Orofacial pain related to traumatic neuroma in a patient with multiple TMJ operations.
The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. However, sonography indicated the location of the suspected lesion. Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ.
Division of Oral and Maxillofacial Surgery, Niigata Graduate School of Medical and Dental Sciences 5274, 2-Banchou, Gakkouchoudoori, chuuouku, Niigata, 951-8514 Japan. damadama@dent.niigata-u.ac.jp
Yasumitsu
Y
Kodama
Kenji
K
Seo
Takafumi
T
Hayashi
Takanori
T
Kobayashi
Masahiro
M
Niwano
Takahiro
T
Koyama
Masaaki
M
Murayama
Ritsuo
R
Takagi
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016477:Artifacts; D001706:Biopsy; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D009463:Neuroma / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D011862:Radiography, Panoramic; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D061028:Trigger Points; D014463:Ultrasonography
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal