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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Temporomandibular joint (TMJ) dysfunction describes a pain-dysfunction phenomenon that usually afflicts persons in their 4th or 5th decade. The syndrome can be produced by a variety of etiologic factors including occlusal disharmony, articular disorders, and muscle imbalance. It may cause severe otalgia and refer pain to the temple, occiput, nape of neck, and shoulders. Often, associated joint clicking or popping, aural fullness, vertigo, tinnitus, subjective hypoacusis, and nausea occur. As it has not been previously reported in infants, we would like to describe our experience with this disorder in an 11-month-old boy who was referred to our clinic with a presumed diagnosis of otitis media. The embryology of the temporomandibular joint is reviewed and appropriate treatment with anti-inflammatory analgesics, warm compresses, orthodontics, and external brace appliances is discussed. Because of referral patterns in the infant age group, the pediatric otolaryngologist should be similar with this entity and its presentation in children.
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PMID:Temporomandibular joint dysfunction in infancy. 381 95

The craniocervical syndrome is an entity whose symptoms: vertigo, cephalea, tinnitus, facial pain, otalgia, dysphagia, pain of the carotid artery are thought to be caused by cervical factors. In the majority of cases the cranio-cervical syndrome is caused by a spondylarthrogenic segmental dysfunction whose pathophysiology is explained. In the pathogenesis lesions of the joints of the skull which may be responsible for pain and dysfunction in the segmental areas are of great importance. The neurology of the joints of the skull, as well as the pathological mechanisms of spondylarthrogenic disturbances, responsible for the different kinds of dysfunction of the equilibrium and for cephalea are discussed. The pathophysiological basis of manual diagnosis is explained; also the radiological findings of the upper cervical vertebral column are principally discussed. A short review of therapeutic recommendations is given.
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PMID:[The cervico-cranial syndrome in the practice of the otorhinolaryngologist]. 403 8

Temporomandibular joint dysfunction is a benign, relatively uncommon childhood disorder and should be considered in children who have intermittent unilateral otalgia of three to four days' duration and whose audiographic, tympanometric, and clinical otologic examinations reveal normal findings. Most of the patients in our study had undergone orthodontic therapy during the year preceding the onset of temporomandibular joint dysfunction, and the vast majority of them had received orthodontic treatment within two weeks of each episode of otalgia. The diagnosis can be confirmed clinically by reproducing the pain associated with masticatory muscle spasm by palpation of the preauricular areas, intraotic manipulation, and palpation of the pterygoid muscles. Treatment consists of administering acetaminophen, applying hot compresses to the preauricular area, and opening and closing the mouth 30 to 40 times after each compress as an effort to interrupt the muscle spasm.
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PMID:The phantom earache. Temporomandibular joint dysfunction in children. 403 30

A study of 112 referred children with acute otalgia labeled 'acute otitis media' by the referring physicians was carried out at the E.N.T. clinic of Lagos University Teaching Hospital in 1981-1982. Only 11% of these were actually due to acute otitis media, reflecting poor technique at otoscopy. Of the acute otalgia cases 56% were due to ear pathology while 44% resulted from referred pain. Otological causes included foreign body in the ear (23%), acute otitis media (11%), otitis externa (10%), secretory otitis media (6%) and myringitis bullosa haemorrhagica (4%). Cases due to referred otalgia were from tonsillitis (21%), foreign body in the pharynx (5%), traditional uvulectomy (5%), and foreign body in the nose (2%). Thus, there is a need for more careful examination of the ear in all cases of acute otalgia.
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PMID:Acute otalgia in Nigerian children. 409 73

Headaches are a frequent symptom in ENT-patients. The complex sensory innervation of the ear, nose and paranasal sinuses is demonstrated. Heterotopic or referred pain must be differentiated from homotopic pain that is experienced at the point of injury. The nervous pathways of heterotopic otalgia are shown. The quality of pain of the most common rhinological and otological diseases is reported.
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PMID:[Headaches caused by ENT diseases]. 638 2

Although petrous apicitis was a frequent occurrence in the first half of this century, it has become an uncommon disease because of the widespread use of antibiotics for otitis media. In this series of eight cases of petrous apicitis it is evident that petrositis cannot be equated with Gradenigo's triad (otitis, abducens paralysis, and deep pain) since none of the cases manifested with the classical syndrome. Abducens paralysis was seen in only two of the eight cases. Deep facial or ear pain was present in four of the eight cases and appeared to be the most useful symptom in the diagnosis of petrositis. Four of the eight cases were discovered only after previous, unsuccessful surgical procedures. Chronic petrous apicitis may be occult and manifest only after failure to control suppuration by conventional tympanomastoid surgery. When petrositis is suspected, conventional x-ray study may show bone erosion and asymmetric clouding of the petrous tip. Computed tomographic scanning was most useful in the delineation of bone destruction and of the apex. When the diagnosis of petrous apicitis is made, aggressive surgical drainage is indicated.
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PMID:Petrous apicitis. Clinical considerations. 666 Jul 45

