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

Ninety-one new patients with myofascial pain-dysfunction (MPD) syndrome were studied prospectively. The patients experienced aural fullness, tinnitus, vertigo, odynophagia, and headache in addition to the cardinal symptoms of otalgia, muscle tenderness, temporomandibular joint (TMJ) click, and trismus. Some nonmasticatory muscles were found to be tender as frequently as the masticatory muscles. It is proposed that MPD syndrome as seen clinically involves more than just the masticatory musculature and is a composite of several head and neck myofascial pain syndromes including tensor tympani syndrome, muscle tension headache, cervical syndrome, and hyoid syndrome.
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PMID:Myofascial pain-dysfunction syndrome: the role of nonmasticatory muscles in 91 patients. 682 16

One hundred and seventy-one children up to 15 years of age and with acute otalgia were examined to find out whether otalgia or any other symptoms were so closely related to acute otitis media (AOM) as to make otoscopic examination unnecessary. AOM was diagnosed in 46%, simplex otitis in 15%, serous otitis media (SOM) in 17%, and normal eardrums in 22%. Children with AOM had fever and spontaneous perforation of the eardrums in 78% and 30% of the cases, respectively. Of the children who had not AOM (54%), the otalgia could in most cases be classified as referred pain due to, for instance, discomfort when swallowing, nasal obstruction or throat pain. Other reasons were general irritability due to fever, teething or moderate hearing loss. The difficulties in diagnosing AOM simply on the basis of symptoms were demonstrated in the investigation. Symptoms such as otalgia, otorrhea, fever or upper respiratory tract infection (URI), possibly except for the combination of otorrhea and fever, can occur without AOM. A correct otoscopic examination and evaluation of the eardrums is necessary in children with otalgia, other symptoms of URI or in doubtful cases of acute illness. Physicians without possibilities to evaluate the eardrums properly should thus refer the patient to an otologist without delay.
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PMID:Acute otalgia in children - findings and diagnosis. 689 Nov 67

All clinicians responsible for diagnosing and treating diseases of the head and neck should be familiar with the possible clinical manifestations of a mineralized stylohyoid or stylomandibular ligament. Many patients with Eagle's syndrome have been misdiagnosed as having neuralgias, TMJ problems, psychosomatic disorders, or other vague, ill-defined diseases of the head and neck. Unfortunately , patients have been treated for these conditions with negative results. Extraction of teeth, especially third molars, has been performed unnecessarily in an attempt to alleviate the symptoms caused by a mineralized stylohyoid or stylomandibular ligament. Patients complaining of vague facial pain (especially when swallowing, turning the head or opening the mouth), dysphagia, otalgia, and headache with dizziness and with radiographic evidence of mineralization in the stylohyoid-stylomandibular ligament complex may have Eagle's syndrome. If digital palpation of the tonsillar fossa on the affected side causes the typical pain that the patient has been experiencing and if the mineralized abnormality can be felt in the fossa, the patient is considered to have the syndrome, and surgical resection of the abnormality should be considered.
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PMID:Eagle's syndrome diagnosed after history of headache, dysphagia, otalgia, and limited neck movement. 695 Sep 78

The purpose of this study was to determine the relationship between TMJ symptoms, (muscle tenderness, joint noise, deviant jaw opening and closing patterns, and limited jaw opening), and a history of referred pain patterns (earaches, headaches, neck pain, and sinus problems). A questionnaire was completed by 100 subjects regarding histories of the previously mentioned problems. The researcher then examined the subject's TMJs, and their symptoms were recorded as being present or absent. The following relationships were found to be significant: Headaches and lateral pterygoid muscle tenderness, Earache and medial pterygoid muscle tenderness, Neck pain and one or more tender muscles, Sinus problems and one or more tender muscles, Sinus problems and temporal muscle tenderness, Sinus problems and medial pterygoid muscle tenderness. However, r values for the above relationships were between 0.22 and 0.3 indicating that the relationships were not strong. It appears that some normal patients already have patterns of masticatory muscle tenderness and associated referred pain patterns prior to seeking treatment for acute TMJ symptoms.
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PMID:TMJ symptoms and referred pain patterns. 695 Oct 44

Thirty-one children between the ages of 6 and 16 years with otalgia but normal eardrums were investigated for temporomandibular joint dysfunction. Ear disease was excluded by microscopic examination, pure tone audiometry and impedance tympanometry. Dental disease was excluded by clinical and radiographic examination. Temporomandibular joint dysfunction was diagnosed by finding tenderness of the joint or masticatory muscles in at least two separate sites at one examination. Twenty-one patients were assessed as having joint dysfunction and in 18 of these the diagnosis was made when the child was seen in pain. Tympanometry on painful ears did not reveal any abnormality or trend in the values for compliance or middle ear pressure. Simple methods of treatment were effective in all cases. Temporomandibular joint dysfunction should be suspected in any child who complains of recurrent otalgia in the absence of dental and otological disease.
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PMID:Temporomandibular joint dysfunction in children presenting as otalgia. 712 75

