title: Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study.
abstract: Surgical trauma at the temporalis muscle is a potential cause of post-craniotomy headache and temporomandibular disorders (TMD). The aim of this study was to evaluate the prevalence of pain, masticatory dysfunction and trigeminal somatosensory abnormalities in patients who acquired aneurysms following pterional craniotomy.
  
  
  
  Fifteen patients were evaluated before and after the surgical procedure by a trained dentist. The evaluation consisted of the (1) research diagnostic criteria for TMD, (2) a standardized orofacial pain questionnaire and (3) a systematic protocol for quantitative sensory testing (QST) for the trigeminal nerve.
  
  
  
  After pterional craniotomy, 80% of the subjects, 12 patients, developed orofacial pain triggered by mandibular function. The pain intensity was measured by using the visual analog scale (VAS), and the mean pain intensity was 3.7. The prevalence of masticatory dysfunction was 86.7%, and there was a significant reduction of the maximum mouth opening. The sensory evaluation showed tactile and thermal hypoesthesia in the area of pterional access in all patients.
  
  
  
  There was a high frequency of temporomandibular dysfunction, postoperative orofacial pain and trigeminal sensory abnormalities. These findings can help to understand several abnormalities that can contribute to postoperative headache or orofacial pain complaints after pterional surgeries.
authors.affiliation: Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil. thibrazoloto@gmail.com.
authors.forename: Thiago Medina
authors.initials: TM
authors.lastname: Brazoloto
authors.affiliation: Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil.
authors.forename: Silvia Regina Dowgan Tesseroli
authors.initials: SR
authors.lastname: de Siqueira
authors.affiliation: Department of Neuropsychiatry, Universidade Federal de Pernambuco, Recife, PE, Brazil.|Universidade de Pernambuco, Recife, Brazil.
authors.forename: Pedro Augusto Sampaio
authors.initials: PA
authors.lastname: Rocha-Filho
authors.affiliation: Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.affiliation: Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil.
authors.forename: José Tadeu Tesseroli
authors.initials: JT
authors.lastname: de Siqueira
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects*; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D051271:Headache Disorders, Secondary / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019291:Skull Base / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D020433:Trigeminal Nerve Diseases / Q000209:etiology*
keywords: Headache; Orofacial pain; Post-craniotomy headache; Pterional craniotomy; Quantitative sensory testing; Temporomandibular disorder