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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2011.tde-19122011-120643
Document
Author
Full name
Mariana Siviero
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Siqueira, Silvia Regina Dowgan Tesseroli de (President)
Chavez, Victor Elias Arana
Teixeira, Manoel Jacobsen
Title in Portuguese
Avaliação sensitiva orofacial, gustativa, olfativa e salivar em doentes com neuralgias trigeminais
Keywords in Portuguese
Dor orofacial
Limiar sensorial
Modalidades sensoriais
Neuralgia do trigêmeo
Neuralgia facial
Neuralgia pós-herpética
Síndrome da ardência bucal
Abstract in Portuguese
Neuralgia pós-herpética trigeminal (NPH), neuralgia idiopática do trigêmeo (NIT) e síndrome da ardência bucal (SAB) são doenças neuropáticas da face, caracterizadas por dor na ausência de sinais que evidenciem a causas. Este estudo teve por objetivos determinar as características sensitivas, olfativas, gustativas e salivares em doentes com NPH, NIT e SAB comparados a controles. Foram avaliados 20 doentes de cada grupo, diagnosticados de acordo com critérios da International Association for the Study of Pain (IASP), e 60 indivíduos saudáveis, através de um protocolo sistematizado que incluiu os seguintes testes quantitativos sensitivos: limiares térmicos (frio e calor), limiares mecânicos tácteis, limiares dolorosos de superfície, limiares gustativos (doce, azedo, salgado e amargo), limiares olfativos e fluxo salivar. Os testes foram realizados no território de inervação trigeminal. Os dados foram analisados através dos testes estatísticos ANOVA 1 fator, Tukey, Kruskal-Wallis e Dunn, e o nível de significância foi de 5%. Os limiares térmicos de frio foram diferentes (maiores) somente no ramo mandibular dos doentes com NPH (p=0,001) e os limiares térmicos de calor foram diferentes (maiores) em todos os ramos trigeminais nos doentes com NPH e SAB (p=0,001); a sensibilidade mecânica táctil estava alterada no ramo mandibular de doentes com NPH (p=0,001) e em todos os ramos trigeminais dos doentes com SAB (p= 0,001; p=0,004 e p=0,001); os limiares gustativos salgado e doce, além do limiar olfativo, foram maiores em todos os doentes quando comparados aos controles (p=0,004; p=0,001 e p=0,0389); o sabor ácido obteve os menores limiares e não foram encontradas diferenças para a identificação do sabor amargo ou na avaliação salivar quantitativa (p=0,1694 e p=0,001). Este estudo apresentou evidências de anormalidades sensitivas nos doentes com dor neuropática trigeminal, tanto somestésicas como gustativas e olfativas. A sensibilidade somatosensitiva apresentou-se mais alterada nos doentes com NPH e SAB quando comparados a NIT e aos controles. Mecanismos periféricos e centrais relacionados à percepção e modulação sensitiva podem estar envolvidos na fisiopatologia dos achados aqui observados
Title in English
Somesthetic, gustatory, olfactory function and salivary flow in patients with neuropathic trigeminal pain
Keywords in English
Burning mouth syndrome
Facial neuralgia
Facial pain
Modalities sensorial
Neuralgia postherpetic
Sensory thresholds
Trigeminal neuralgia
Abstract in English
Trigeminal postherpetic neuralgia (PHN), idiopathic trigeminal neuralgia (ITN) and burning mouth syndrome (BMS) are painful neuropathies with no clear signs about their causes. The objectives of this study were to determine somatosensory, olfactory, gustative and salivary characteristics of patients with PHN, ITN and BMS compared to controls. Twenty patients from each group, diagnosed according to the criteria from the International Association for the Study of Pain (IASP), and 60 healthy controls were evaluated with a systematized quantitative approach which included thermal (cold and warm), mechanical (tactile), pain, gustative (sweet, sour, salty and bitter) and olfactory thresholds, and quantitative salivary flow evaluation. Data were analyzed with ANOVA 1 factor, Tukey, Kruskal-Wallis and Dunn tests with a level of significance of 5%. Thermal thresholds for cold were different (higher) only in the mandibular branch of patients with PHN (p=0.001) and warm thresholds were higher in all trigeminal branches of PHN and BMS (p=0,001); tactile mechanical sensitivity was altered at the mandibular branch of PHN (p=0,001) and in all trigeminal branches of BMS (p= 0,001; p=0,004 e p=0,001). The salty, sweet and olfactory thresholds were higher in all studied groups (p=0,004; p=0,001 e p=0,0389); the sour threshold was lower and there were no differences in bitter taste or salivary flow (p=0,1694 e p=0,001). This study showed evidences of somatosensory, gustative and olfactory abnormalities in patients with neuropathic orofacial pain. Somatosensory findings were discrete in ITN and more common in PHN and BMS. Peripheral and central mechanisms of perception and modulation could be involved in the physiopathology of these findings
 
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MarianaSiviero.pdf (2.26 Mbytes)
Publishing Date
2011-12-19
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • SIVIERO, M., et al. Rapid communication: Central Mechanisms in burning mouth syndrome involving the olfactory nerve: preliminary study. Clinics (USP. Impresso), 2011, vol. 66, p. 509-512.
  • SIVIERO, M., et al. Somesthetic, gustatory, olfactory function and salivary flow in patients with neuropathic trigeminal pain. Oral Diseases, 2010, vol. 16, p. 482-487.
  • SIQUEIRA, SILVIA R. D. T. DE, et al. Quantitative sensory testing in trigeminal traumatic neuropathic pain and persistent idiopathic facial pain [doi:10.1590/S0004-282X2013000300009]. Arquivos de Neuro-Psiquiatria [online], 2013, vol. 71, p. 174-179.
  • SIVIERO, M., et al. Facial sensibility of patients with trigeminal neuralgias. Clinical Neurology and Neurosurgery (Dutch-Flemish ed.), 2011, vol. 113, p. 268-271.
  • Siqueira SRDT, et al. Facial Sensibility, Smell and Taste in Trigeminal Neuropathic Pain. In Annual Meeting of the International Association of Dental Research, Miami, 2009. Annual Meeting of the International Association of Dental Research., 2009. Abstract.
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