Resultados de una cohorte de pacientes tratados con osteopatía en un hospital polivalente / Results of a cohort of patients treated with osteopathy in a polivalent hospital

Introducción: la osteopatía aborda al paciente de manera global y aplica técnicas de tratamiento manual. Se realizó una evaluación retrospectiva sobre 447 pacientes para conocer los resultados del tratamiento del dolor lumbar y cervical. Material y métodos: fueron incluidos en este estudio 447 pacientes con diagnóstico de lumbalgia y cervicalgia (77,4% de sexo femenino). Los pacientes atendidos ya habían realizado tratamientos convencionales sin haber conseguido resultados satisfactorios. Se evaluó a los pacientes con la escala de valor numérico de dolor (EVN), y los puntajes (scores) de Oswestry (ODI) y el índice de discapacidad de la región cervical (NDI). Los 4 osteópatas intervinientes son profesionales certificados en esta disciplina. Resultados: el 42,8% de los pacientes fueron derivados por el Servicio de Traumatología y el 41,3% por el Servicio de Medicina Familiar. El 34,2% tuvieron diagnóstico de dolor lumbar y al 20,81% se le diagnosticó dolor cervical. Tanto en la valoración del dolor como en los scores utilizados se encontraron diferencias estadísticamente significativas entre la primera y la última sesión. Discusión: en pacientes con diagnóstico de lumbalgia y cervicalgia que no habían obtenido resultados satisfactorios con tratamientos convencionales previos, el tratamiento osteopático derivó en mejoras significativas en todos los parámetros estudiados. (AU)

Introduction: osteopathy addresses the patient globally and applies manual treatment techniques. A retrospective evaluation was carried out on 447 patients to know the results of the treatment of lumbar and cervical pain. Material and methods: 447 patients with a diagnosis of low back pain and cervical pain (77.4% female) were included in this study. The patients already had undergone conventional treatments without having achieved satisfactory results. The patients were evaluated with the numerical value of pain scale (VNS), and Oswestry scores (ODI) and the index of disability of the cervical region (NDI). The 4 intervening osteopaths are certified professionals in this discipline. Results: 42.8% of the patients were referred by the Traumatology Service and 41.3% by the Family Medicine Service. 34.2% had a diagnosis of lumbar pain and 20.8% were diagnosed with neck pain. Statistically significant differences were found between the first and last sessions in both the pain assessment and the scores used. Discussion: in patients with low back pain and neck pain who had not obtained satisfactory results with previous conventional treatments, osteopathic treatment resulted in significant improvements in all the parameters evaluated. (AU)

Proposal and test-retest reliability of a scale for cervical, thoracic, and lumbar spine pain in brazilian young people / Proposição e reprodutibilidade de uma escala de dor na coluna cervical, torácica e lombar em jovens brasileiros

ABSTRACT Objective: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. Methods: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. Results: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). Conclusions: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people.

RESUMO Objetivo: Propor e analisar a reprodutibilidade de um instrumento para verificar a presença e a intensidade da dor na coluna cervical, torácica e lombar em jovens brasileiros. Métodos: Estudo de reprodutibilidade com uma amostra de 458 participantes (13 a 20 anos). Dois grupos foram formados para cada sexo de acordo com o intervalo de dias entre teste e reteste (10±3 e 28±2 dias). Para a análise da dor na coluna, foi apresentada a figura de um corpo humano com as áreas da coluna cervical, torácica e lombar delimitadas. A seguinte pergunta foi realizada: durante um dia comum, você sente dor em alguma dessas regiões da coluna? Se sim, qual é a intensidade de 0 a 10 (marque um traço)? A extremidade com o número 0 correspondia à ausência de dor e o número 10, à dor muito intensa. A concordância na frequência e intensidade da dor foi verificada por meio do teste Kappa e da plotagem de Bland-Altman, respectivamente. Resultados: Os coeficientes de correlação intraclasse variaram de 0,71 (intervalo de confiança de 95% - IC95% - 0,59-0,79) a 0,94 (IC95% 0,90-0,96). Os resultados relativos à concordância no escore de dor mostraram que as diferenças médias foram próximas de 0 e a maior diferença média foi de -0,40 (IC95% -5,14-4,34). A concordância no relato de dor variou de 72,2 (Kappa 0,43; IC95% 0,28-0,58) a 90,1% (Kappa 0,76; IC95% 0,60-0,92). Conclusões: O instrumento demonstrou ser uma forma reprodutível de verificar a dor em diferentes regiões da coluna vertebral em jovens brasileiros.

Translation to Brazilian Portuguese and Cultural Adaptation of the Craniocervical Dysfunction Index

Abstract Introduction Functional disorders of the craniocervical region affect 77.78% of Brazilian teachers. Among the most common instruments used to assess craniocervical disorders in a detailed and objective way, none had been translated to Brazilian Portuguese and adapted to Brazilian culture. Objectives To translate to Brazilian Portuguese and to culturally adapt the Craniocervical Dysfunction Index (CDI). Method The first phase of the study consisted of the translation, synthesis, backtranslation, and review of the contents by a committee of experts, who developed a trial version and sent all the steps to the original author. The trial version was applied to 50 teachers of an institution. The reliability and internal consistency were evaluated by Cronbach α. For the validation, the Brazilian Portuguese version of the CDI was correlated with the Visual Analogue Scale (VAS) domains for cervicalgia and evaluated by Spearman ρ. Result Some expressions were adapted to the Brazilian culture. Among the participants who did not report neck pain in the VAS, 84.21% suffered from craniocervical dysfunction acording to the CDI. Among the participants who reported neck pain in the VAS, 100% suffered from craniocervical dysfunction according to the CDI. The CDI showed good internal consistency and satisfactory reliability measured by Cronbrach α (α = 0.717). There was a strong correlation between the CDI and the VAS score (ρ = 0.735). Conclusion No difficulties were encountered in the translation and back-translation of the CDI, and no problems were observed regarding the trial version developed; therefore, the Brazilian Portuguese version of the CDI is a valid and reliable instrument to evaluate the functional alteration of the craniocervical region.

Translation and validation of Neck Bournemouth Questionnaire to Brazilian Portuguese / Tradução e validação do Neck Bournemouth Questionnaire para o português do Brasil

Abstract Objective: To translate the Neck Bournemouth Questionnaire to Brazilian Portuguese, cross-culturally adapt, and to verify its validity and its reliability. Methods: The development of the Brazilian version of Neck Bournemouth Questionnaire (Brazil-NBQ) was based on the guideline proposed by Guillemin. The applied process consisted of translation, back-translation, committee review and pre-test. Sixty-one volunteers presenting neck pain participated in this study. Thirty-five of them participated during pre-testing phase to verify the instrument comprehension, and the remaining 26 took part during psychometric analysis. Psychometric evaluation included interrater and intrarater reliability and construct validity (correlation among Brazil-NBQ, SF-36, Numerical rating score and Neck Disability Index). Results: Some terms and expressions were changed to obtain cultural equivalence for Brazil-NBQ during the translation phase. The NBQ showed an intrarater ICC of 0.96 and interrater ICC of 0.87. Construct validity analysis showed moderate correlations with SF-36 and strong correlation with Numerical rating score and Neck Disability Index. Conclusion: Neck Bournemouth Questionnaire was translated and culturally adapted to Portuguese language, and it demonstrated to be valid and reliable to evaluate patients’ neck pain.

