Abstract:-Objective:To determine the psychological aspects of orofacial pain in trigeminal neuralgia (TN) and temporomandibular disorder (TMD), and associated factors of coping as limitations in daily activities and feelings about the treatment and about the pain. Method: 30 patients were evaluated (15 with TN and 15 with TMD) using a semi-directed interview and the Hospital Anxiety Depression (HAD) scale. Results: TN patients knew more about their diagnosis (p<0.001). Most of the patients with TN considered their dise… Show more
“…Unfortunately, more than 75% of patients need neurosurgery to control pain during the first 5 years (10). The long history of pain and return of crises are important factors that underscore the need for support of these patients (11).…”
This study compared pain intensity and psychosocial characteristics between patients with burning mouth syndrome (BMS) and those with trigeminal neuralgia (TN). Data from 282 patients with BMS and 83 patients with TN were analyzed. Patients reported duration of illness: duration ≤ 6 months was defined as acute illness and > 6 months as chronic illness. Present pain intensity and worst pain intensity during the past 6 months were reported using a 0-10 numeric rating scale (NRS). In addition, depression and somatization scores were evaluated on questionnaires. Patients with chronic BMS reported significantly higher pain intensity and had worse psychosocial characteristics than did those with acute BMS. Pain intensity was higher in TN patients than in BMS patients, although neither pain intensity nor psychosocial characteristics significantly differed between patients with acute and chronic illness.Logistic regression analysis of BMS and TN patients revealed that the odds ratio for worst pain was significantly lower for BMS patients than for TN patients and that the odds ratio for somatization score was 3.8 times higher in BMS patients. These findings suggest that BMS patients may require pain control targeting the central nervous system or psychosocial characteristics. (J Oral Sci 54, 321-327, 2012)
“…Unfortunately, more than 75% of patients need neurosurgery to control pain during the first 5 years (10). The long history of pain and return of crises are important factors that underscore the need for support of these patients (11).…”
This study compared pain intensity and psychosocial characteristics between patients with burning mouth syndrome (BMS) and those with trigeminal neuralgia (TN). Data from 282 patients with BMS and 83 patients with TN were analyzed. Patients reported duration of illness: duration ≤ 6 months was defined as acute illness and > 6 months as chronic illness. Present pain intensity and worst pain intensity during the past 6 months were reported using a 0-10 numeric rating scale (NRS). In addition, depression and somatization scores were evaluated on questionnaires. Patients with chronic BMS reported significantly higher pain intensity and had worse psychosocial characteristics than did those with acute BMS. Pain intensity was higher in TN patients than in BMS patients, although neither pain intensity nor psychosocial characteristics significantly differed between patients with acute and chronic illness.Logistic regression analysis of BMS and TN patients revealed that the odds ratio for worst pain was significantly lower for BMS patients than for TN patients and that the odds ratio for somatization score was 3.8 times higher in BMS patients. These findings suggest that BMS patients may require pain control targeting the central nervous system or psychosocial characteristics. (J Oral Sci 54, 321-327, 2012)
“…TN is characterized as excruciating pain and, during crises, patients may have symptoms of anxiety and depression. However, secondary diagnosis of anxiety or depression is seldom present, differently from other chronic facial pains 28 . The differential diagnosis with regard to dental diseases should also be judicious, since reports of iatrogenesis in these organs are frequent 29 .…”
“…Patients with TN live in fear of unpredictable painful attacks, which may lead to sleep deprivation and life-threatening malnutrition. Furthermore, this condition can lead to irritability, severe anticipatory anxiety, and depression [1][2][3][4][5][6] .…”
OBJECTIVE:Trigeminal neuralgia is a disorder associated with severe episodes of lancinating pain in the distribution of trigeminal nerve. The majority of these patients eventually requires surgical management to achieve remission of symptoms. Microvascular decompression addresses the root cause of the disease and is more effective than ablative procedures at preventing recurrence of symptoms. However, several long-term follow-up studies have disclosed that the efficacy of the procedure gradually decreases over time and have related recurrence to some clinical variables. Our objective is to study the impact of the type of interposing materials used for decompression on long-term success rate.
MATERIALS and METHODS:We conducted a retrospective chart review of 65 patients with trigeminal neuralgia operated between 2007 and 2010 in an otology/base of skull tertiary referral center. Endoscopy-assisted microvascular decompression was used for all patients. Three types of interposing material were used: Teflon in 30 patients (Group I); muscle in 19 patients (Group II); and a combination of both in 16 patients (Group III). The minimum follow-up period was 3 years.
RESULTS:In total, 17 (26.1%) of the 65 patients had recurrence of their symptoms. Average time for recurrence was 7.82+/-4.31 months; 95% of recurrences appeared within the first year. Recurrence rate was lower in Group II (5.2%) as compared to Group I (40%) and Group III (23%), and the difference was statistically significant (p≤0.05).
CONCLUSION:Microvascular decompression with interposition of a muscle pad carries a lower recurrence rate as compared to interposition of Teflon alone or in combination with muscle.
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