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Auriculotemporal Nerve Entrapment

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Abstract

Auriculotemporal nerve (ATN) entrapment commonly causes pain around the ear and jaw and can have overlapping characteristics to migraine headaches. Diagnosis is made by physical examination of the temporal fossa and the temporomandibular joint and by injection of local anesthetic over the nerve. Treatment of ATN entrapment includes medications, nerve injections, cryoneuroablation, chemical neurolysis, neuromodulation, and surgical decompression.

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References

  1. Calandre EP, Hidalgo J, Garcia-Leiva JM, Rico-Villademoros F. Trigger point evaluation in migraine patients: an indication of peripheral sensitization linked to migraine predisposition? Eur J Neurol Off J Eur Fed Neurol Soc. 2006;13(3):244–9.

    CAS  Google Scholar 

  2. Speciali JG, Gonçalves DA. Auriculotemporal neuralgia. Curr Pain Head Rep. 2005;9:277–80.

    Article  Google Scholar 

  3. Stuginski-Barbosa J, Murayama RA, Conti PC, Speciali JG. Refractory facial pain attributed to auriculotemporal neuralgia. J Headache Pain. 2012;13(5):415–7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Martis C, Athanassiades S. Auriculotemporal syndrome (Frey’s syndrome), secondary to fracture of the mandibular condyle. Plast Reconstr Surg. 1969;44(6):603–4.

    Article  CAS  PubMed  Google Scholar 

  5. Gordon AB, Fiddian RV. Frey’s syndrome after parotid surgery. Am J Surg. 1976;132(1):54–8.

    Article  CAS  PubMed  Google Scholar 

  6. Ansari H, Robertson CE, Lane JI, Viozzi CF, Garza I. Auriculotemporal neuralgia secondary to TMJ synovial cyst: a rare presentation of a rare entity. Headache. 2013;53(10):1662–5.

    Article  PubMed  Google Scholar 

  7. Chan M, Dmytriw AA, Bartlett E, Yu E. Imaging of auriculotemporal nerve perineural spread. Ecancermedicalscience. 2013;7:374.

    PubMed  PubMed Central  Google Scholar 

  8. De Benedittis G. Auriculotemporal syndrome (Frey’s syndrome) presenting as tic douloureux. Report of two cases. J Neurosurg. 1990;72(6):955–8.

    Article  PubMed  Google Scholar 

  9. Goldstein DS, Pechnik S, Moak J, Eldadah B. Painful sweating. Neurology. 2004;63(8):1471–5.

    Article  PubMed  Google Scholar 

  10. Ngeow WC, Chai WL. Numbness of the ear following inferior alveolar nerve block: the forgotten complication. Br Dent J. 2009;207(1):19–21.

    Article  CAS  PubMed  Google Scholar 

  11. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.

    Google Scholar 

  12. Murayama RA, Stuginski-Barbosa J, Moraes NP, Speciali JG. Toothache referred from auriculotemporal neuralgia: case report. Int Endod J. 2009;42(9):845–51.

    Article  CAS  PubMed  Google Scholar 

  13. Damarjian E. Auriculo-temporal neuralgia – an original diagnostic and therapeutic approach. R I Med J. 1970;53(2):100–1.

    CAS  PubMed  Google Scholar 

  14. Trescot AM. Headache: is it a migraine? Think again. Technol Reg Anesth Pain Manag. 2005;9:68–72.

    Article  Google Scholar 

  15. Frey L. Le syndrome du nerf auriculo-temporal. Rev Neurol (Paris). 1923;2:97–104.

    Google Scholar 

  16. Kamath RA, Bharani S, Prabhakar S. Frey’s syndrome consequent to an unusual pattern of temporomandibular joint dislocation: case report with review of its incidence and etiology. Craniomaxillofac Trauma Reconstr. 2013;6(1):1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Choi HG, Kwon SY, Won JY, Yoo SW, Lee MG, Kim SW, et al. Comparisons of three indicators for Frey’s syndrome: subjective symptoms, minor’s starch iodine test, and infrared thermography. Clin Exp Otorhinolaryngol. 2013;6(4):249–53.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Scrivani SJ, Keith DA, Kulich R, Mehta N, Maciewicz RJ. Posttraumatic gustatory neuralgia: a clinical model of trigeminal neuropathic pain. J Orofac Pain. 1998;12(4):287–92.

    CAS  PubMed  Google Scholar 

  19. Loughner BA, Larkin LH, Mahan PE. Nerve entrapment in the lateral pterygoid muscle. Oral Surg Oral Med Oral Pathol. 1990;69(3):299–306.

    Article  CAS  PubMed  Google Scholar 

  20. Chim H, Okada HC, Brown MS, Alleyne B, Liu MT, Zwiebel S, et al. The auriculotemporal nerve in etiology of migraine headaches: compression points and anatomical variations. Plast Reconstr Surg. 2012;130(2):336–41.

    Article  CAS  PubMed  Google Scholar 

  21. Andersen NB, Bovim G, Sjaastad O. The frontotemporal peripheral nerves. Topographic variations of the supraorbital, supratrochlear and auriculotemporal nerves and their possible clinical significance. Surg Radiol Anat. 2001;23(2):97–104.

    Article  CAS  PubMed  Google Scholar 

  22. Janis JE, Hatef DA, Thakar H, Reece EM, McCluskey PD, Schaub TA, et al. The zygomaticotemporal branch of the trigeminal nerve: part II. Anatomic variations. Plast Reconstr Surg. 2010;126(2):435–42.

    Article  CAS  PubMed  Google Scholar 

  23. Janis JE, Hatef DA, Thakar H, Reece EM, McCluskey PD, Schaub TA, et al. The zygomaticotemporal branch of the trigeminal nerve: part II. Anatomical variations. Plast Reconstr Surg. 2010;126(2):435–42.

    Article  CAS  PubMed  Google Scholar 

  24. Fernandes PR, de Vasconsellos HA, Okeson JP, Bastos RL, Maia ML. The anatomical relationship between the position of the auriculotemporal nerve and mandibular condyle. Cranio. 2003;21(3):165–71.

    Article  PubMed  Google Scholar 

  25. Williams PL, Warwick R, editors. Gray’s anatomy. 36th ed. Edinburgh: Churchill Livingstone; 1980.

    Google Scholar 

  26. Totonchi A, Pashmini N, Guyuron B. The zygomaticotemporal branch of the trigeminal nerve: an anatomical study. Plast Reconstr Surg. 2005;115(1):273–7.

    CAS  PubMed  Google Scholar 

  27. Schmidt BL, Pogrel MA, Necoechea M, Kearns G. The distribution of the auriculotemporal nerve around the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86(2):165–8.

    Article  CAS  PubMed  Google Scholar 

  28. Anil A, Peker T, Turgut HB, Gulekon IN, Liman F. Variations in the anatomy of the inferior alveolar nerve. Br J Oral Maxillofac Surg. 2003;41(4):236–9.

    Article  CAS  PubMed  Google Scholar 

  29. Komarnitki I, Andrzejczak-Sobocinska A, Tomczyk J, Deszczynska K, Ciszek B. Clinical anatomy of the auriculotemporal nerve in the area of the infratemporal fossa. Folia Morphol (Warsz). 2012;71(3):187–93.

    CAS  Google Scholar 

  30. Kemp WJ, Tubbs RS, Cohen-Gadol AA. The innervation of the scalp: a comprehensive review including anatomy, pathology, and neurosurgical correlates. Surg Neurol Int. 2011;2:178.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Shanker H, Brethauer J. Ultrasound guided steroid injection for auriculo-temporal neuralgia (poster presentation). San Francisco: American Society of Anesthesiologists; 2007.

    Google Scholar 

  32. Trescot AM. Headache management in an interventional pain practice. Pain Phys. 2000;3(2):197–200.

    CAS  Google Scholar 

  33. Adams S. Cranial neuralgia and chronic post-traumatic headache with pulsed radio-frequency ablation of the left supraorbital, auriculotemporal and greater and lesser occipital nerves: a case report (poster presentation). Tampa: American Pain Society; 2014.

    Google Scholar 

  34. Pomprasit M, Chintrakarn C. Treatment of Frey’s syndrome with botulinum toxin. J Med Assoc Thai Chotmaihet Thangphaet. 2007;90(11):2397–402.

    PubMed  Google Scholar 

  35. Simopoulos T, Bajwa Z, Lantz G, Lee S, Burstein R. Implanted auriculotemporal nerve stimulator for the treatment of refractory chronic migraine. Headache. 2010;50(6):1064–9.

    Article  PubMed  Google Scholar 

  36. Deshpande KK, Wininger KL. Feasibility of combined epicranial temporal and occipital neurostimulation: treatment of a challenging case of headache. Pain Phys. 2011;14(1):37–44.

    Google Scholar 

  37. Poggi JT, Grizzell BE, Helmer SD. Confirmation of surgical decompression to relieve migraine headaches. Plast Reconstr Surg. 2008;122(1):115–22.

    Article  CAS  PubMed  Google Scholar 

  38. Guyuron B, Kriegler JS, Davis J, Amini SB. Five-year outcome of surgical treatment of migraine headaches. Plast Reconstr Surg. 2010;127(2):603–8.

    Article  Google Scholar 

  39. Guyuron B, Harvey D, Reed D. A prospective randomized outcomes comparison of two temple migraine trigger site deactivation techniques. Plast Reconstr Surg. 2015;136(1):159–65.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Esther Rawner MD .

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Physical exam of the auriculotemporal nerve (MOV 27252 kb)

Landmark-guided injection of the auriculotemporal nerve (MOV 34915 kb)

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Trescot, A.M., Rawner, E. (2016). Auriculotemporal Nerve Entrapment. In: Trescot, A.M. (eds) Peripheral Nerve Entrapments. Springer, Cham. https://doi.org/10.1007/978-3-319-27482-9_15

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  • DOI: https://doi.org/10.1007/978-3-319-27482-9_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27480-5

  • Online ISBN: 978-3-319-27482-9

  • eBook Packages: MedicineMedicine (R0)

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