Nonotogenic otalgia may be due to referred or reflex pain, neuralgia, or to a psychogenic problem. Referred pain is due to irritative lesions involving the fifth, ninth, or tenth cranial nerves and spinal nerves C2 and C3. If pathologic problems in the area supplied by these nerves have been ruled out, the neuralgia should be considered in the differential diagnosis. Psychogenic factors must be identified and treated before any type of surgical therapy is recommended.
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PMID:Nonotogenic otalgia: diagnosis and treatment. 721 45

Cervical masses in adult patients should be regarded as metastatic until proven otherwise. Work-up must therefore begin with a thorough search for a possible primary cancer. 90% of all head and neck primaries that present with a cervical mass are located in the oral cavity, pharynx or larynx. Pain [particularly otalgia], dysphagia, nasal obstruction, unilateral hearing loss, and hoarseness are the most common key symptoms of these tumors. Cancer cannot always be ruled out, even with regression of symptoms following antibiotic treatment or normal laboratory findings. If no primary lesion is found, then fine-needle aspiration biopsy of the neck mass is indicated. Only if fine-needle aspiration biopsy fails to come up with a diagnosis, should open [whenever possible excisional] biopsy be performed.
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PMID:[Diagnostic procedures in obscure cervical nodes in adults]. 750 54

Children, 4-6 years old, 153 Caucasian and 50 African-American, from a pre-school and kindergarten programme in a low income industrial area, who participated in a voluntary oral health examination, were questioned and examined for signs and symptoms of craniomandibular disorders (CMD) and of oral parafunctions. Most of the CMD signs and symptoms were mild. Eight per cent had recurrent (at least 1-2 times per week) TMJ pain, and 5% had recurrent neck pain, African-American children more often than Caucasian children (P < 0.05). Seventeen per cent had recurrent headache. Three per cent had recurrent earache. Pain or tiredness in the jaws during chewing was reported by 25% of the children, more often by African-American than by Caucasian children (P < 0.001) and more often by girls than by boys (P < 0.05). Pain at jaw opening occurred in 10% of the children, more often in the African-American than in the Caucasian group (P < 0.001). Thirteen per cent of the children had problems in opening the mouth. Deviation during opening was observed in 17% and reduced opening in 2%. Reduced lateral movements, locking or luxation were not observed in any child. Palpation pain was found in the lateral TMJ area in 16%, in the posterior TMJ area in 25%, in the temporalis and masseter areas in 10%, and pain for all regions was found more often in the African-American than in the Caucasian children (P < 0.01). Thirty-four per cent of the African-American, and 15% of the Caucasian children admitted to having ear noises (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevalence of signs and symptoms of craniomandibular disorders and orofacial parafunction in 4-6-year-old African-American and Caucasian children. 772 49

A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the electrodissection technique as opposed to the blunt dissection and ligation technique. One hundred and four patients, each serving as his or her own control, were randomized to have either the right or left tonsil removed by electrodissection. There was significantly less pharyngeal pain on the electrodissection side in the first post-operative day in adult patients. This, however, was transient as there was increased pharyngeal discomfort and otalgia, both in severity and duration, on the electrodissection side by the end of first week. There was no difference in the incidence of haemorrhage between the two techniques.
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PMID:Post-operative morbidity in electrodissection tonsillectomy. 774 36

The association of the severity of temporomandibular arthropathy to ear, nose, and throat symptoms in patients with temporomandibular disorders has been poorly investigated in spite of its importance in clinical practice. The aim of this study was to see whether persons with more severe arthropathy have more ear, nose, and throat symptoms. Anamnestic and clinical evaluations were obtained at admission for 815 subjects with signs and symptoms of temporomandibular disorders of arthrogenic origin in physical tests. The severity of arthropathy was evaluated by a clinical index scoring joint sounds, tenderness to temporomandibular palpation, and pain severity in the temporomandibular joint region. Univariate analysis showed that the severity of arthropathy was significantly associated with ear, nose, and throat symptoms as a whole (P < .001) and specifically with deafness (P < .001) and dizziness (P < .05); however, tinnitus and earache were not statistically significantly associated. Multiple analysis showed deafness to be the only ear, nose, and throat variable independently associated with severity of arthropathy (P < .01). These findings lead to the conclusion that there is a considerable association between temporomandibular disorders of arthrogenic origin and ear, nose, and throat symptoms, especially deafness. They also suggest that further investigations should be done to compare the specific roles of craniocervical arthritis versus temporomandibular disorders in the etiology of ear, nose, and throat symptoms related to craniomandibular and craniocervical joint involvement.
J Orofac Pain 1994
PMID:Ear, nose, and throat symptoms in patients with TMD: the association of symptoms according to severity of arthropathy. 781 27


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