant. In the control group, temporal pain and tenderness were 74% and 81% respectively on day 7. VAS scores of both groups decreased over time and were negligible after 3 months. There were no significant postoperative complications in either group and no reaction or rejection of silastic sheet in the cases. CONCLUSION: Post-surgical craniofacial pain secondary to the harvesting of temporalis fascia is observed in a majority of the patients. This novel technique involving silastic sheet interposition can decimate early post-operative temporal pain, tenderness and masticatory pain.


Assuntos
Dor Facial/prevenção & controle , Dor Pós-Operatória/prevenção & controle , Músculo Temporal/transplante , Coleta de Tecidos e Órgãos/efeitos adversos , Timpanoplastia/efeitos adversos , Adulto , Dor Facial/etiologia , Fáscia/transplante , Feminino , Humanos , Masculino , Dor Pós-Operatória/etiologia , Projetos Piloto , Método Simples-Cego , Resultado do Tratamento , Timpanoplastia/métodos , Adulto Jovem
5.
Pediatr Rheumatol Online J ; 17(1): 83, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856854

RESUMO

BACKGROUND: The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA). METHODS: Forty-five patients with JIA (median age 12 years) and 16 healthy matched controls (median age 13 years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophizing, pain locations and jaw function). RESULTS: JIA patients with orofacial pain had higher degree of stress, depression, catastrophizing and jaw dysfunction compared to subjects without. In turn, these factors were associated with orofacial pain intensity. Also, patients with orofacial pain had higher systemic inflammatory activity. CONCLUSIONS: Orofacial pain in patients with JIA is associated with stress, psychological distress, jaw dysfunction and loss of daily living activities. Pain intensity seems to be the major pain aspect related to these factors. In addition, systemic inflammatory activity appears to be an important factor contributing to orofacial pain in JIA.


Assuntos
Atividades Cotidianas , Artrite Juvenil/complicações , Dor Facial/etiologia , Estresse Psicológico/complicações , Articulação Temporomandibular , Adolescente , Artrite Juvenil/diagnóstico , Artrite Juvenil/fisiopatologia , Criança , Estudos Transversais , Dor Facial/psicologia , Feminino , Seguimentos , Humanos , Masculino , Medição da Dor , Estudos Retrospectivos , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
6.
BMJ Case Rep ; 12(11)2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31690691

RESUMO

Acoustic neuroma (AN) usually manifests with asymmetric hearing loss, tinnitus, dizziness and sense of disequilibrium. About 10% of patients complain of atypical symptoms, which include facial numbness or pain and sudden onset of hearing loss. Patients with atypical symptoms also tend to have larger tumours due to the delay in investigation. We report a particularly interesting case of a patient presented to us with numbness over her right hemifacial region after a dental procedure without significant acoustic and vestibular symptoms. Physical examination and pure tone audiometry revealed no significant findings but further imaging revealed a cerebellopontine angle mass. The changing trends with easier access to further imaging indicate that the presentation of patients with AN are also changing. Atypical symptoms which are persistent should raise clinical suspicion of this pathology among clinicians.


Assuntos
Neoplasias Cerebelares/patologia , Ângulo Cerebelopontino/patologia , Dor Facial/fisiopatologia , Perda Auditiva/fisiopatologia , Neuroma Acústico/patologia , Audiometria de Tons Puros , Neoplasias Cerebelares/complicações , Neoplasias Cerebelares/cirurgia , Dor Facial/etiologia , Feminino , Perda Auditiva/etiologia , Humanos , Pessoa de Meia-Idade , Neuroma Acústico/complicações , Neuroma Acústico/cirurgia , Período Pós-Operatório , Resultado do Tratamento
7.
Otolaryngol Pol ; 73(5): 18-24, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31701903

