Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study

Brazoloto, Thiago Medina; Siqueira, Sílvia Regina Dowgan Tesseroli de; Rocha-Filho, Pedro Augusto Sampaio; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen; Siqueira, José Tadeu Tesseroli de

doi:10.1007/s00701-017-3137-9

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…This condition can also initiate inflammatory reactions in the joint, eliciting secondary biomechanical changes and joint pain. Simultaneously, patients with TMDs can have abnormal trigeminal pain processes [ 31 ], which may be related to an imbalance of 5-hydroxytryptamine and catecholamine neurotransmitters. Therefore, psychological or emotional problems are also involved in the pathogenesis of TMDs, emphasizing the significance of mental state evaluation.…”

Section: Discussionmentioning

confidence: 99%

Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study

Cai

et al. 2021

Med Sci Monit

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Background The aim of this study was to investigate the association of oral behaviors (OBs) with anxiety, depression, and jaw function in patients with temporomandibular disorders (TMDs) in China. Material/Methods A total of 537 patients diagnosed with TMD were included in this study (average age, 31.5512.08 years; 86 men [16.0%] and 451 women [84.0%]). There were 31 cases of masticatory muscle pain, 459 cases of disc displacement, and 13 cases of arthralgia/arthrosis, and 34 cases were uncategorized. Patients were assessed using the Oral Behaviors Checklist (OBC), Jaw Functional Limitation Scale (JFLS), Generalized Anxiety Disorder-7 (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). The relationships between OBC scores and mouth opening, pain scores, JFLS, PHQ-9, and GAD-7 were evaluated with Spearmans correlation analysis. The median TMD symptom duration was 3 (0.5154) months; men and women did not differ significantly in symptom duration or in the number of episodes of depression and anxiety. Results The following OBs were common in patients with TMDs: putting pressure on the jaw (52.9%), chewing food on 1 side (47.5%), and holding teeth together during activities other than eating (33.3%). The OBC scores were significantly correlated with the JFLS, PHQ-9, and GAD-7 scores ( P <0.01). Conclusions Patients with TMDs exhibit specific OBs, which are associated with depression, anxiety, and jaw function. It is necessary to further investigate the interaction of OBs with depression and anxiety in the development of TMDs.

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Section: Discussionmentioning

confidence: 99%

Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study

Cai

et al. 2021

Med Sci Monit

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“…1 Postoperative temporomandibular dysfunction may also play a crucial role in headache formation after pterional craniotomy. 23 In our study, mean AHAC intensity perceived by craniotomy patients with versus without surgically induced muscle damage differed by 1.1 NRS with higher scores following CMI. Headache severity has been clearly shown to be the major determinant of headache-related disability in a large population of migraine patients.…”

Section: Discussionmentioning

confidence: 49%

“…29 Another potentially disabling factor that has recently been identified in a preliminary study is the manifestation of temporomandibular disorders with masticatory dysfunction after pterional craniotomy. 23 An interdisciplinary multimodal approach to the individual patient's needs is necessary to mitigate the burden of acute postsurgery headache as well as its possible detrimental long-term effects. Besides the well-established utilization of opioids, paracetamol/acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) in the acute stage, 9 sufficient AHAC management commonly requires further concerted pre-, intra-, and postoperative measures.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Surgery-Related Muscle Injury on Prevalence and Characteristics of Acute Postcraniotomy Headache – A Prospective Consecutive Case Series

