Neurogenic temporomandibular joint dislocation treated with botulinum toxin: report of 4 cases.
Many patients suffer recurrent episodes of temporomandibular joint (TMJ) dislocation due to an excess of muscle contraction or spasticity in the depressor muscles of the jaw. The manual repositioning using the Nelaton maneuver is the first treatment. Occasionally, it may be necessary to use sedation or general anesthesia to achieve the desired muscle relaxation. In case of recurrence, surgical treatment is indicated. One nonsurgical method of treatment is the local infiltration of botulinum toxin type A. We present 4 cases of recurrent TMJ dislocation in patients suffering from conditions of neurologic origin, with considerable motor deterioration, treated with local infiltration of botulinum toxin type A. In conclusion, the injection of botulinum toxin type A is an effective method in cases of neurogenic TMJ dislocation, with low morbididty and side effects, improving patients' quality of life.
Vázquez Bouso
Olga
O
Maxillofacial Surgical Department, Joan XXIII Hospital, Tarragona, Spain.
Forteza González
Gabriel
G
Mommsen
Jens
J
Grau
Víctor Gumbao
VG
Rodríguez Fernández
Javier
J
Mateos Micas
Mario
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D004204:Joint Dislocations / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009126:Muscle Relaxation / Q000187:drug effects; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009422:Nervous System Diseases / Q000150:complications* / Q000188:drug therapy; D011626:Pterygoid Muscles / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D055502:Secondary Prevention; D013704:Temporomandibular Joint / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy* / Q000473:pathology
D019274:Botulinum Toxins, Type A