Tinnitus in temporomandibular joint disorders: is it a specific somatosensory tinnitus subtype?

ABSTRACT: The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus"

Facial impaled trauma involving anterior cranial fossa: case report

An extraordinary case of trans-orbital penetrating injury is presented. A 42-year-old male was surprised while he was stealing into an apartment. While he was trying to escape through the window, he fell on a rod of the fence with not severe ocular and cerebral complications. We describe a unique presentation of a trans-orbital penetration injury that had a good outcome and not severe ocular and cerebral complications. After being transported at the S.M. Goretti Hospital in Latina, the rod was removed outside the operating room and the CT scan was performed. Patient underwent urgent surgery after stabilization of vital parameters

Myositis Ossificans of the Medial Pterygoid Muscle

Myositis ossificans (MO) is a disease whose main feature is the formation of heterotopic bone involving muscle or any other soft tissue. Pathogenesis is not all clear, but trauma is universally recognized as a trigger event. Myositis ossificans can be divided into 2 classifications: MO progressiva and MO traumatica. The authors present a case of a 64-year-old man who was diagnosed with MOT of the left medial pterygoid muscle. The patient had a long clinical history of signs and symptoms of temporomandibular articulation related to previous conditions, and no major traumatic events were reported, apparently related to MOT

Chondrocalcinosis: Rare localization in the temporomandibular joint

In this paper introduces a rare case of chondrocalcinosis of the temporomandibular joint secondary to hyperparathyroidism, diagnosed in a 64-year-old man. The patient complained of symptoms characterized by the presence of a swelling in the left pretragic preauricular region, accompanied by a limitation of the mandibular movements. Radiographic examinations suggested a diagnosis of synovial chondromatosis. Subsequently definitive histological analysis removed mass stated for a chondrocalcinosis of the left temporomandibular joint. The differential diagnosis is very hard, in this case it has been difficult for the rarity of the pathology described in literature; the exact diagnosis can be only formulated on histologic and citologic examination of the mass excised

Cleft lip and palate: Technical strategies for the primary palatoplasty

Surgical procedures in cleft lip and palate repair are continuously evolving. In the international literature, many guidelines exist dealing with different timings and surgical approaches. The authors present a technical strategy on primary palatoplasty and the guidelines for the surgical management of cleft lip and palate adopted by the Department of Maxillo-Facial Surgery of the Universita "La Sapienza" of Rome. This approach has been developed to allow a physiological facial growth and to preserve the essential main features of the stomatognathic system enclosing phonation and swallowing. Moreover, the authors present their own surgical technique for primary palate repair at 24 to 48 months with the galea-pericranium free flap

Sinus disventilation and atrophy of the upper maxilla: a combined surgical approach is possible?

This study aims to assess the effectiveness and reliability of a new combined approach to treat the maxillary atrophy and chronic rhinosinusitis (CRS) and other rhino-sinusal pathologies. This 1-step procedure consisting functional endoscopic sinus surgery (FESS) and maxillary sinus-lift with simultaneous implant placement for patients with a severe reabsorbed maxillary bone and sinuses' disease. In case of disventilation and maxillary sinuses flogosis, the mucociliary clearance and physiological ventilation have to be aided, in order to make a safer and predictable sinus-lift surgery. This new surgical approach provides the restitution ad integrum of sinus health and at the same time, its grafting. If possible, implants were placed during the same surgical procedures. A 1 center retrospective study was performed in a private clinic of Rome, from January 2006 to November 2013. Seventy-eight adult patients with maxillary atrophy and sinus disventilation no responding to 3-week pharmacological therapy were admitted. All of them underwent to medical history, clinical examination, nasal endoscopies, and computed tomography (CT) scan of nose and paranasal sinuses. Patients were divided in 2 groups using Lund Mackay CT scoring. A 1-step surgery based on FESS and maxillary sinus-lift was performed. Simultaneous implant placement was performed when a crestal thickness of at least 4 mm was present on CT examination. Patient's symptoms scoring was evaluated through visual analogical scale both pre- and postoperatively. Computed tomography scores were usually not in accordance with presurgical clinical condition. Patients with clinical symptoms of disventilatory sinus and low evidence of CRS on CT showed relevant improvements in symptoms' scores after endoscopic surgery. All implants achieved good primary stability; Only 1 patient had lost implant due to peri-implantitis during 1-year follow-up period (1.3%

Re: 2000 Years Temporomandibular Joint Ankylosis in Ancient Rome

[No abstract available

TMJ functional surgery in internal derangement

nternal derangement is the most common type of TMD affecting the TMJ being a common cause of persistent facial pain, headaches, jaw clicking, and jaw locking. This study is a retrospective analysis of all patients affected by internal derangement, according to Wilkes’ criteria, who underwent surgery with the same technique and same surgeon. From 1982 to 2005, at the Department of Maxillo-Facial Surgery, “Sapienza” Università di Roma, 352 patients were treated throughout open joint surgery for a total number of 696 treated joints. Long term follow up was accomplished in every patient from the smallest value of 3 years to the highest of 26 with a mean value of 12.5 years. A post surgical evaluation of the local pain was performed according to same classes of pre-surgical evaluation supplying the following results: in 543 joints there was no local pain corresponding to class I (78%), in 70 joints a class II pain range was present (10%), in 42 joints a class III was reported (6%), 28 joints presented a class IV (4%) and 13 joints class V (2%). Post surgical headache and cervical pain varied significantly: Class I counted 190 patients (54%), Class II counted 77 patients 22%, class III counted 39 patients (11%), class IV counted 21 patients (6%) and Class V counted 25 patients being the 7% of the whole sample. The results we had widely confirm the viability of our surgical approach for internal derangement