Resumo Objetivo: Traduzir o Neck Bournemouth Questionnaire para o português do Brasil, adaptá-lo culturalmente e verificar a sua validade e confiabilidade. Métodos: O desenvolvimento da versão brasileira do Neck Bournemouth Questionnaire (NBQ-Brasil) foi baseado nas diretrizes propostas por Guillemin. O processo aplicado consistiu em tradução, retrotradução, revisão por um comitê e pré-teste. Participaram deste estudo 61 voluntários que apresentavam dor cervical; 35 deles participaram durante a fase de pré-teste para verificar a compreensão do instrumento e os 26 restantes durante a análise psicométrica. A avaliação psicométrica incluiu a análise da confiabilidade interavaliadores e intra-avaliador e da validade do construto (correlação entre o NBQ-Brasil, o SF-36, a escala numérica de dor e o Neck Disability Index). Resultados: Alguns termos e algumas expressões foram alterados para se obter equivalência cultural com o NBQ-Brasil durante a fase de tradução. O NBQ mostrou uma CCI intra-avaliador de 0,96 e CCI interavaliadores de 0,87. A análise da validade do construto mostrou correlações moderadas com o SF-36 e correlação forte com a escala numérica de dor e o Neck Disability Index. Conclusão: O Neck Bournemouth Questionnaire foi traduzido e adaptado culturalmente para o idioma português e demonstrou ser válido e confiável para avaliar a dor cervical dos pacientes.

Dolor cervical como presentación de neumomediastino espontáneo en urgencia pediátrica. Caso clínico / Cervical pain as presentation of spontaneous pneumomediastinum in pediatric emergency. Case report

Spontaneous Pneumomediastinum is a rare clinical situation in pediatric emergency services, sometimes it presents with guiding symptoms, but in other occasions in a very nonspecific way. Definitely, needs to be highly suspected, emphasizing in the anamnesis the antecedent of intense physical exercise before the development of the triggering symptoms that determinates the consult, generally having a good evolution that gets solved in 3-4 days. There is a pediatric clinical case presented, that permits us to discuss the more relevant aspects of the clinical presentation, diagnosis methods and the updated management, in pediatric emergency services.

Carotidinia o carotiditis: Una entidad más frecuente de lo que se sospecha / Carotidynia or carotiditis: an entity more frequent than we suspect

La carotidinia es una entidad poco frecuente que se presenta con dolor cervical unilateral y es poco sospechada. Tiene generalmente resolución autolimitada. Parece atribuirse a una inflamación de la pared carotidea de origen variable. Puede ser idiopática, infecciosa, medicamentosa, etc. El diagnóstico por imágenes es fundamental. El ultrasonido Doppler consiste en el estudio inicial para el estudio del dolor cervical unilateral y puede ver claramente la pared carotidea y su engrosamiento, así como detectar complicaciones. Se presentan tres casos de Carotidinia evaluados por ecografía y Doppler.

Desconforto vocal em indivíduos com queixa cervical: uma abordagem baseada em questionários de autoavaliação / Vocal discomfort in individuals with cervical complaints: an approach based onself-assessment questionnaires

Objetivo Verificar a relação entre a ocorrência de desconforto vocal e queixa cervical, a partir de questionários de autoavaliação. Métodos Trinta indivíduos de 18 a 65 anos de idade, todos com algum tipo de queixa cervical, responderam à versão traduzida e adaptada culturalmente do questionário de autoavaliação cervical The Copenhagen Neck Functional Disability Scale (CNFDS) - denominado em português Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC) - e dois instrumentos de autoavaliação vocal: o Questionário de Qualidade de Vida e Voz (QVV) e a Escala de Desconforto do Trato Vocal (EDTV). Testes estatísticos foram aplicados para analisar a possibilidade de relação entre os dados obtidos. Resultados A maioria dos participantes referiu presença de desconforto vocal, sendo que quase metade deles apresentou relevante quantidade de sintomas desse desconforto. Dentre esses, a secura foi referida com maior frequência e a coceira, o sintoma que apresentou maior intensidade. Não houve correlação entre o EFIPC e o QVV ou o EDTV. Houve correlação negativa entre QVV e EDTV. Conclusão Apesar dos participantes apresentarem ocorrência elevada de desconforto vocal não houve correlação entre os questionários escolhidos. .

