title: Botulinum toxin treatment for upper airway collapse resulting from temporomandibular joint dislocation due to jaw-opening dystonia.
abstract: To examine the effects of botulinum toxin injection application for the treatment of upper airway obstruction due to hyperactive lateral pterygoid muscle contraction, we applied botulinum toxin injection. A 20 year-old male patient had involuntary mouth opening after a diabetic coma. His mouth opened excessively (84 mm) particularly when he was in a nervous or stressed condition. This resulted in a bilateral temporomandibular dislocation and, consequently, upper airway collapse. The differential diagnosis of jaw-opening oromandibular dystonia was made. Botulinum toxin type A was bilaterally injected into the lateral pterygoid muscle. The excessive mouth opening was reduced, and the patient showed no temporomandibular joint (TMJ) dislocation or experienced any further airway collapse after the injections. We successfully applied botulinum toxin to a patient with upper airway obstruction and TMJ dislocation relative to jaw-opening dystonia.
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan. kyoshida@kuhp.kyoto-u.ac.jp
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yoshida
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Iizuka
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003929:Diabetic Neuropathies / Q000150:complications; D004421:Dystonia / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000209:etiology; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011626:Pterygoid Muscles / Q000503:physiopathology*; D011782:Quadriplegia / Q000150:complications / Q000209:etiology; D016059:Range of Motion, Articular; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000209:etiology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A