Correlation between facial types and muscle TMD in women: an anthropometric approach

Temporomandibular disorders (TMD) affecting the articular disc and/or the facial muscles are common among the population, recording a higher incidence in women age 20-40 years. The aim of this study was to investigate the correlation between facial types and muscle TMD in women. This study comprised 56 women age 18 to 49 years, seeking treatment for TMD at the School of Medicine, Federal University of São Paulo. All of the study individuals were diagnosed with muscle TMD, based on the Research Diagnostic Criteria (RDC). Facial type was determined using the Facial Brugsch Index and classified as euryprosopic (short and/or broad), mesoprosopic (average width) and leptoprosopic (long and/or narrow). The data were submitted to the Chi-square test and ANOVA-Tukey’s test to conduct the statistical analysis. The faces of 27 individuals were classified as euryprosopic (48%), 18 as mesoprosopic (32%), and 11 as leptoprosopic (20%). A statistically significant difference (Chi-square, p = 0.032) was found among the facial types, in that leptoprosopic facial types showed the lowest values for muscle TMD. A greater number (p = 0.0007) of cases of muscle TMD were observed in the 20 to 39 year-old subjects than in the subjects of other age segments. In conclusion, women with euryprosopic facial types could be more susceptible to muscle TMD. Further studies are needed to investigate this hypothesis.

[Specific problem related to oro maxillo facial sphere and hwaring in 340 Lebanese musicians practicing wind instruments]

The aim of this study is to detect the problems related to wind instruments in order to determine the contributing factors. This study is a prospective study of a sample of Lebanese wind-instruments musicians. Questionnaire of 17 items about personal data, musical activities in general and specific problems related to wind instruments. 340 response out of 400 [85%]. Gender: male 100%. Age: 28.5 +/- 6.5 years [13-50]. Practice of any physical activity: 57.5%. Smokers: 40.5%. Data about musical practice-Years of practice: 6.5 +/- 5.5. Daily practice: 2.5 +/- 1.5 hours with 35 +/- 2 rest periods of 16.5 +/- 15 minutes. Weekly practice: 5 +/- 2 days. Data about medical problems-Hear loss 34%; respiratory difficulties: 19.5%; wound of lips muscles: 5%; gums and tongue lesions: 7.8%; myospasms of the cheeks and lips: 34.5%; dental problems: 30.7%temporo-mandibular disorders [TMD]: 22.5%. There is a high association between risk factors and pathology. Risks related to the instrument's use: hear loss [p=0.001], traumas to lips muscles [p=0.065], myospasms [p=0.064], TMD [p=0.000]. Other factors: physical activity is beneficial; smoking is harmful [breathing difficulties, spasms, headaches]. Factors influencing the different problems: age [31 +/- 7 years]; years of practice [9 +/- 6]; hours of practice per day [2 +/- 15]; days of practice per week [4.5 +/- 2.5]. Wind instruments are related to problems of mouth, facial muscles and hearing. This may lead musicians to stop their activities or to irreversible professional disabilities. A medical follow-up during the musicians training is needed to prevent these problems

A light microscopic study of fibrosis involving muscle in oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a common pre-malignant condition of the mouth in arecanut chewers in Indian subcontinent. It is characterized by restriction in opening of the mouth, tongue protrusion, and cheek flexibility. Reports of muscle changes in OSF, using light microscopy are few. Incisional biopsy sections of thirty OSF patients were stained with Masson's Trichrome stain, to study the fibrosis involving the muscle. Wide spectrum of changes were observed where fibrosis was being evident sub-epithelially, not extending in to the muscle to cases where only a few remnants of muscle fibers were seen and the missing muscle bundle area being replaced by fibrous tissue. The probable mechanism by which these changes occur is discussed.

L'hemispasme facial et son traitement par la toxine botulique

Authors report results of treatment of hemifacial spasm with Botulinum Toxin. The rationale of this treatment it to create a local and transitory neuro-muscular junction bloc and weakness of the muscles who are hyperactive in facial spasm. between September 1995 and May 1998, 14 patients with hemifacial spasm were treated with Botulinum Toxin. Indications, modalities of utilisation, injection techniques and favourable as well as secondary effect are commented and compared to other series

Espasmo hemifacial: estudo pela angiografia por ressonancia magnetica / Hemifacial spasm: study by magnetic ressonance angiography

Nove pacientes com espasmo hemifacial "idiopatico" foram examinados por imagens de ressonancia magnetica, incluindo sequencias de angiografia por ressonancia magnetica. Em 8 pacientes (88 por cento), foram encontradas alteracoes do leito arterial da fossa posterior compativeis com a irritacao do nervo facial ipsolateral ao espasmo hemifacial. A angiografia por ressonancia magnetica e um procedimento nao invasivo e parece ser metodo sensivel e adequado para a investigacao da etiologia do espasmo hemifacial.

Proposta de uma escala de pontuaçäo para o exame orofacial / Proposal of the scale of punctuation from orofacial examination

A partir do exame orofacial, os autores mostram uma tabela dividida em 6 tópicos na qual cada item foi pontuado para permitir a quantificaçäo dos resultados e estudos estatísticos

Blepharospasm hemifacial spasm and tremors possibly due to isolated caudate nucleus lesions.

Isolated caudate nucleus lesions have only rarely been documented to cause focal extrapyramidal dysfunction. Two cases with possible infarcts in the head of left caudate nucleus presenting with contralateral tremors and blepharospasm with hemifacial spasm are reported. The possible mechanisms for such a presentation are discussed.

Espasmo hemifacial: dez anos de experiência / Hemifacial spasm: ten years experience

Os autores apresentam sua experiência em 10 anos no tratamento do espasmo hemifacial do Grupo de Paralisia Facial do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. Apresentam e discutem ainda todas as formas de tratamento na literatura. Säo estudados 35 casos de espasmo hemifacial idiopático e apresentados os resultados do tratamento clínico e cirúrgico. O tratamento clínico indicado foi com carbamazepina, clonazepan e diazepan e aqueles casos que näo responderam satisfatoriamente a tratamento cirúrgico através de neurectomia seletiva ou descompressäo do "loop" vascular a nível da fossa posterior ou ainda descompressäo do nervo a nível de segmento mastoídeo. Dos resultados apresentados conclui-se: a) a importância do estudo radiológico. b) que a etiologia mais frequente é pós galvanoterapia. c) o tratamento clínico deve sempre ser a primeira opçäo. d) o tratamento cirúrgico de escolha é a neurectomia seletiva principalmente nos casos EH pós galvanoterapia

Estudo da clínica ocular em hansenianos em hospital de dermatologia sanitária: a prevençäo em nossas mäos / Ocular study of Hansen's disease at a dermatological hospital: the prevention in our hands

Este estudo foi baseado na observaçäo de 363 pacientes portadores de diferentes tipos da Doença de Hansen. Ao examinarmos o paciente, näo tínhamos conhecimento prévio do seu tipo de lepra, de modo que o exame do paciente podia ser realizado sem que houvesse a influência de um diagnóstico precedente. O protocolo consistiu dos seguintes ítens: acuidade visual, funçäo do músculo facial, estudo das sobrancelhas, cílios, aparelho lacrimal, pupila, motilidade ocular, sensibilidade corneana, teste de Schirmer e estudo do segmento anterior do globo ocular com lâmina de fenda. Nosso estudo compreendeu 363 pacientes portadores das seguintes formas: Virchowiana (275), Tuberculóide (57), Indeterminada (29) e Dimorfa (2). A idade variou de 18 a 82 anos. Havia: 229 homens e 134 mulheres; 183 brancos, 157 mulatos e 23 negros