ABSTRACT
O presente artigo de revisão tem por objetivo orientar o leitor quanto ao diagnóstico diferencial de otalgia e seus respectivos tratamentos. O trabalho se mostra importante devido a frequente queixa do sintoma nas consultas de emergências.
This review article aims to guide the reader to the differential diagnosis of earache and its treatment. The work is relevant due to the frequent complaint of the symptom in clinical emergencies.
Subject(s)
Earache/diagnosis , Earache/therapy , Medical History TakingABSTRACT
Eagle's Syndrome is caused by elongation of the styloid process or ossification of the stylohyoid ligament. We aimed to evaluate the contribution of 3-Dimensional Multidetector CT findings on Eagle's syndrome. Three-Dimensional Multidetector CT were performed on 13 patients with Eagle's syndrome. Maximum intensity projection [MIP] and volume rendering [VR] images having optimal resolution in all patients were obtained using 3D reconstructions on work-station. Styloid process and its extension, and stylohyoid ligament were evaluated. A styloid processes e"3cm were accepted to be longer than normal. We also had a control group of patients which consisted of ten patients who had no complaints of dysphagia, throat pain, or foreign body sensation in the throat. Elongation of the styloid process was revealed by 3D VR imaging in all patients. We found elongated styloid process bilaterally in two patients. Elongation of the styloid process was clearly revealed by 3D VR imaging in high contrast and spatial resolution under the anatomic orientation like conventional X-ray in all patients. The diagnosis of Eagle's syndrome was confirmed surgically in four of 13 patients. We conclude that 3D VR imaging is a valuable diagnostic method in detecting elongated styloid process
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Skull Base/diagnostic imaging , Syndrome , Imaging, Three-Dimensional , Deglutition Disorders/diagnosis , Earache/diagnosisABSTRACT
The disco-malleolar and anterior malleolar ligaments are common to the middle ear, the temporomandibular joint and the jaw, all of them sharing a common embryological origin; these ligaments' morphometric and functional aspects were studied in 23 temporal bones. Experimental design: The epitympanum roof and the temporomandibular joint roof were elevated by micro-dissection of the middle cranial fossa, exposing both disco-malleolar and anterior malleolar ligaments and their association with the malleus, the temporomandibular joint disc and the mandibular lingula. Principal observations: Both ligaments start in the malleus and take anterior and divergent routes towards the temporomandibular joint and lingula, passing through Huguier's canal. The disco-malleolar and anterior malleolar ligaments' mean lengths were 6.88 mm (SD 0.81) and 4.22mm (SD 1.17), respectively, no statistically significant difference being revealed between the sides. Temporomandibular joint disc traction was applied for verifying malleus mobility; malleus movement was observed when applying disco-malleolar traction in 30.5% of the samples. Correlation was observed between malleus movement and disco-malleolar length (R2=-0.499, p<0.05). Both ligaments common to the stomatognathic system and middle ear were present in all specimens. Conclusions: There was an anatomical and functional relationship between human TMJ and the middle ear.
Los ligamentos disco-maleolar y maleolar anterior son comunes en el oído medio, la articulación temporomandibular y la mandíbula, todas ellos comparten un origen embriológico común. Los aspectos morfométricos y funcionales de estos ligamentos fueron estudiados en 23 huesos temporales. Diseño experimental: el techo del epitímpano y el techo de la articulación temporomandibular fue elevada mediante micro-disección de la fosa craneal media, exponiendo ambos ligamentos disco-maleolar y maleolar anterior y su asociación con el maleus, el disco de la articulación temporomandibular y língula mandibular. Principales observaciones: Ambos ligamentos comienzan en el maleus y toman una ruta anterior y divergente hacia la articulación temporomandibular y língula, pasando a través del canal de Huguier. Las longitudes medias del ligamento disco-maleolar y maleolar anterior fueron 6,88 mm (DS 0,81) y 4,2mm (DS 1,17), respectivamente, no fueron reveladas diferencias estadísticamente significativas entre las partes. La tracción del disco de la articulación temporomandibular fue aplicada para verificar la movilidad del maleus; el movimiento del maleus fue observado cuando se aplicó tracción del ligamento disco-maleolar en el 30,5% de las muestras. Se observó correlación entre el movimiento del maleus y la longitud disco-maleolar (R2 = -0,499, p <0,05). Ambos ligamentos comunes al sistema estomatognático y el oído medio estaban presentes en todos los especímenes. Conclusiones: Existe una relación anatómica y funcional entre la ATM humana y el oído medio.