Purpose To verify the relationship between the occurrence of vocal discomfort and cervical complaints by using self-assessment questionnaires. Methods Thirty individuals (18–65 years of age) with various cervical complaints answered a translated and culturally adapted version of the self-assessment cervical questionnaire, The Copenhagen Neck Functional Disability Scale (CNFDS), titled Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC), the vocal self-assessment instruments Voice-Related Quality of Life (V-RQOL), and the Vocal Tract Discomfort Scale (VTDS). Statistical tests were used to analyze the possible relationships between the data obtained. Results Most of the participants reported the presence of vocal discomfort, with almost half presenting with a significant number of vocal discomfort symptoms; among these symptoms, dryness was reported most frequently and itching was reported with the highest intensity. No correlation was found between the EFIPC and V-RQOL or VTDS findings, but a negative correlation was found between the V-RQOL and VTDS findings. Conclusion Although the participants reported a high occurrence of vocal discomfort, no correlation was found between the selected questionnaires. .

Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain

Background: There is sparse literature that provides evidence of cervical and shoulder postural alignment of 15 to 17-year-old adolescents and that analyzes sex differences. Objectives: To characterize the postural alignment of the head and shoulder in the sagittal plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and explore the relationships between three postural angles and presence of neck and shoulder pain. Method: This cross-sectional study was conducted in two secondary schools in Portugal. 275 adolescent students (153 females and 122 males) aged 15 to 17 were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) was used to assess shoulder pain, whereas neck pain was self-reported with a single question. Results: Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7, 47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed protraction of the head, whereas 58% of them had protraction of the shoulder. The boys showed a significantly higher mean cervical angle, and adolescents with neck pain revealed lower mean cervical angle than adolescents without neck pain. 53% of the girls self-reported regular neck pain, contrasting with 19% of the boys. Conclusions: This data shows that forward head and protracted shoulder are common postural disorders in adolescents, especially in girls. Neck pain is prevalent in adolescents, especially girls, and it is associated with forward head posture. .

Eagle's Syndrome

Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. OBJECTIVE: To describe a case of Eagle's syndrome. CASE REPORT: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT) of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. FINAL COMMENTS: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical...

Adaptación cultural y validación argentina del cuestionario Northwick park de dolor cervical en el ámbito hospitalario de la ciudad autónoma de Buenos Aires / [Cultural adaptation and Argentine validation of the Northwick Park Neck Pain Questionnaire in the hospitals of the Autonomous City of Buenos Aires].

OBJECTIVE: [corrected] To make cultural adaptation and validation of the Northwick Park Neck Pain Questionnaire (NPQ) in Argentina, determining its psychometric properties in patients with neck pain of mechanical origin referred to the physiotherapy Service at D. F. Santojanni Hospital. MATERIALS AND METHODS: autorization of original author of the NPQ was requested. Then we make the linguistic adaptation and pilot study. Psychometric analyses included test-retest reliability (intraclass correlation coefficient), validity (Pearson correlation coefficient NPQ-Visual Analog Scale, VAS), internal consistency (Cronbach Coefficient Alpha) and sensibility to change (paired t test). Sixty patients were inclueed from September 2007 to February 2009 with mechanical neck pain. The variables percentage of disability (NPQ) and pain (VAS) were measured on the day of admission, 24 hours later and when the patient was discharged. RESULTS: Twenty six patients completed the study, 4 were eliminated and 30 did not complete the 3rd measurement. We get a good test-retest reliability (CCI 0,8979) and a high internal consistency (Cronbach Coefficient Alpha 0,86). Validity obtained a good correlation (r=0,678). Sensitivity to change was good (r=0,661). CONCLUSION: The NPQ is a valid, reliable and sensitive instrument to assess disability associated with neck pain of mechanical origin in patients treated at the hospitals of the Autonomous City of Buenos Aires.