RESUMO

INTRODUCTION: The aim of the study was to assess the effectiveness of surgical treatment of patients with Eagle's syndrome, taking into account both early and late results. MATERIAL AND METHODS: The study group consisted of 15 patients who underwent resection of the styloid process due to Eagle syndrome in the period of 2005-2017. During the follow-up visit, the patients were asked to fill in a post-operative questionnaire that compared the pre-operative symptoms and their severity with the patients' current health condition. The VAS pain scale was used to assess each symptom, and the Laitinen scale was used to assess the quality of life. Data from patients' medical records were also included. The results of the surveys were subjected to statistical analysis. RESULTS: The study showed that in 11 out of 15 cases there was a significant improvement in the level of pain (70.5% on average) and an improvement in quality of life (on average 65%) comparing to the pre-operative condition. The Wilcoxon test for binding pairs, the Mann-Whitney test, the Kruskal-Wallis test and the Spearman correlation coefficient were used in the statistical analysis. There were statistically significant correlations between the recorded improvement rate and the length of the resected styloid process and its setting. DISCUSSION: The study proved that resection of prolonged styloid process from extraoral approach in most cases is an effective method of treatment of Eagle syndrome, that carries low risk of complications.


Assuntos
Ossificação Heterotópica/psicologia , Ossificação Heterotópica/cirurgia , Qualidade de Vida/psicologia , Índice de Gravidade de Doença , Osso Temporal/anormalidades , Adulto , Dor Facial/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Ossificação Heterotópica/fisiopatologia , Medição da Dor , Osso Temporal/fisiopatologia , Osso Temporal/cirurgia
8.
Acta Clin Croat ; 58(Suppl 1): 82-89, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31741564

RESUMO

The concept of diagnostics and therapy of musculoskeletal and neuropathic diseases of the stomatognathic system, which are the subject of this paper, has been developing for decades. It can be said that in order to avoid misunderstanding, the orofacial pain as a clinical problem, in the narrower sense, involves non-odontogenic and non-malignant causes of orofacial region. In this study, the results of clinical diagnosis of the population of 557 consecutive patients with orofacial pain based on multidisciplinary diagnostics were evaluated. 15.6% of patients have given up on the participation in the study. It has been shown that the patients who dropped out of the study were significantly older (p=0.0411) than those who agreed to participate, but there was no difference in gender ratio (p=0.185) since the proportion of female patients prevailed. In an analysis of 84.4% of patients participating in the study, the elevated anxiety values were established (mean value on STAI 1 was 39.2 and STAI 2 was 41.1) and statistical significance was found in correlation between elevated anxiety and intensity of pain as shown on visual analogue scale on open mouth (p<0.0001). Compared to the age, the statistical significance was for STAI 1 (p=0.0097) but not for STAI 2 (p=0.5599). The most common form of therapy is Michigan stabilization splint: for disc displacement of temporomandibular joint (TMJ) in 38.9% of patients and in combination with physiotherapy in 18.7% of patients; for osteoarthritis of TMJ in 28.4% and in combination with physiotherapy in 26.4% of patients. The treatment with anticonvulsant drugs for trigeminal neuralgia predominates in 54.3% of patients, which is combined with acupuncture in 25.7% of patients and only acupuncture in 17.1% of patients. In this study, a multidisciplinary co-operation in initial diagnostics and differential was designed to develop subspecialist knowledge on orofacial pain.


Assuntos
Dor Facial/terapia , Osteoartrite/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Neuralgia do Trigêmeo/terapia , Terapia por Acupuntura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Criança , Dor Facial/etiologia , Dor Facial/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/complicações , Osteoartrite/diagnóstico , Medição da Dor , Modalidades de Fisioterapia , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico , Neuralgia do Trigêmeo/complicações , Neuralgia do Trigêmeo/diagnóstico , Adulto Jovem
10.
Acta Odontol Latinoam ; 32(2): 65-70, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664295

RESUMO

The aim of this study was to screen for painful TMD conditions by implementing the validated Axis I screening instrument from the Diagnostic Criteria for Temporomandibular Disorders. Using the screener as a surrogate, the prevalence of the conditions was estimated among a convenience sample of dental students in Peru. A total 2,562 dental students, 63.7% women, aged 18 to 62 completed the instrument. Prevalence was estimated using both the short and long versions. The prevalence of painful TMD conditions was 19.4% with the short and 16.1% with the long version. The distribution of the conditions according to gender differed significantly between groups (p<.001). Prevalence estimates of painful TMD conditions using the screening instrument seems to be logistically adequate in a field assessment involving multiple geographic and cultural regions in Peru. These estimates seem to be consistent with internationally reported values.