Subject(s)
Humans , Male , Adult , Female , Temporomandibular Joint/anatomy & histology , Temporomandibular Joint/physiology , Temporomandibular Joint Disc/anatomy & histology , Temporomandibular Joint Disc/embryology , Temporomandibular Joint Disc/physiology , Anatomy, Comparative , Earache/diagnosis , Earache/prevention & control , Ligaments, Articular , Mandible/anatomy & histology , Mandible/embryology , Mandible/physiology , Ear, Middle/anatomy & histology , Ear, Middle/embryology , Ear, Middle/physiologyABSTRACT
Presentamos un caso de adhesión unilateral del disco de la articulación temporo-mandibular en un paciente de 51 años, sexo femenino, con queja de otalgia bilateral ocasional, de intensidad moderada, a lo largo de los últimos 10 años. La paciente no refirió dolor o ruidos articulares de ninguna naturaleza. Clínicamente, presentaba limitación de apertura bucal, con desvío hacia la izquierda sin corrección de la trayectoria al final del movimiento mandibular. La impresión diagnóstica clínica e imagenológica fue de desplazamiento anterior parcial con reducción del disco articular derecho; y aparente desplazamiento anterior parcial, adhesión del disco articular (anchored disc phenomenon - ADP) e hipomovilidad del cóndilo izquierdo
It is reported on a case of a 51-year-old female patient presenting TMJ (temporomandibular joint) disk adhesion on the left side and complaining of otalgia over the last 10 years. The patient did not complain of articular pain or clicking. Clinically, the patient presented jaw opening limitation, with deflection of the mandible to the left side without correction of the trajectory at the end of the jaw opening movement. Our diagnostic impression was partial anterior disk displacement with reduction, for the right side; and elusive partial anterior disk displacement, disk adhesion (anchored disc phenomenon - ADP), and hipomobility of the condyle, for the left side
Subject(s)
Middle Aged , Temporomandibular Joint Disc/pathology , Temporomandibular Joint Disc , Earache/diagnosis , DentistryABSTRACT
Objetivo: relatar a história clínica e o diagnóstico de um caso de síndrome de Eagle e revisar a literatura. Relato do caso: paciente de 34 anos, sexo feminino, apresentava dor à movimentação cervical, sensação de corpo estranho na garganta, otalgia, odinofagia aos sólidos, dor ao falar, ao inspirar, bocejar e ao protusir a língua, há pelo menos 5 anos. O diagnóstico clínico foi complementado por tomografia computadorizada de base de crânio com reconstrução em três dimensões que evidenciou alongamento bilateral das apófises estilóideas. Considerações finais: o tratamento cirúrgico instituído promoveu regressão de todos os sintomas, demonstrando que a suspeita clínica de síndrome de Eagle deve fazer parte do diagnóstico diferencial das cervicalgias, evitando, assim, retardar o tratamento adequado.
Objective: report a case of Eagle 's syndrome, it clinical findings and research the literature. Report: a 34-years-old female complain of cervical pain on rotation of the neck, throat foreign body sensation, ear pain, pain onswallonwing solid food, pain on speaking, breathing, yawning and pain on extension of the tongue for 5 years. The clinical diagnosis was complemented by computed tomography of the base of the skull with three-dimensional image, showing elongated styloid processes bilaterally. Conclusion: although Eagle's syndrome is rare, it clinical manifestations are peculiar, so the dijferential diagnosis may include it, avoiding the treatment delay.
Subject(s)
Humans , Female , Adult , Neck Pain/diagnosis , Foreign Bodies/diagnosis , Earache/diagnosis , Pharynx , Oropharynx , Deglutition Disorders , Syndrome , Tomography, X-Ray ComputedABSTRACT
Os autores fazem uma revisão bibliográfica sobre as principais causas de dores relacionadas ao ouvido e sua abordagem diagnóstica e terapêutica frente a este sintoma.
Subject(s)
Humans , Earache/classification , Earache/diagnosis , Earache/ethnologyABSTRACT
As desordens têmporo-mandibulares são alterações freqüentes nos ambulatórios de Otorrinolaringologia, muitas vezes não diagnosticadas com precisão. A freqüência de sinais e sintomas otológicos é inquestionável. Sabemos que existe, e de forma severa. Objetivo: Realizou-se um estudo com o objetivo de comparar os sintomas otológicos com diferentes modalidades de desordens, avaliando-se as queixas mais encontradas e as possíveis alterações audiométricas associadas. Resultados: Com os resultados obtidos, concluiu-se que a otalgia foi a queixa predominante, sendo a principal fonte de dor na inserção do ligamento têmporo-mandibular direito. Conclusão: A analise audiométrica possibilitou separar dois grupos distintos. O primeiro com audiometria normal (62,5%) em pacientes com idade média de 35,2 anos; e o segundo com audiometria alterada (37,5%) e idade média de 51,7 anos.
Temporomandibular joint disorders are common alterations found in Otolaryngology out patients departments, most of the time not precisely diagnosed. The presence of signs and otologic symptoms are unquestionable, we not only know they exist, but also know how severe they are. Purpose: A study was made in order to compare the otologic symptoms and different kinds of disorders, analyzing the most frequent complaints and the possible audiometric variations associated with them. Results: With the obtained results, we concluded that otalgia was the most common symptom and the right temporomandibular ligament insertion was the usual origin of pain. Conclusion: Our audiometric findings made us separate two distinct groups. The first one with normal audiometric test (62,5%), with a mean age of 35,2 and the second one corresponding to 37.5% of patients with anormal audiometric results and a mean age of 51,7.