Cervicalgia, enfoque clínico / Neck pain, clinical approach

El dolor cervical es motivo de consulta frecuente en atención médica primaria. Solicitar exámenes innecesarios aumenta los costos de salud. Dada la abundante oferta de exámenes, muchos de elevado costo, su uso racional es un objetivo clínico económico necesario en la medicina moderna. Se destacan algunos signos clínicos que ayudan a precisar enfermedades orgánicas severas. Se mencionan alertas clínicas que hacen sospechar enfermedades que deben ser derivadas a un nivel de mayor complejidad. Se propone un método de estudio para separar los casos de mayor gravedad orientado a los médicos de familia, de atención primaria e internistas. Se sugiere un tratamiento útil a la gran mayoría de los pacientes que consultan por dolor de cuello y se destacan vicios posturales frecuentes.

Neck pain is frequent complaint in primary care. Request unnecessary tests increases health care costs. Given the abundant supply of tests, many high cost, their rational use is a necessary economic clinical goal in modern medicine. Highlights some clinical signs that help pinpoint severe organic disease. Clinical alerts are cited that suggest that diseases should be referred to a higher level of complexity. We propose a method of study to separate the more serious cases aimed at family doctors, primary care physicians and internists. We suggest a useful treatment for the vast majority of patients complaining of neck pain and postural defects often stand out.

Síndrome de eagle importancia para el odontológo: revisión de la literatura / Eagle Syndrome importance for practitioner: a literature review

El síndrome de Eagle es una entidad descrita por el Dr. Watt W. Eagle en 1937, en un estudio realizado en un grupo de pacientes cuyo síntoma principal manifestado era dolor cervicofaringeo. Dicha patología, también conocida con el nombre de síndrome de la arteria carótida, síndrome estiloide o síndrome del proceso estiloide alargado y osificado, se caracteriza por una malformación de la apófisis estiloide en donde se evidencia la elongación de dicha estructura o la calcificación de sus ligamentos, presentándose generalmente en personas de sexo femenino entre la tercera y sexta década de la vida. El método de diagnóstico más utilizado es la radiografía panorámica. De acuerdo a la sintomatología manifestada en el paciente, se orienta el tratamiento a seguir

The Eagle's syndrome, is an entity described for the first time by Dr. Watt W. Eagle in 1937, during a research that took place in a group of patients whose main symptom was cervical pain. This pathology, also known as carotid artery syndrome, styloid syndrome or elongated and ossified styloid process syndrome, is characterized by styloid apophysis malformation where elongation is evidenced. It's most likely to be found in females, among the 3rd and 6th decade of life. Diagnosis is carried out by Orthopantomography. An accurate treatment will be decided according to every patient in particular

Peoría paradójica en fístulas carótido-cavernosas durales: cuando el cuerpo se enferma más para curarse / Paradoxical worsening in carotid-cavemous ductal fistulas: when the body get more sick in order to cure

Las fístulas carótido-cavernosas son comunicaciones arteriovenosas patológicas entre la arteria carótida interna intravenosa y el seno venoso-cavernoso que la rodea. Un sistema de flujo y presión elevados irrumpe sobre otro de bajo flujo y velocidad. Ello origina los síntomas y signos. La gran mayoría, son resultantes de traumatismos craneales siendo de alto flujo y alta velocidad-fístulas traumáticas o directas; menos comunes son las llamadas fístulas espontáneas o durales localizadas en la duramadre y alimentadas por ramas menígeas provenientes de las arterías carótidas externa, interna o ambas y de las arterias vertebrales. Estas últimas raras veces tienen implicaciones graves para la vida, pero la pérdida visual constituye el mayor riesgo; no obstante, con elevada frecuencia, ocurre la oclusión espontánea, por lo que se impone la observación hasta que la sintomatología justifique el tratamiento. En el curso evolutivo puede ocurrir la trombosis aguda de la fístula y más propiamente de la totalidad de la vena oftálmica superior la que produce un distintivo cuadro de notable agravamiento de los síntomas que en forma contradictoria ocurre antes de la mejoría y reversión de los síntomas, el síndrome de empeoramiento o peoría paradójica. Para ilustrar el síndrome se presentan los casos clínicos de los pacientes