Assuntos
Dor Facial/diagnóstico , Estudantes de Odontologia/psicologia , Transtornos da Articulação Temporomandibular/diagnóstico , Adolescente , Adulto , Dor Facial/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Estudantes de Odontologia/estatística & dados numéricos , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto Jovem
11.
Niger J Clin Pract ; 22(10): 1365-1371, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607725

RESUMO

Objective: Orofacial pain (OFP) is a unique group of dental conditions with focus on chronic nonodontogenic pain affecting mouth, jaws, and face. The aim of this study is to investigate the knowledge of dentists in Saudi Arabia toward OFP assessment. Materials and Methods: An English language questionnaire containing 20 close-ended questions was used to capture data. The questionnaire included diagnostic criteria and clinical symptoms and signs of various OFP conditions. It was distributed to general dental practitioners (GDP) and dental specialists in four major provinces in Saudi Arabia. Results: A total of 318 questionnaires were completed by 163 males and 155 females. Most participants were GDPs (193/318) and the remaining were specialists from different dental specialties. A majority of participants were not able to diagnose neuropathic OFP or neurovascular/vascular OFP conditions (33% and 28.6%, respectively). On the other hand, only 40.3% were confident enough to diagnose different types of temporomandibular disorders. The results also showed that graduates from non-Saudi programs had significantly higher self and knowledge assessment score (59.8% and 43.4%, respectively) compared with graduates from Saudi programs (39.9% and 22.6%, respectively). The dental specialists had higher self-assessment scores compared with GDPs (48% vs. 43.7%). Overall, there was a weak positive correlation between self-assessment and knowledge assessment (20.2%). Conclusion: This study demonstrates a higher OFP knowledge and confidence for dental specialists compared with GDPs. However, this difference does not necessarily translate into more competencies in clinical practice. Therefore, the implementation of OFP courses in dental schools' curricula may benefit future dentists and improve patients' care.


Assuntos
Competência Clínica/normas , Odontólogos/psicologia , Educação em Odontologia , Dor Facial/diagnóstico , Odontologia Geral/educação , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Currículo , Avaliação Educacional/métodos , Dor Facial/etiologia , Dor Facial/fisiopatologia , Feminino , Humanos , Masculino , Neuralgia/diagnóstico , Medição da Dor , Arábia Saudita , Faculdades de Odontologia , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico
12.
BMC Neurol ; 19(1): 217, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481028

RESUMO

BACKGROUND: Microvascular decompression (MVD) is a type of neurosurgery used to treat trigeminal neuralgia (TN) caused by the vertebrobasilar contact/compression. The surgery is not risk-free, however; it may cause recurrent facial pain or other side-effects. The objective of this study was to assess the long-term pain relief and the complications of MVD surgery for the vertebrobasilar compression treatment. METHODS: Twenty-three patients with TN compressed by the vertebra-basilar artery (VBA) were treated with MVD. Teflon felt was placed between the brain stem and the offending artery to mobilize the artery towards the skull base and the clivus. The Barrow Neurological Institute (BNI) Pain Intensity Scale score was used to assess pre- and post-surgical pains. RESULTS: Of 23 patients with pre-operative BNI IV to V, 19 patients (83%) were pain-free after surgery. Four patients experienced transient partial pain relief with BNI II-III, and 3 of them (13%) were completely pain-free within 3 months. The success rate was 96%. Three patients (13%) had pain recurrences, and one received a second MVD surgery for pain relief during the period of follow-up. Four patients suffered from TN hypesthesia, and only 2 patients (8.6%) had permanent facial hypesthesia, while one patient (4.3%) developed a gradual hearing loss after surgery. CONCLUSIONS: While our success rate of immediate pain relief after surgery was comparable with some reports, the percentage of patients who had pain recurrences was lower, and cases who had permanent facial hypesthesia or developed a gradual hearing loss were fewer after MVD surgery. Our rate of transient complications was higher, and the postoperative pain relief seemed unusually delayed. Our study indicates that MVD is an effective, reliable, and safe neurosurgery for treatment of TN compressed by the VBA albeit our small sample size. Failure of treatment and recurrence of the disease as well as complications could be minimized by preventing displacement of the Teflon implant and extraneous Teflon touching the trigeminal nerves.


