Temporomandibular joint syndrome treatment with peripheral nerve stimulation

Authors

  • Alejandra Arévalo-Sáenz Department of Neurosurgery, Hospital Clinic San Carlos, Madrid, Spain
  • Fernando J. Rascón-Ramírez Department of Neurosurgery, Hospital Clinic San Carlos, Madrid, Spain
  • Manuel Pedrosa Sánchez Department of Neurosurgery, University Hospital La Princesa, Madrid, Spain

DOI:

https://doi.org/10.55005/v3i1.8

Keywords:

temporo-mandibular joint, peripheral electrical stimulation, auriculo-temporal nerve, orofacial pain syndrome

Abstract

Introduction: Temporomandibular joint syndrome is defined by a triad of intense joint pain together with restriction of mouth opening and jaw clicking. The objective of this study is to evaluate the efficacy and safety of peripheral nerve stimulation for the treatment of this pathology.
Material and Methods: A retrospective study was conducted. All patients met selection criteria that include prior resistance to medical or surgical treatment and completion of a series of pre-surgical tests. An octopolar electrode was implanted in the affected preauricular region. The results were measured using the Analog Pain Scale, a short questionnaire on pain, improvement of restriction in mouth opening and reduction of analgesic medication.
Results: A total of 10 patients with 14 performed procedures were included. The mean reduction in pain measured by VAS was 86.2% at one month and 79% at one year after surgery. All patients experienced a drastic improvement in pain and its impact according to the Brief Pain Inventory, the mean improvement being 90% at 4 weeks and 82% at one year. There was an improvement in the mean oral opening of 10.14 mm (minimum of 4 and maximum of 13 mm). One case was excluded due to the complication demanding the system removal.
Conclusions: Patients with temporomandibular joint syndrome who do not respond to conventional treatments are ideal candidates for peripheral nerve stimulation, showing improvement in pain, oral restriction, and quality of life with a low percentage of serious complications.

References

Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, Januzzi E, de Souza BDM. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig. 2021 Feb;25(2):441-453. doi: 10.1007/s00784-020-03710-w.

Velly AM, Anderson GC, Look JO, Riley JL, Rindal DB, Johnson K, Wang Q, Fricton J, Huff K, Ohrbach R, Gilbert GH, Schiffman E; National Dental Practice-Based Research Network Collaborative Group. Management of painful temporomandibular disorders: Methods and overview of The National Dental Practice-Based Research Network prospective cohort study. J Am Dent Assoc 2022;153(2):144-157.

Dibbets JM, van der Weele LT. Prevalence of TMJ symptoms and X-ray findings. Eur J Orthod. 1989;11(1):31-36. doi:10.1093/oxfordjournals.ejo.a035961

Maglione H, Fernandez Soetbeer G, Allende G. Craniomandibular dysfunction: frequency and forms of presentation in a population of young adults and their demand for care. Research Cabinet. Univ J.F. Kennedy. Rev CAO 2006; 199:32-42

Fricton JR, Olsen T. Predictors of outcome for treatment of temporomandibular disorders. J Orofac Pain. 1996;10(1):54-65.

De Leeuw R (Ed.) Orofacial Pain: Guideliness for Assessment, Diagnosis, and Management American Academy of Orofacial Pain AAOP . 4th ed. London: Quintessence Publishing Co, Inc., 2008; 8: 167-170. www.aaop.org

Becker IM. Occlusion as a causative factor in TMD. Scientific basis to occlusal therapy. N Y State Dent J. 1995;61(9):54-57.

Tchivileva IE, Hadgraft H, Lim PF, Di Giosia M, Ribeiro-Dasilva M, Campbell JH, Willis J, James R, Herman-Giddens M, Fillingim RB, Ohrbach R, Arbes SJ Jr, Slade GD. Efficacy and safety of propranolol for treatment of temporomandibular disorder pain: a randomized, placebo-controlled clinical trial. Pain. 2020 Aug;161(8):1755-1767. doi: 10.1097/j.pain.0000000000001882.

Buescher JJ. Temporomandibular joint disorders. Am Fam Physician. 2007 Nov 15;76(10):1477-82.

