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Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study

  • Clinical Article - Functional
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Abstract

Background

Surgical trauma at the temporalis muscle is a potential cause of post-craniotomy headache and temporomandibular disorders (TMD). The aim of this study was to evaluate the prevalence of pain, masticatory dysfunction and trigeminal somatosensory abnormalities in patients who acquired aneurysms following pterional craniotomy.

Methods

Fifteen patients were evaluated before and after the surgical procedure by a trained dentist. The evaluation consisted of the (1) research diagnostic criteria for TMD, (2) a standardized orofacial pain questionnaire and (3) a systematic protocol for quantitative sensory testing (QST) for the trigeminal nerve.

Results

After pterional craniotomy, 80% of the subjects, 12 patients, developed orofacial pain triggered by mandibular function. The pain intensity was measured by using the visual analog scale (VAS), and the mean pain intensity was 3.7. The prevalence of masticatory dysfunction was 86.7%, and there was a significant reduction of the maximum mouth opening. The sensory evaluation showed tactile and thermal hypoesthesia in the area of pterional access in all patients.

Conclusions

There was a high frequency of temporomandibular dysfunction, postoperative orofacial pain and trigeminal sensory abnormalities. These findings can help to understand several abnormalities that can contribute to postoperative headache or orofacial pain complaints after pterional surgeries.

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Acknowledgements

The authors acknowledge the patients who participated in this study.

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Authors and Affiliations

  1. Dentistry Division of the Central Institute and Neurosurgical Division of the Psychiatry Institute, Hospital das Clínicas of the Medical School of University of São Paulo (USP), Avenida Doutor Enéas Carvalho de Aguiar, 255, 6º andar, sala 2, São Paulo, SP, 05403-900, Brazil

    Thiago Medina Brazoloto, Silvia Regina Dowgan Tesseroli de Siqueira, Eberval Gadelha Figueiredo, Manoel Jacobsen Teixeira & José Tadeu Tesseroli de Siqueira

  2. Department of Neuropsychiatry, Universidade Federal de Pernambuco, Recife, PE, Brazil

    Pedro Augusto Sampaio Rocha-Filho

  3. Universidade de Pernambuco, Recife, Brazil

    Pedro Augusto Sampaio Rocha-Filho

Authors
  1. Thiago Medina Brazoloto
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  2. Silvia Regina Dowgan Tesseroli de Siqueira
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  3. Pedro Augusto Sampaio Rocha-Filho
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  4. Eberval Gadelha Figueiredo
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  5. Manoel Jacobsen Teixeira
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  6. José Tadeu Tesseroli de Siqueira
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Correspondence to Thiago Medina Brazoloto.

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No funding was received for this research.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Brazoloto, T.M., de Siqueira, S.R.D.T., Rocha-Filho, P.A.S. et al. Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study. Acta Neurochir 159, 799–805 (2017). https://doi.org/10.1007/s00701-017-3137-9

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  • DOI: https://doi.org/10.1007/s00701-017-3137-9

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