Assuntos
Dor Facial/etiologia , Hipestesia/etiologia , Cirurgia de Descompressão Microvascular/métodos , Neuralgia do Trigêmeo/cirurgia , Idoso , Artéria Basilar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Recidiva , Resultado do Tratamento , Nervo Trigêmeo
14.
Curr Pain Headache Rep ; 23(10): 74, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31388843

RESUMO

PURPOSE OF REVIEW: Trigeminal neuralgia (TN) is characterized by recurrent attacks of lancinating facial pain in the dermatomal distribution of the trigeminal nerve. TN is rare, affecting 4 to 13 people per 100,000. RECENT FINDINGS: Although there remains a debate surrounding the pathogenesis of TN, neurovascular compromise is the most currently accepted theory. Minimal stimulation caused by light touch, talking, or chewing can lead to debilitating pain and incapacitation of the patient. Pain may occur sporadically, though is primarily unilateral in onset. The diagnosis is typically determined clinically. Treatment options include medications, surgery, and complementary approaches. Anti-epileptic and tricyclic antidepressant medications are first-line treatments. Surgical management of patients with TN may be indicated in those who have either failed medical treatment with at least three medications, suffer from intolerable side-effects, or have non-remitting symptoms. Surgical treatment is categorized as either destructive or non-destructive. Deep brain and motor cortex neuro-modulatory stimulation are off label emerging techniques which may offer relief to TN that is otherwise refractory to pharmacological management and surgery. Still, sufficient data has yet to be obtained and more studies are needed.


Assuntos
Dor Facial/terapia , Neuralgia/terapia , Nervo Trigêmeo/cirurgia , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/terapia , Descompressão/métodos , Dor Facial/etiologia , Humanos , Neuralgia/diagnóstico , Resultado do Tratamento , Nervo Trigêmeo/patologia
15.
Transplant Proc ; 51(7): 2498-2500, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31405737

RESUMO

INTRODUCTION: Mucormycosis is a severe infection in renal transplant recipients. Here, we report a case of maxillary sinus mucormycosis in a patient who presented with a facial pain complaint. CASE: A 51-year-old female patient with renal transplantation due to autosomal dominant, polycystic kidney disease and diabetic nephropathy was admitted to our hospital with facial pain and minimal edema of the left half of her face on the 8th month of transplantation. On physical examination, there was only tenderness and slight edema on the left half of the face. On the paranasal computed tomography, extensive soft tissue densities involving septations, filling the left maxillary sinus, extending to the nasal cavity, and obliterating the left osteometeal unit were observed. Because facial pain was not relieved by antibiotics and several, potent analgesic drugs on the second day, mucormycosis infection with bone involvement was suspected. A left maxillary sinus excision was performed. Microscopic examination of the debridement specimen revealed necrotic bone interspersed with fungal hyphae, and culture isolated Rhizopus oryzae. Liposomal amphotericin B was started. The patient was on tacrolimus, prednisolone, and mycophenolate mofetil. Tacrolimus was switched to cyclosporine to regulate serum glucose levels. The left maxillary sinus was washed with liposomal amphoterin B daily and curetted with intervals. The patient started dialysis because of severe renal function loss. The patient was discharged on the 96th day of liposomal amphotericin B. CONCLUSION: It should be kept in mind that mucormycosis may be present in the sinuses even if there is no evidence for nasal, oral, and dental examination in renal transplant patients with facial pain.


