Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock in adolescents and young adults

tmj Head & face medicine 2021 · PMID 33773589

Temporomandibular joint (TMJ) 'closed lock' is a clinical condition causing TMJ pain and limited mouth opening (painful locking). Recent studies suggest an increasing prevalence of degenerative joint disease associated with the onset of TMJ closed lock in adolescents and young adults. Early interventions are recommended, but the curative effect of standard therapies remains controversial. In this retrospective study, an alternative method of non-surgical treatment of TMJ closed lock is presented, and its long-term efficacy has been observed. Forty adolescents and young adults, aged 16 to 30 years old, with distinct combination of symptoms of TMJ closed lock, were enrolled. Patients received anesthetic blockages of the auriculotemporal nerve, then performed mandibular condylar movement exercise for 10 min, and subsequently received hypertonic dextrose prolotherapy in retro-discal area of TMJ. Clinical assessments at baseline and at follow-up (2 weeks, 2 months, 6 months, and 5 years) included intensity and frequency of TMJ pain, mandibular range of motion, TMJ sounds, and impairment of chewing. Cone beam CT images of the TMJs revealed joint space changes in all patients and degenerative bone changes in 20% (8/40) of the patients. The patients were diagnosed as having disc displacement without reduction with limited opening. Successful reduction of displaced disc had been achieved in the treatment. And pain at rest and pain on mastication had substantially decreased in all patients and mandibular function and mouth opening had significantly improved since 2 weeks' follow-up. The overall success rate kept at a high level of 97.5% (39/40) at 6 months and 5 years' follow-up. The technique combining mandibular condylar movement exercise with auriculotemporal nerve block and dextrose prolotherapy is straightforward to perform, inexpensive and satisfactory to young patients with TMJ closed lock.

bu makaleden üretilen sorular (6)

tmj orta

Adolesan kapali kilit (closed lock) hastasinda Zhou yaklasimini planliyorsunuz.

Zhou ve ark. calismasinda enjeksiyon agrisini azaltmak ve fonksiyonu artirmak icin dekstroz proloterapisi neyle kombine edilmistir?

cevabı gör

doğru cevap: %2 lidokain ile aurikulotemporal sinir blogu ve egzersiz tedavisi

açıklama: Zhou ve ark. (Head Face Med 2021): kapali kilitte dekstroz proloterapisi oncesinde %2 lidokain ile aurikulotemporal sinir blogu ve egzersiz tedavisi kombine edilebilir.

Zhou H ve ark., Head Face Med 2021;17:11 (auriculotemporal nerve block + dextrose prolotherapy, TMJ closed lock) PMID 33773589

tmj orta

Zhou protokolunde igne secimini gozden geciriyorsunuz.

Zhou ve ark. kapali kilit kohortunda bildirilen igne olcusu asagidakilerden hangisidir?

cevabı gör

doğru cevap: 26-G 22 mm igne

açıklama: Zhou ve ark. (Head Face Med 2021) adolesan/genc eriskin kapali kilit kohortunda 26-G 22 mm igne kullanimi bildirmistir.

Zhou H ve ark., Head Face Med 2021;17:11 (auriculotemporal nerve block + dextrose prolotherapy, TMJ closed lock) PMID 33773589

tmj orta

Enjeksiyon oncesi aurikulotemporal sinir blogunun mantigini aciklayacaksiniz.

Aurikulotemporal sinir birçok TMJ proloterapi protokolunde neden enjeksiyon oncesi bilincli olarak bloke edilir?

cevabı gör

doğru cevap: Kondil boynu etrafinda dolanip retrodiskal bolgeden gectigi ve igne yolunda risk yapisi oldugu icin

açıklama: Zhou (Head Face Med 2021): aurikulotemporal sinir kondil boynu etrafinda dolanip retrodiskal bolgeden gecer, bu nedenle protokollerde bilincli olarak bloke edilir ve ayni zamanda igne yolunda bir risk yapisidir.

Zhou H, et al. Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock. Head Face Med 2021;17:11 PMID 33773589

tmj zor

Aurikulotemporal sinir blogunu uyguluyorsunuz.

Zhou protokolunde aurikulotemporal sinir blogu icin kullanilan lokal anestezik hacim ve zamanlama nedir?

cevabı gör

doğru cevap: 2 mL %2 lidokain, enjeksiyondan yaklasik 10 dk once

açıklama: Zhou (Head Face Med 2021): aurikulotemporal sinir blogu 2 mL %2 lidokain ile enjeksiyondan yaklasik 10 dk once uygulanir.

Zhou H, et al. Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock. Head Face Med 2021;17:11 PMID 33773589

tmj orta

Zhou calismasinin kanit duzeyini bir hasta sunumunda belirtiyorsunuz.

Zhou ve ark. aurikulotemporal blok + dekstroz proloterapisi calismasinin kanit duzeyi nedir?

cevabı gör

doğru cevap: Kohort

açıklama: Zhou ve ark. (Head Face Med 2021) bir kohort calismasidir; kapali kilitte aurikulotemporal blok, dekstroz proloterapisi ve egzersiz tedavisini kombine etmistir.

Zhou H ve ark., Head Face Med 2021;17:11 (auriculotemporal nerve block + dextrose prolotherapy, TMJ closed lock) PMID 33773589

tmj orta

Aurikulotemporal sinirin hem blok hem risk hedefi olmasinin nedenini aciklayacaksiniz.

Aurikulotemporal sinir TMJ proloterapisinde neden hem bloke edilen hem de igne yolundaki risk yapisidir?

cevabı gör

doğru cevap: Kondil boynu etrafinda dolanip retrodiskal bolgeden gectigi icin

açıklama: Zhou (Head Face Med 2021): aurikulotemporal sinir kondil boynu etrafinda dolanip TMJ'nin retrodiskal bolgesinden gecer; bu nedenle hem bloke edilir hem de igne yolunda risk yapisidir.

Zhou H, et al. Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock. Head Face Med 2021;17:11 PMID 33773589

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