Huckhagel

Westphal

Klinger

2021

J Neurol Surg A Cent Eur Neurosurg

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Background and Objective The latest third edition of the International Classification of Headache Disorders delineates diagnostic criteria for acute headache attributed to craniotomy (AHAC), but data on possible predisposing factors are sparse. This prospective observational study aims to evaluate the impact of surgery-related muscle incision on the prevalence, severity, and characteristics of AHAC. Patients and Methods Sixty-four consecutive adults (mean age: 54.2 ± 15.2 years; 26 males and 38 females) undergoing cranial neurosurgery for various reasons without preoperative headache were included. After regaining consciousness, all patients reported their average daily headache on a numeric pain rating scale (NRS; range: 0–10), headache characteristics, as well as analgesic consumption from day 1 to 3 after surgery. Three distinct patient cohorts were built with respect to the surgical approach (craniotomy ± muscle incision; burr hole surgery) and group comparisons were performed. Additionally, patients with AHAC ≥ 3 NRS were reevaluated at 7.2 ± 2.3 months following treatment by means of standardized questionnaires to determine the prevalence of persistent headache attributed to craniotomy as well as headache-related disability and quality of life. Results Thirty of 64 (46.9%) patients developed moderate to severe AHAC (NRS ≥ 3) after cranial neurosurgery. There were no significant group differences with regard to age, gender, or general health condition (American Society of Anesthesiologists Physical Status Classification). Craniotomy patients with muscle incision suffered from significantly higher early postoperative mean NRS scores compared with their counterparts without procedure-related muscle injury (3.4 ± 2.3 vs. 2.3 ± 1.9) as well as patients undergoing burr hole surgery (1.2 ± 1.4; p = 0.02). Moreover, the consumption of nonopioid analgesics was almost doubled following muscle-transecting surgery as compared with muscle-preserving procedures (p = 0.03). Young patient age (odds ratio/95% confidence interval for each additional year: 0.93/0.88–0.97) and surgery-related muscle injury (5.23/1.62–19.41) were identified as major risk factors for the development of AHAC ≥ 3 NRS. There was a nonsignificant trend toward higher pain chronification rate as well as headache-related disability after craniotomy with muscle injury. Conclusion Surgery-related muscle damage may be an important predisposing factor for AHAC. Therefore, if a transmuscular approach is unavoidable, the neurosurgeon should be aware of the need for adequately adjusted intra- and postoperative analgesia in these cases.

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“…The greater the amount of air in the root of the trigeminal nerve, the more severe the harassment of the trigeminal nerve, and therefore the more severe the postoperative pain. Studies have shown that mechanical or chemical stimulation of the trigeminal nerve is one of the key factors of pain after craniotomy(Zhao and Levy 2014, Brazoloto, de Siqueira et al 2017). However, no research has been found to investigate whether the gas at the root of the trigeminal nerve can cause headaches.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Post-craniotomy Headache After Microvascular Decompression in Hemifacial Spasm

Huang

Jiang

et al. 2022

Preprint

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Objective: Patients who undergo microvascular decompression (MVD) often experience post-craniotomy headache (PCH), while the PCH is always neglected. This study is aimed to describe the natural course and risk factors of PCH. Methods The severity and duration of PCH in 87 patients who undergo MVD were recorded. Factors related to the severity and duration of PCH were analyzed. Results Most patients (63.2%) had at least one assessment of moderate to severe PCH. Almost all patients (92%) would gradually decrease to disappear within 7 days. A small number of patients (25.5%) had PCH at the incision, and other patients had PCH inside the head. Younger age and gas in the prepontine cistern were the salient features of patients in the severe group. Younger, higher SAS, gas in the prepontine cistern area, and postoperative fever were independent risk factors that affect the duration of PCH. Conclusions PCH is the most common and self-limiting complication after MVD among patients with HFS. Young age, temperature > 38˚C after MVD within 24h, and gas around the TN are associated may predict the severity and duration of PCH. Significance This is the first study to describe the severity, duration, location, and risk factors of PCH.

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Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study

Abstract: 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.

Cited by 12 publications

References 15 publications

Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study

Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study

The Impact of Surgery-Related Muscle Injury on Prevalence and Characteristics of Acute Postcraniotomy Headache – A Prospective Consecutive Case Series

Factors Associated With Post-craniotomy Headache After Microvascular Decompression in Hemifacial Spasm

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