Drangsholt M, Le Resche L,. Temporomandibular disorder pain. In:CrombieIK,Croft PR, Linton SJ, LeResche L, VonKorff(eds). Epidemiology of Pain. Seattle: IASP Press, 2004

Parate LH, Tejesh CA, Geetha CR, Mohan CV. Peripheral nerve stimulator-guided mandibular nerve block: A report of three cases. Saudi J Anaesth. 2016 Oct-Dec;10(4):491-492. doi: 10.4103/1658-354X.179126.

Kalladka M, Shastry S, Thondebhavi M, Quek S, Singh S, Khan J.Nerve blocks in the management of acute temporomandibular disorder emergencies—a narrative review. J Oral Maxillofac Anesth 2022;1. 5 | https://dx.doi.org/10.210

Daut RL, Cleeland CS, Flanery RC. Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases. Pain. 1983;17(2):197-210. doi:10.1016/0304-3959(83)90143-4

Badia X, Muriel C, Gracia A, et al. Validación española del cuestionario Brief Pain Inventory en pacientes con dolor de causa neoplásica [Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain]. Med Clin (Barc). 2003;120(2):52-59. doi:10.1016/s0025-7753(03)73601-x

Costen JB. A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. 1934. Ann Otol Rhinol Laryngol. 1997;106(10 Pt 1):805-819. doi:10.1177/000348949710601002

Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008;359(25):2693-2705. doi:10.1056/NEJMra0802472

Phillips JM, Gatchel RJ, Wesley AL, Ellis E 3rd. Clinical implications of sex in acute temporomandibular disorders. J Am Dent Assoc. 2001;132(1):49-57. doi:10.14219/jada.archive.2001.0025

Simons DC, Travell JG. Myofascial pain and dysfunction: The trigger point manual. Vol 1. Upper Half of the Body. 2nd Ed. Atlanta, GA: Emory University. 1998.

Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil. 2010;37(6):411-429. doi:10.1111/j.1365-2842.2010.02087.x

Franco Gay ML, López Alarcón MD. Estimulación periférica & subcutánea. Indicaciones. En. Guía Práctica de la neuroestimulación. Grupo español de Neuromodulación. Ed: ESRA-España. Living & Working 2009; Cap.3: p.15-9.

Wall PD, Sweet WH. Temporary abolition of pain in man. Science. 1967;155(3758):108-109. doi:10.1126/science.155.3758.108

Meglio M, Cioni B, Rossi GF. Spinal cord stimulation in management of chronic pain. A 9-year experience. J Neurosurg. 1989;70(4):519-524. doi:10.3171/jns.1989.70.4.0519

Weiner RI. Peripheral nerve stimulation. In: Burchiel KJ (editor). Surgical Management of Pain. New York. Thieme Medical Publishers, Inc 2002. p. 498-504.

Brewer AC, Trentman TL, Ivancic MG, et al. Long-term outcome in occipital nerve stimulation patients with medically intractable primary headache disorders. Neuromodulation. 2013;16(6):557-564. doi:10.1111/j.1525-1403.2012.00490.x

Lenchig S, Cohen J, Patin D. A minimally invasive surgical technique for the treatment of posttraumatic trigeminal neuropathic pain with peripheral nerve stimulation. Pain Physician. 2012;15(5):E725-E732.

Rosendal F, Moir L, de Pennington N, Green AL, Aziz TZ. Successful treatment of testicular pain with peripheral nerve stimulation of the cutaneous branch of the ilioinguinal and genital branch of the genitofemoral nerves. Neuromodulation. 2013;16(2):121-124. doi:10.1111/j.1525-1403.2011.00421.x

Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C. Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation. Pain Physician. 2015;18(2):E229-E236

Shi J, Qian Y, Han W, Dong B, Mao Y, Cao J, Guan W, Zhou Q. Risk Factors for Outcomes After Microvascular Decompression for Trigeminal Neuralgia. World Neurosurg. 2020 Apr;136:e559-e566. doi: 10.1016/j.wneu.2020.01.082.

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Published

2023-03-31

How to Cite

Arévalo-Sáenz, A., Rascón-Ramírez, F. J. ., & Pedrosa Sánchez, M. (2023). Temporomandibular joint syndrome treatment with peripheral nerve stimulation. Neurohirurgija - The Serbian Journal of Neurosurgery, 3(1). https://doi.org/10.55005/v3i1.8

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Original Research