颞下颌关节内类固醇注射对缓解耳痛的影响

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摘要

背景:颞下颌关节紊乱(TMD)是耳痛最常见的非耳科原因之一。治疗选择从非侵入性选择,如非甾体抗炎药(NSAID)和物理治疗,到更有侵入性的治疗选择,如关节内注射皮质类固醇和手术。本研究的目的是强调在TMJ关节内注射类固醇对耳痛的影响,而不仅仅是关节区域的疼痛。方法:对12例23 ~ 47岁以颞下颌关节及太阳穴疼痛为主并伴有明显耳痛的患者(女10例,男2例)进行病例系列研究。每位患者被要求在注射前后对耳痛进行评分,从0到2(0:无痛- 1:轻微疼痛- 2:严重疼痛)。结果:10例患者经1次或2次注射后耳痛完全缓解。2例注射3次后出现持续性耳痛。结论:颞下颌关节内类固醇注射是一种可以在门诊安全进行的小手术,是缓解颞下颌关节紊乱(TMD)继发性耳痛的有效选择。
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Temporomandibular Intra-Articular Steroid Injection: Its Impact on Relieving Otalgia
Background: Temporomandibular joint disorder (TMD) is one of the most common non otological causes of otalgia. Treatment options vary from noninvasive options, such as non-steroidal anti-inflammatory drugs (NSAID) and physiotherapy to more invasive options of treatment such as intra-joint injections with corticosteroids and surgery. The aim of this study is to highlight the impact of the intra-articular steroid injection in TMJ on the otalgia not only the pain over the joint region. Methods: This study is a case series study that has been conducted on 12 patients (10 females and 2 males) aging from 23 to 47 years old with complaint of pain at area of temporomandibular joint and temple with prominent otalgia. Each patient has been asked to put a grade for otalgia from 0 to 2 before and after injection (0: no pain - 1: mild pain - 2: sever pain). Results: Ten cases showed complete relief of otalgia either after one or two injections. Two cases showed persistent otalgia after 3 attempts of injection. Conclusion: Temporomandibular intra articular steroid injection is a minor procedure that could be carried out safely at outpatient clinics and an effective option for relieving otalgia secondary to temporomandibular joint disorder (TMD).
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