Simultaneous otoplasty and temporomandibular arthroplasty.

By altering the standard postauricular incision for access to the temporomandibular joint (TMJ), a standard otoplasty can be performed simultaneously with TMJ arthroplasty. The procedure is described and results are presented. In six patients with at least a 2-year follow-up, the esthetic results have been stable. There has been no morbidity as a result of such simultaneous surgery.

Neuralgias.

Cranial neuralgias are relatively uncommon but the excruciating nature of the pain they cause make them the focus of much clinical and research interest. The underlying mechanism of the disease remains to be uncovered. The complexities of the trigeminal system make the quest for comprehensive understanding a difficult one. Fortunately, pharmacotherapy is quite effective for many patients. For those patients who cannot be managed medically, there are a variety of surgical options. Criteria have been proposed for evaluating surgical efficacy in trigeminal neuralgia. These parameters should be used when considering the surgical options for each patient. Above all, the Latin motto, Primum non nocerum (first, do not harm) should prevail. With this in mind, the physician and surgeon will make the best choice for the care of each patient.

Head and neck fibromyalgia and temporomandibular arthralgia.

The attentive clinician can no longer be satisfied with global diagnostic categories such as "TMJ syndrome" or "MPD syndrome." Nor can one be content with nonspecific diagnostic testing or generic referral. This article has outlined specific components of head and neck pain originating in the masticatory musculoskeletal system. Much progress has been made in recent years, particularly in regard to diagnostic imaging. The future will bring us data on long-term treatment efficacy and a better understanding of chronic pain conditions that lack discrete organic lesions. Finally, the manifestation of psychiatric or psychologic abnormalities as pain is under scientific scrutiny and a better understanding of conversion phenomena will assure proper use of available treatment modalities.

A simple method of nasoendotracheal tube fixation.

The critical need to maintain closed-circuit airways during maxillofacial surgery has led to a number of innovations in anesthetic tube placement and stabilization. Several redesigns and alterations of endotracheal tubes have been described and are currently in use. Also several methods of securing endotracheal tubes have been described. These range from suturing the tubing to the patient's scalp to fabricating maxillofacial prostheses. In this report, a readily available and easy method of securing anesthetic tubes is described. This technique has been used successfully in hundreds of patients at our institutions.

A modified auriculotemporal nerve block for regional anesthesia of the temporomandibular joint.

A technique for producing regional auriculotemporal nerve analgesia is described. Undesirable side effects have been minimized by avoiding facial nerve branches and blood vessels, and injection at the site of the nerve trunk.