The efficacy of 'Difflam' Oral Rinse and soluble aspirin in the post-operative management of tonsillectomy in adult patients has been compared. Whilst aspirin proved slightly more effective in relieving pain and discomfort of swallowing, 'Difflam' Oral Rinse was superior in the relief of earache, in promoting the healing of the tonsil bed and in the duration of necessity of treatment. It is therefore suggested that the two preparations might be taken concomitantly to provide quick, as well as long-lasting, pain relief.
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PMID:A comparative study of benzydamine hydrochloride 0.15% w/v ('Difflam' Oral Rinse) and acetyl salicylic acid as analgesics following tonsillectomy. 673 25

A small series of pain syndrome patients shows that disturbances of the head and neck motor system can lead to various pain syndromes as the vicious circle between pain and muscle tension is initiated by a triggering factor. These pain syndromes include varying combinations of the following symptoms: headache, referred otalgia, arthralgia of the temporomandibular joint, styloid syndrome, tendopathia of the hyoid bone, carotidynia, cervical dysphagia and probably most patients with superior laryngeal nerve neuralgia or glossopharyngeal neuralgia. A detailed differentiation of those syndromes is of little value for diagnostic and therapeutical purposes, because the mixed distribution of the pain irradiation does not indicate the localisation of the primary pathology. The pain syndromes of the head and neck motor system can be caused by temporomandibular joint pathology as well as by anatomical or functional alterations of the cervical spine. Acute exacerbations are triggered off by various influences such as inflammation, trauma, scarring after surgery or radiotherapy. Thus diagnostic and therapeutic measures must take into consideration both the motor system itself and any possible triggering factors. The problem frequently needs interdisciplinary co-operation. An attempt to handle the problem within the boundaries of a single discipline such as ENT, may lead to unnecessary and misleading steps. Guidelines for the management of such pain syndromes are outlined.
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PMID:[Pain syndromes of the head, neck and locomotor system--determining current status]. 674 25

The effect of peroral penicillin V (55 mg/kg/day) on acute otitis media was investigated in 149 children between the ages of one and ten years in a double-blind, placebo-controlled investigation. The parameters of the disease employed were symptom scores for earache, the use of analgetics, otoscopy, as well as tympanometry. The children were followed up for three months. Penicillin had a significant effect on pain on the second day of treatment. The acute course of the disease was satisfactory in 69% of the children in the placebo group and in 86% in the penicillin group. In patients with pneumococci or hemolytic streptococci in the rhinopharynx, the pain already disappeared after one to two doses of penicillin, whereas the treatment had no effect on the patients with Haemophilus influenzae. There was no difference between the penicillin and placebo groups with regard to the results of otoscopy and tympanometry after one week, one month and three months. No serious complications were observed. It is concluded that an attitude of "masterful inactivity" with regard to the treatment of acute otitis media is justifiable, and in the majority of cases advisable, provided sufficient analgesic treatment is given and also that the patient can be closely followed. As there are still many unanswered questions more controlled investigations are warranted.
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PMID:Penicillin and acute otitis: short and long-term results. 677 24

The effect of peroral penicillin-V (55 mg/kg/day in 7 days) on acute otitis media was studied in 149 children between the ages of 1 and 10 years in a double-blind, placebo-controlled investigation. The parameters of the disease employed were symptom scores for earache, fever and common cold, the use of analgetics, otoscopy, as well as tympanometry. The children were followed-up for 3 months. Penicillin had no effect on fever and common cold, but earache was significantly reduced on the 2nd day of treatment. The acute course of the disease was satisfactory in 69% of the children in the placebo group and in 86% in the penicillin group. In patients with pneumococci or haemolytic streptococci in the nasopharynx, the pain disappeared after 1-2 doses of penicillin, whereas the treatment had no effect in children with Haemophilus influenzae. There was no difference between the penicillin and the placebo groups with regard to the results of otoscopy and tympanometry after 1 week, 1 month and 3 months. No serious complications were observed. It is concluded that an attitude of "masterly inactivity" with regard to the treatment of acute otitis media is justifiable, provided sufficient analgesic treatment is given and also that the patient can be closely followed. As there are still many unanswered questions more controlled investigations are warranted.
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PMID:Penicillin in acute otitis media: a double-blind placebo-controlled trial. 679 64


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