Assuntos
Hospedeiro Imunocomprometido , Transplante de Rim/efeitos adversos , Sinusite Maxilar/imunologia , Mucormicose/imunologia , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Dor Facial/etiologia , Feminino , Humanos , Sinusite Maxilar/complicações , Sinusite Maxilar/microbiologia , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Rhizopus/isolamento & purificação
16.
Orv Hetil ; 160(27): 1047-1056, 2019 Jul.
Artigo em Húngaro | MEDLINE | ID: mdl-31264469

RESUMO

Orofacial pain is the common name of a variety of disorders from inflammatory diseases to neuropathic pain syndromes. This condition is quite common, it may involve 7% of the whole population. Patients (and doctors) are not aware of the origin of their complaints, therefore initial management falls among the variety of healthcare professionals. The aim of our review was to summarize the current evidence of chronic orofacial pain including diagnosis, management and pitfalls. Orv Hetil. 2019; 160(27): 1047-1056.


Assuntos
Dor Crônica/diagnóstico , Dor Crônica/terapia , Dor Facial/diagnóstico , Dor Facial/terapia , Neuralgia/complicações , Medição da Dor/métodos , Dor Crônica/etiologia , Depressão , Dor Facial/etiologia , Humanos , Comunicação Interdisciplinar , Resultado do Tratamento
17.
J Craniofac Surg ; 30(5): e424-e428, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299801

RESUMO

Eagle syndrome (ES) is a rare symptomatic condition generally caused by abnormal elongation of the styloid process or calcification of stylo-hyoid ligament.Patients with ES typically present a variety of symptoms, which range from mild discomfort to acute neurologic and referred pain in head-and-neck region.Eagle syndrome could be identified through physical examination but often goes undetected in the absence of imaging studies.Although uncommon, it should be considered in the differential diagnosis in patients with cervico-facial pain.The authors report 3 cases with clinical evidence of ES, including both neurologic and vascular patterns, with a clinical and radiological diagnosis.The authors also propose a brief review of its main clinical presentations, diagnostic studies, and part of treatment options of the syndrome.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Dor Facial/etiologia , Ossificação Heterotópica/etiologia , Osso Temporal/anormalidades , Adulto , Isquemia Encefálica/complicações , Infarto Cerebral/complicações , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico , Radiografia , Adulto Jovem
19.
Singapore Med J ; 60(5): 224-228, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31187144

RESUMO

Tooth pain is a common presentation in primary care, with 32.4% of Singaporeans experiencing pain from dental caries in their lifetime. Some systemic conditions can have oral presentations, and oral conditions may be associated with chronic disease. A good history and examination is key in delineating odontogenic from non-odontogenic causes of tooth pain. Primary care physicians should accurately diagnose and assess common dental conditions and make appropriate referrals to the dentist. Common non-odontogenic causes of orofacial pain can be mostly managed in primary care, but important diagnoses such as acute coronary syndrome, peritonsillar abscess and temporal arteritis must not be missed. Ibuprofen has been shown to be effacious, safe and cost-effective in managing odontogenic pain. Antibiotics are indicated when there is systemic or local spread of dental infection. Without evidence of spread, antibiotics have not been shown to reduce pain or prevent subsequent dental infections.


Assuntos
Dor Facial/terapia , Comunicação Interdisciplinar , Colaboração Intersetorial , Equipe de Assistência ao Paciente , Doenças Dentárias/terapia , Odontalgia/terapia , Analgésicos/uso terapêutico , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Dor Facial/etiologia , Medicina Geral , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Singapura , Doenças Dentárias/diagnóstico , Doenças Dentárias/etiologia , Odontalgia/etiologia
20.
J Craniofac Surg ; 30(7): e643-e645, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31233003

RESUMO

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.


Assuntos
Bursite/diagnóstico por imagem , Dor Facial/etiologia , Doenças da Boca/etiologia , Osso Esfenoide/patologia , Transtornos da Articulação Temporomandibular/patologia , Bursite/complicações , Feminino , Cefaleia/etiologia , Humanos , Pessoa de Meia-Idade
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