Pterygoid hamulus bursitis as a cause of craniofacial pain: a case report

Cho, Jin-Yong; Cheon, Kang-Yong; Shin, Dong-Whan; Chun, Won-Bae; Lee, Ho

doi:10.5125/jkaoms.2013.39.3.134

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…The contraction of the tensor veli palatini muscle creates tension in the soft palate and helps to open the Eustachian tube during speech, deglutition, mastication, respiration, yawning and sneezing. Therefore, PHS pain can be varied from earache, otic fullness, odynophagia, dysphagia, gustative hyperesthesia, pain in soft palate, jaw pain, dysaesthesias and even headaches [1].…”

Section: Discussionmentioning

confidence: 99%

“…Pain in the soft palate or pharyngeal region may occur due to various causes. Such pain is very difficult to diagnose because its varied origins may include vascular, muscular, ligamental, and/or osseous factors [1]. Although the pterygoid hamulus (PH) of the sphenoid bone may be responsible for atypical pain in this region, the etiology of this syndrome is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

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An unusual clinical vignette of oro-pharyngeal discomfort: Pterygoid Hamulus syndrome

Firdouse

Firdoose²,

Ghousia³

2020

Medicine and Pharmacy Reports

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Background. A straightforward clinical reasoning is always difficult in patients with persistent orofacial pain with vague symptoms. Craniofacial pain or orofacial pain can have a mixture of causes ranging from neurogenic, myogenic, and psychogenic factors intertwined amidst the intricate anatomy with a high vascular network. This plethora of uncertainty blurs the judgment for such patients to whom we provide care. We hereby present a case of a 17 year old female with vague pain on talking, chewing and even swallowing when initially examined; this chronic orofacial pain often worsened her quality of life. The aim of this manuscript is to present a case of Pterygoid Hamulus syndrome that was misdiagnosed as glossopharyngeal and myofascial neuralgia. Methods. The condition was managed by surgical excision of the elongated pterygoid hamulus, following a recurrence of her symptoms. Results. The patient was relieved of pain only after the surgical excision of the elongated hamulus. Conclusions. The surgery was decided upon only after conservative management had not provided much relief and the manuscript also discusses the ambiguous composite pain referral pattern in Pterygoid Hamulus syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An unusual clinical vignette of oro-pharyngeal discomfort: Pterygoid Hamulus syndrome

Firdouse

Firdoose²,

Ghousia³

2020

Medicine and Pharmacy Reports

View full text Add to dashboard Cite

show abstract

“…It can be either conservative or surgical. Injection of steroids has been used with a mixed bag of results [ 5 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Pterygoid Hamular Bursitis: A Possible Link to Craniofacial Pain

Shetty

Shah

et al. 2018

Case Reports in Surgery

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A striking feature of the skull base is the pterygoid hamulus known for its bizarre morphology and biomechanical location. Pterygoid hamular bursitis is an inflammation of bursae located between the tendon, muscle, and bony prominences. The minimal objective finding in an apparently normal orofacial apparatus and dependence on the subjective symptoms experienced by the patient with widespread referral pattern often perplexes the clinician. Bursitis should be considered in the differential diagnosis of craniofacial neuralgia, temporomandibular joint dysfunction, and chronic craniofacial pain. Clinical signs and symptoms of this intriguing entity are diverse and multifaceted that can sometimes demand services of clinicians across various specialties considering the anatomic density of the region. Care must be taken to avoid delay, misdiagnosis, and overtreatment.

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“…Thirteen publications of PHS cases were retrieved [1,[4][5][6][7][8][9][10][11]16,[18][19][20]. The course of PHS patient care is characterized by medical nomadism and diagnostic wandering often leading to the performance of iatrogenic (dental treatments) and ineffective (persistence of chronic pain for several years) procedures.…”

Section: Commentsmentioning

confidence: 99%

Pterygoid hamulus syndrome: a case report

Galvez

Moreau

Fénelon

et al. 2020

J Oral Med Oral Surg

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Introduction: Pterygoid hamulus syndrome (PHS) is a little-known differential diagnosis of orofacial pain. It is characterized by oropharyngeal pain, secondary to inflammatory bursitis of the tensor veli muscle of post-traumatic origin, frequently fostered by an associated hypertrophy of the hamular process. Observation: A 64-year-old female patient, type 2 diabetic, consulted for constant posterior palatal pain located near to 17, lasting for 10 years. The inspection did not reveal any mucosal lesions. Right hamulus palpation increased the pain and revealed hamulus hypertrophy. A diagnosis of PHS was evoked. Comment: A review of the literature is proposed. The treatment of PHS is initially conservative, but a surgical treatment can be proposed in case of morphological anomalies. Conclusion: PHS is a little-known syndrome whose diagnosis must be mentioned by the oral surgeon faced with chronic oropharyngeal pain. The diagnosis is clinical and radiological, the treatment is medical and/or surgical.

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Pterygoid hamulus bursitis as a cause of craniofacial pain: a case report

Cited by 10 publications

References 22 publications

An unusual clinical vignette of oro-pharyngeal discomfort: Pterygoid Hamulus syndrome

An unusual clinical vignette of oro-pharyngeal discomfort: Pterygoid Hamulus syndrome

Pterygoid Hamular Bursitis: A Possible Link to Craniofacial Pain

Pterygoid hamulus syndrome: a case report

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