Caroid-cavernous fistulas are pathological arteriovenous communications between the intracavernous internal carotid artery and the cavernous sinus. A system of high flow and pressure bursts over another system of low flow and slow velocity. This causes the symptoms and signs. The vast majority are related with head trauma being high flow and high speed fistulas: traumatic or direct. Less common are the so-called spontaneous or dural fistulas located in the duramater and fed by meningeal branches from the external, internal, or both carotic arteries and the vertebral arteries. These latest rarely have serious implications for life, but visual loss is the greatest risk; however, with high frequency spontaneously occlusion occurs, and then observation imposes until symptoms justified the treatment. During its evolution acute thrombosis of the fistula itself can occur along the entire length of the ophthalmic vein which produces a distinctive and paradoxical worserning and reversal of symptoms, which is called the syndrome of paradoxical worserning. Clinical cases of two patients are presented to illustrate the syndrome

Development and evaluation of 'neck pain and functional limitation scale': A validation study in the Asian context.

Background :There is a paucity of literature on validated outcome measurement tools for evaluation of neck pain and related disability in the Asian context. Aim :The main aim of the present study was to design a new tool called neck pain functional limitation scale (NPFLS) for measuring disability related to neck pain and observe its reliability, concurrent validity and criterion validity. Setting and design :This study was performed at the institutional hospital. Materials and methods :A total of 157 subjects (neck pain group) and 25 control subjects (control group) without neck pain were recruited for this study. NPFLS was framed as a new tool for this study, which consisted of 5 domains - pain intensity, activities of daily living, social activities, functional activities and psychological factors. Neck Bournemouth questionnaire (NBQ) was used as a gold standard to measure the concurrent validity and criterion validity of the NPFLS. Statistical analysis :Criterion validity and concurrent validity between the neck Bournemouth questionnaire (NBQ) and NPFLS scores were tested statistically using Mann-Whitney U test and Spearman correlation test. The reliability was tested by examining the internal consistency to calculate the Cronbach's alpha value for each item in NPFLS. Results : No significant difference between NPFLS and NBQ was observed using Mann-Whitney U Test, with P value greater than 0.05 (P= 0.557). Besides that, NPFLS had a high concurrent validity (r= 0.916) and good internal consistency with high Cronbach's alpha value of (r= 0.948), which demonstrated strong correlation between the items of NPFLS and NBQ. Conclusion : NPFLS demonstrated good reliability, high concurrent validity and criterion validity in this study. NPFLS can be used to assess neck pain and disability among patients with neck pain.

Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder

The objective of this study was to evaluate the stability and the distribution of weight of individuals with TMD (Temporomandibular Disorder) when placed in an orthostatic position. Forty female volunteers, participating in this study, were distributed into a control and a TMD group. Clinical examinations of the craniomandibular system and of the neck were performed. Postural stability was evaluated using a stabilographic platform. Through this system, the sway index (SI), the maximum medial-lateral distance (MMLD), the maximum anterior-posterior distance (MAPD) and the medial-lateral symmetry (MLS) could be determined. Tests were performed in the mandibular rest position and during isometric and isotonic contraction. The variables were analyzed through repeated measures ANOVA. The level of significance was p < 0.05. The results of this study indicate that individuals with TMD present more pain in the cervical region (p < 0.05). The group with TMD showed a significant reduction in SI (p < 0.05), MMLD (p < 0.05) and MLS (p < 0.01). Individuals with TMD presented greater postural asymmetry, and cervical pain demonstrated a potential link with an increase in postural stability.

Síndrome de Eagle: relato de caso / Eagle's Syndrome: case report

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.