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Doctoral Thesis
DOI
10.11606/T.5.2006.tde-05012007-142354
Document
Author
Full name
Silvia Regina Dowgan Tesseroli de Siqueira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Teixeira, Manoel Jacobsen (President)
Aguiar, Paulo Henrique Pires de
Camparis, Cinara Maria
Reed, Umbertina Conti
Veiga, José Carlos Esteves
Title in Portuguese
Avaliação funcional mandibular e sensitiva orofacial de doentes com neuralgia trigeminal tratados com compressão do gânglio trigeminal com balão
Keywords in Portuguese
Dor facial
Medição da dor
Neuralgia do trigemeo/complicações
Neuralgia do trigemio/cirurgia
Neurocirurgia
Síndrome da disfunção temporomandibular
Abstract in Portuguese
Esse trabalho teve como objetivos avaliar as características odontologicas, verificar a ocorrência de complicações sensitivas orofaciais e determinar os aspectos funcionais mandibulares de 105 doentes com neuralgia idiopática do trigêmeo (NIT) submetidos 'a compressão radiculo-ganglionar com balão inflável. Foram realizadas 5 avaliações para cada doente: uma pré-cirúrgica e 4 pós-cirúrgicas (7, 30, 120 e 210 dias). Ocorreu comprometimento sensitivo mais intenso no território dos ramos maxilar e mandibular do nervo trigêmeo (p < 0,001) e poucas anormalidades no território do ramo oftálmico (p = 0,1815). As qualidades sensitivas calor, frio, tato, e dor foram afetadas. As queixas subjetivas de dormência foram mais frequentes do que as objetivadas durante o exame de sensibilidade facial (p < 0,001). foi elevada a ocorrência de disfunção oclusal (62,9%); 42,6% dos doentes apresentaram queixas espontâneas relacionadas à mastigação; houve intensificação da dor miofascial na musculatura mastigatória após a cirurgia (p < 0,001), que retornou aos valores iniciais após os 210 dias; a mobilidade mandibular também agravou-se (p < 0,001). Os autores concluiram que o procedimento é eficaz e seguro quando aplicado em doentes com NIT envolvendo o ramo oftálmico. Entretanto, recidiva é frequente e as complicações sensitivas e ou motoras orofaciais poderiam comprometer a qualidade de vida e dificultar a reabilitação funcional dos doentes.
Title in English
Sensitive and functional evaluation of the orofacial region of patients with trigeminal neuralgia treated with balloon compression.
Keywords in English
Dental pain
Neurosurgery
Orofacial pain
Surgery complications
Trigeminal neuralgia
Abstract in English
The aim of this study was to determine dental characteristics, abnormalities in masticatory function and ocurrence of orofacial sensorial complications in 105 patients with trigeminal neuralgia treated with radiculo-ganglionar compression of the trigeminal ganglion with balloon. The patients were evaluated in the pre-operative period and in 4 post-operative evaluations (7, 30, 120 and 210 days). Sensory deficits were more severe in the area innervated by the maxillary and the mandibular trigeminal branches (p < 0.001); the ophthalmic branch presented abnormalities in few cases. The sensory qualities heat, cold, tactile and pain were affected. Subjective numbness was more frequent than sensory abnormalities findings at the post-operative sensitive evaluation (p < 0.001). Dental occlusion abnormalities were observed in 62.9% of the patients and 42.6% of patients' complaints were spontaneous masticatory difficulties. During the post-operative period, myofascial pain of the masticatory muscles was statistically significant (p < 0.001), but normalized after 210 days in average. It also compromised the jaw mobility (p < 0.001). It was concluded that this procedure is safe for patients with idiopathic trigeminal neuralgia involving the ophthalmic branch; however, sensory and motor complications of the method can affect the quality of life and rehabilitation of the patient.
 
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Publishing Date
2007-01-09
 
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