Orofacial pain related to traumatic neuroma in a patient with multiple TMJ operations

Cranio. 2012 Jul;30(3):183-7. doi: 10.1179/crn.2012.028.

Abstract

The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. However, sonography indicated the location of the suspected lesion. Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Artifacts
  • Biopsy
  • Diagnosis, Differential
  • Facial Pain / diagnosis*
  • Facial Pain / drug therapy
  • Facial Pain / etiology*
  • Facial Pain / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neurologic Examination
  • Neuroma / complications*
  • Neuroma / diagnosis*
  • Neuroma / surgery
  • Radiography, Panoramic
  • Temporomandibular Joint Disorders / surgery*
  • Tomography, X-Ray Computed
  • Trigger Points
  • Ultrasonography

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal