OBJECTIVETo analyze the relationship between symptoms and signs of temporomandibular disorders (TMD) and the patients' quality of life (QOL).

METHODSA total of 492 TMD patients were included in this study. The clinical examination results were recorded using Fricton index of temporomandibular joint function. "Visual analog scale (VAS) evaluation of QOL disturbance" was designed to quantitate patients' QOL, to evaluate the degree that the patients QOL was affected.

RESULTSChewing, daily life and emotion among all 8 items of QOL were frequently affected by TMD, and joint clicking had the least influence on QOL. Intermittent closed lock had more severe interference with QOL than joint clicking only. Severe and moderate pain or limited mouth opening affected the QOL more severely than mild pain or mild limited mouth opening. The simple linear relationship between Fricton index and patients' QOL was poor (r < 0.4).

CONCLUSIONSPain is the most frequently seen symptom in TMD. TMD could affect patients' QOL, including both physical and social-psychological functions. The results suggest that the patients' QOL as well as TMD symptoms and signs should be considered in the management of TMD.

Adult ; Facial Pain ; etiology ; Female ; Humans ; Male ; Quality of Life ; Temporomandibular Joint Disorders ; complications

Pus overflow from patent's fistula belew the left face near mandibular angle 2 years agowith a little pain. Symptoms relieved after oral antibiotics. This symptom frequently occurred in the past six months. Postoperative facial paralysis occurred after surgery, and recovered after treatment. It was diagnosed as the postoperative facial paralysis after first branchial fistula surgery.
Branchial Region ; pathology ; surgery ; Face ; Facial Paralysis ; etiology ; Fistula ; pathology ; surgery ; Humans ; Mandible ; Pain

OBJECTIVETo investigate the pain features of temporomandibular disorders (TMD) by qualitatively and quantitatively analyzing patient multi-dimension sensations.

METHODSTwo hundred and fifty patients with painful TMD from January to December 2005 were included, short-form mcgill pain questionnaire (SF-MPQ) and visual analog scale (VAS) were administered to assess patients' sensation, affection and intensity of pain. The data were analyzed by SAS 8.0 software.

RESULTSAll patients were assigned to three groups including 139 joint pain, 47 muscle pain and 64 both joint and muscle pain group. In joint pain group, the total number of descriptors was 250, 1.80 in average; in muscle pain group, the total number was 99, 2.11 in average; in both joint and muscle pain group, the total number was 107, 1.64 in average. The sensitive descriptors most frequently chosen in all three groups were "aching", "heavy", and "tender". "Tiring-exhausting" and "sickening" were high frequency descriptors in affective items. There were higher affective scores in the muscle pain group than in others. Muscle pain group had a higher VAS score at rest than the other two (P < 0.05), but had a lower VAS score during function than the other two (P < 0.001). All three groups usually had no pain at rest, and complained a slight to moderate pain during function.

CONCLUSIONSTMD pain was generally slight to moderate; "aching", "heavy", and "tender" were the most frequently sensitive descriptors, while unpleasant feelings were described as "tiring-exhausting" and "sickening"; pain generally occurred or exacerbated during mandibular function; compared to joint pain, muscle pain had its own features.

Adult ; Facial Pain ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged ; Pain ; epidemiology ; etiology ; Pain Measurement ; Surveys and Questionnaires ; Temporomandibular Joint Disorders ; complications ; epidemiology ; Young Adult

The clinical manifestation of acute invasive fungal sinusitis was associated with facial pain,altered sense of smell, blindness and headache. Physical examinations show that dark brown nasal secretions with bone resorption in paranasal sinus. Radiographi parameters showed uneven density in paranasal sinus and intraorbital extension. Fungus smears and pathological examination can make a definitive diagnosis.
Acute Disease ; Facial Pain ; etiology ; Fungi ; isolation & purification ; Headache ; etiology ; Humans ; Mycoses ; complications ; pathology ; Paranasal Sinuses ; Sinusitis ; complications ; microbiology ; pathology

Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.
Carcinoma, Hepatocellular/complications/*pathology ; Facial Nerve Diseases/diagnosis/etiology ; Facial Pain/etiology ; Facial Paralysis/diagnosis/etiology ; Hepatitis B, Chronic/diagnosis ; Hepatitis C, Chronic/diagnosis ; Humans ; Immunohistochemistry ; Liver Neoplasms/complications/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Skull Neoplasms/*diagnosis/pathology/secondary ; Tomography, X-Ray Computed

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.
Case-Control Studies ; Chronic Disease ; Evaluation Studies as Topic ; Facial Pain ; etiology ; physiopathology ; Female ; Humans ; Neck Pain ; etiology ; physiopathology ; Sensory Thresholds ; Skin ; physiopathology ; Statistics, Nonparametric ; Thermosensing ; Trigeminal Nerve Injuries ; complications ; physiopathology ; Whiplash Injuries ; complications ; physiopathology

OBJECTIVETo investigate changes of two sodium channels, PN(3) and NaN, during orofacial pain by occlusal trauma in rat.

METHODSExpressions of PN(3) mRNA and NaN mRNA in trigeminal ganglion were tested during various periods of persistent occlusal trauma with reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSIn groups, including control, occlusal trauma groups, PN(3) mRNA and NaN mRNA were all expressed in trigeminal ganglion neurons. In the control group, there were similar density values bilaterally. In the occlusal trauma group, the density values in gel electrophoresis of PN(3) mRNA and NaN mRNA on the intervention side were slightly greater than those on the control side.

CONCLUSIONSThe stimulation of occlusal trauma upregulates expressions of PN(3) mRNA and NaN mRNA, which suggests the signal occurring and conduction of chronic pain by occlusal trauma have the same molecular mechanism of sodium channel as inflammatory pain.

Animals ; Dental Occlusion, Traumatic ; physiopathology ; Facial Pain ; etiology ; Male ; NAV1.8 Voltage-Gated Sodium Channel ; RNA, Messenger ; biosynthesis ; Rats ; Rats, Sprague-Dawley ; Sodium Channels ; biosynthesis ; genetics ; Trigeminal Ganglion ; metabolism

The maxillary sinus is the largest paranasal sinuses. Foreign bodies of nosal sinus can caused by car accidents, firearm attacks, or iatrogeniccause. We reported two rare cases of foreign body of pulp needle and loach. The clinical manifestations might include facial numbness, facial paresthesia, swelling, nasal congestion, facial pain, eye discomfort, limited mouth opening and relapse and etc. Both CT scan and the medical history were helpful in diagnosis. Functional endoscopic surgery would be the first choice of treatment.
Chronic Disease ; Endoscopy ; Facial Pain ; Foreign Bodies ; diagnosis ; Humans ; Maxillary Sinus ; pathology ; Paranasal Sinus Diseases ; etiology ; pathology ; Paresthesia ; Tomography, X-Ray Computed

OBJECTIVETo compare the central nervous system processing of orofacial pain patients who might have atypical pain (group 1) after occlusal treatment with those patients who had synovitis pain of temporomandibular disorders (TMD) (group 2).

METHODSSeven patients in each group were included in this study. Ten painless normal subjects (group 3) were employed as a control group. Functional magnetic resonance imaging (fMRI) was used to observe the activation of the brain evoked by clenching. The fMRI data were treated statistically as the result of each group.

RESULTSThe main active regions of three groups were different. The main active regions of the group 1 were bilateral thalamus and anterior cingulate cortex. The group 2 activated a quite different pain network, including postcentral gyrus, cingulate gyrus and prefrontal cortices.

CONCLUSIONSThe pain network is different between the two groups of pain patients and the pain network is more sensitive in atypical pain patients than in synovitis pain patients.

Adult ; Brain ; physiopathology ; Dental Restoration, Permanent ; adverse effects ; psychology ; Denture, Partial, Fixed ; adverse effects ; psychology ; Facial Pain ; etiology ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Temporomandibular Joint Disorders ; etiology ; physiopathology