Chronic postoperative orofacial pain. Case reports

Abstract

BACKGROUND AND OBJECTIVES:The presence of neoplasms, chronic and oral diseases may require surgical treatment for its resolution, although it may consequently cause chronic pain. Chronic postoperative orofacial pain remains even after tissue healing and its causes are not defined. Although neuropathic etiology is the most reported, it represents 30% of cases; the other 70% are still unclear and the main risk factors involved in the development of this chronic pain condition remains on discussion. The aim of the study was to report three clinical cases of different postoperative orofacial pain etiologies. CASE REPORTS: Case 1: Female patient, 39-year-old, history of osteoblastoma exeresis in the mandibular body, presenting continuous postoperative shock pain, with intra and extraoral allodynia in the area. Diagnosis: post-traumatic trigeminal neuropathic pain. Case 2: Female patient, 30-year-old, diagnosed with refractory epilepsy and neurocysticercosis, complained of orofacial pain and bitemporal headache worse after craniotomy that treated the reported diseases. Diagnosis: post-craniotomy headache and orofacial pain. Case 3: Female patient, 49-year--old, with hereditary hemorrhagic telangiectasia, complained of pulsing in the alveolar ridge after extraction of three teeth, performed at different times. Diagnosis: Perception of orofacial pain secondary to systemic vascular disease. CONCLUSION: Different surgical procedures, intra and extraoral, led to the development of orofacial postoperative pain in the reported cases, whose etiology is not only neuropathic. Prospective multidisciplinary studies are necessary in order to clarify the causes of orofacial postoperative pain.