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面痛病可分为四大类,即:(1)颞颌关节(TMJ)综合征,(2)颞颌关节退行性关节病(DJD),(3)三叉神经痛及(4)非典型面神经痛和颞颌关节的炎症性关节炎。本文主要介绍耳鼻喉科医生常遇见的前二种病的处理方法。 TMJ综合症:又称Costen综合征或非典型面痛,是一种肌筋膜综合征。多见于女性。年龄多在25～60岁,常伴有抑郁和焦虑情绪。疼痛为深部钝痛,位于软组织或骨部。通常是单侧,累及范围包括面、颈和肩部肌肉,属第5、9脑神经和2、3颈神经分布区。疼痛呈持续性,常持续数月或数年。其他症状可能有下颌运动受限和TMJ弹响。颞颌关节DJD:包括软骨变性、软骨下的骨质增厚,边缘骨刺形成,以及关节下骨囊肿。临床表现包括各种关节积液、滑膜炎症、关节不稳定和摩擦音。“耳痛”是最常见的主诉,咀嚼和
Facial pain can be divided into four broad categories, namely: (1) TMJ syndrome, (2) TMJ dementia (DJD), (3) trigeminal neuralgia and (4) atypical Facial pain and temporomandibular joint inflammatory arthritis. This article describes the treatment of the first two diseases commonly encountered by otolaryngologists. TMJ syndrome: also known as Costen syndrome or atypical nocturnal, is a myofascial syndrome. More common in women. More than 25 to 60 years of age, often accompanied by depression and anxiety. Pain is deep dull pain, located in soft tissue or bone. Usually unilateral, involving the face, neck and shoulder muscles, is the first 5,9 cranial nerve and 2,3 cervical nerve distribution. Pain persisted, often lasting months or years. Other symptoms may have restricted mandibular movement and TMJ snapping. Temporomandibular joint DJD: includes cartilage degeneration, subchondral bone thickening, marginal spur formation, and subchondral bone cysts. Clinical manifestations include a variety of joint effusion, synovial inflammation, joint instability and fricative. “Earache” is the most common chief complaint, chewing and