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PubMed2002

Inflammatory orbital pseudotumor with infratemporal fossa extension mimicking temporomandibular joint dysfunction.

Inflammatory orbital pseudotumor is a benign space-occupying lesion of unknown origin that involves all or part of the fatty tissue within the orbit. Occasionally the disease may extend into the middle cranial, the pterygopalatine, and the infratemporal fossa through the various foramina of the orbit, although extension into the infratemporal fossa is very rare. We present a case which extends into the infratemporal fossa through the inferior orbital fissure, resulting in presenting symptoms mimicking temporomandibular joint dysfunction.

Adult↗
PubMed2001

The effects of isometric exercise on maximum voluntary bite forces and jaw muscle strength and endurance.

The effects of training and exercise on the strength and endurance of limb muscles has been investigated extensively, but the response of the jaw muscles to exercise remains poorly known. The purpose of this study was to determine whether short-term isometric training increases strength and endurance of the superficial masseter and anterior temporalis muscles. Maximum and submaximum voluntary bite forces and corresponding electromyographic (EMG) activity were measured in 28 young adults, randomly divided into exercise and non-exercise (control) groups. Subjects in the exercise group performed isometric clenches against a soft maxillary splint for five 1-min sessions per day over a 6-week period. After exercise, subjects increased their maximum bite forces by 37%, but control subjects' bite forces also increased by 25%. After exercise, EMG levels per unit of bite force generally decreased, but similar decreases were also seen in the non-exercised controls. Masseter muscle activity levels during standardized 10-kg bites decreased after 6 weeks of exercise. Fatigue resistance increased significantly with exercise but did not differ significantly from control values after 6 weeks of exercise. The results of this study indicate that increases in maximum bite force can be easily produced with training, but that actual strengthening of the jaw muscles is more difficult to achieve.

Adult↗
PubMed2002

Exteroceptive suppression patterns of masseter and temporalis muscles in central and peripheral headache disorders.

The objective of this study was to compare the exteroceptive suppression patterns of masseter and temporalis muscles in patients with primary and secondary headache disorders originating from peripheral joint dysfunction. We accomplished the temporalis and masseter exteroceptive suppression in 28 patients with migraine, 25 patients with chronic tension-type headache (CTH), 22 patients with temporomandibular joint (TMJ) dysfunction and 18 healthy controls. The onset latencies and duration of the first suppression period (S1) was not significantly different between the patients and controls. The duration of the second suppression period (S2) was shorter in patients with CTH, migraine (analysed during attack) and TMJ dysfunction than those obtained from controls. A distinctive finding was significantly prolonged onset latency in patients with TMJ over those obtained from patients with CTH and migraine. We concluded that the onset latency of the S2 period is a useful parameter in the differential diagnosis of primary and peripheral headache disorders.

Adult↗
PubMed1998

Effect of parafunctional clenching and estrogen on temporomandibular disorder pain.

To test the hypothesis that the pain-producing effect of parafunctional clenching is mediated by oral contraceptive use and estrogen levels, eight premenopausal women participated in daily (five days/week) 20-minute-long EMG biofeedback training sessions (on the left and right temporalis and masseter muscles) structured as a two-phase cross-over study. Four subjects used oral contraceptives, and four did not. Subjects were instructed to maintain temporalis and masseter activity below 2 microV during decrease training and above 10 microV during increase training. All subjects began their participation at the start of menses. The initial week of training was followed by a week of rest and then a second week of training at mid-cycle. Preliminary screening examinations showed that none of the subjects had TMD. One subject was diagnosed with TMD pain during increase training, and no subjects were diagnosed with TMD during decrease training. Self-reported pain following training increased significantly during increase training. No effects on pain were observed for oral contraceptive status. We conclude that chronic, low-level parafunctional clenching may be a factor producing temporomandibular disorder pain and that oral contraceptive status does not play a role in the TMD pain produced by the experimental protocol.

Adult↗
PubMed1997

Relationships between the orientation and moment arms of the human jaw muscles and normal craniofacial morphology.

It has been suggested that subjects with increased vertical craniofacial dimensions have relatively oblique orientated jaw muscles with a reduced possibility to restrain the vertical component of craniofacial growth. To test this hypothesis, relationships were investigated between the spatial orientation of the jaw muscles and the craniofacial morphology. Computer reconstructions of the external shape of the jaw muscles of 30 adult males with a normal skull were made with the use of serial magnetic resonance imaging (MRI) scans. The orientation of the jaw muscles was defined by a regression line through the centroids of the serial cross-sections. Sagittal and frontal projections of the moment arms of the muscles were measured with respect to the centre of the ipsilateral condyle. Craniofacial morphology was analysed three-dimensionally using lateral head films and coronal MRI scans. The cephalometric data were analysed statistically using regression and factor analyses. Six cephalometric factors with Eigen values higher than 1 were correlated with jaw muscle orientation and moment arm data, using a multiple regression analysis. The anterior face height factor was significantly correlated with the orientation of the jaw opening muscles in the sagittal plane but was not significantly correlated with the orientation of the mandibular elevators. The sagittal moment arms of the mandibular elevators showed significant correlations with the factors describing the gonial angle and the posterior face height. It was concluded that the variation of spatial orientation of the human jaw closing muscles is predominantly associated with the variation of mandibular morphology (expressed by the gonial angle) and the posterior face height. The orientation of the jaw opening muscles shows significant relationships with anterior vertical craniofacial dimensions. The hypothesis that persons with an increased anterior face height have relatively oblique orientated jaw elevators was rejected.

Adult↗
PubMed2006

Advances in facial reanimation.

PURPOSE OF REVIEW: Facial paralysis often has a significant emotional impact on patients. Along with the myriad of new surgical techniques in managing facial paralysis comes the challenge of selecting the most effective procedure for the patient. This review delineates common surgical techniques and reviews state-of-the-art techniques. RECENT FINDINGS: The options for dynamic reanimation of the paralyzed face must be examined in the context of several patient factors, including age, overall health, and patient desires. The best functional results are obtained with direct facial nerve anastomosis and interpositional nerve grafts. In long-standing facial paralysis, temporalis muscle transfer gives a dependable and quick result. Microvascular free tissue transfer is a reliable technique with reanimation potential whose results continue to improve as microsurgical expertise increases. Postoperative results can be improved with ancillary soft tissue procedures, as well as botulinum toxin. SUMMARY: The paper provides an overview of recent advances in facial reanimation, including preoperative assessment, surgical reconstruction options, and postoperative management.

Anastomosis, Surgical↗
PubMedDate not supplied

Evaluation of extraocular muscles using dynamic contrast enhanced MRI in patients with chronic thyroid orbitopathy.

OBJECTIVE: The purpose of the current study is to investigate the underlying pathophysiological changes of extraocular muscle (EOM) in Graves orbitopathy using dynamic contrast MR imaging and to correlate these MR functional changes with the anatomic abnormalities. METHODS: EOMs of 16 patients with Graves disease and 12 normal volunteers were examined by dynamic enhanced MRI. We quantified the peak enhancement ratio of EOMs and calculated the ratio versus temporalis muscle and the ratio of maximum upslope versus temporalis muscle. We compared the ratios between normal volunteers and patient groups. RESULTS: Mean of peak enhancement ratio values for the EOMs in patients with Graves disease tends to decrease according to the severity of the anatomic and clinical changes. The mean maximum upslope also decreased according to the severity of the disease for EOMs. CONCLUSION: Hemodynamic information obtained by dynamic contrast enhanced MRI is useful in evaluating the clinical course of thyroid orbitopathy.

Adolescent↗
PubMed1988

The fasciaform graft: a technique for the repair of large perforations of the tympanic membrane.

Our experience with the fasciaform graft, designed specifically for the repair of subtotal or total perforations of the tympanic membrane, is presented. The technique which utilizes a total tympanic graft of formalized autologous temporalis fascia is described in detail. We have employed this method in 29 patients with total closure of the defect being achieved in 93% of cases. The fasciaform graft is therefore recommended as a successful method of repair for subtotal and total perforations of the tympanic membrane for which the conventional grafting techniques currently available are much less effective.

Adolescent↗
PubMed1989

Postural and maximum activity in elevators during mandible pre- and post-occlusal splint treatment of temporomandibular joint disturbance syndrome.

Electromyograms (EMGs) of the temporal and masseter muscles in sixty patients with temporomandibular joint disturbance syndrome (TMJDS) and thirty controls were recorded and integrated on-line in the postural position and during maximum clenching, before and after occlusal splint therapy. Contrasting with the controls, the myoelectrical activity of the patients was higher in the postural position and lower during maximum clenching, whilst the former in percentage terms increased when compared to the latter. After treatment, the EMG indexes in some patients returned partially, and in others completely, to a normal level. Tenderness in the mandibular elevators, deviated opening and organic change in the TMJ increased the postural myoelectrical activity, in percentage terms, against that of maximum clenching. The myoelectrical activity of the mandibular elevators in the postural position and during maximum clenching was smaller in patients with the occlusal splint than in those without. The results show that the mandibular elevators in the patients with TMJDS were hyperactive and tense, and that the occlusal splint was useful for treating such dysfunction.

Adult↗
PubMed2003

Reliability and temporal variation of masseter muscle thickness measurements utilizing ultrasonography.

Muscle thickness may now be measured in the clinic by ultrasonography. The purpose of this study was to test (i) whether the position of the transducer on the muscle affects muscle thickness measurements and (ii) whether measurements from identical locations vary over time. Muscle thickness of one masseter muscle side was measured in each of 30 volunteers. Measurements were recorded at five different locations on the lateral surface of each muscle. Four measurement sessions were performed, and two sets of measurements were recorded at each session. Spatial position of the transducer had a clear effect on the muscle thickness measurements (P < 0.0001). Measurements made at the most upper and middle level were less and greater (P < 0.0001), respectively, than those made at the upper, lower, and most lower levels. Measurements from various positions did not differ (P > 0.05) when made at the same level. Masseter thickness measurements recorded at a given site were consistent across all of the testing sessions (P=0.575). The data suggest that reliable interpretation of longitudinal measurements of masseter thickness obtained with ultrasonography requires accurate repositioning of the transducer. Ultrasonography may be used to investigate the effect of specific treatment modalities on masseter thickness measurements.

Adult↗
PubMed1991

Exteroceptive suppression of the masseter and temporalis muscles and parkinsonian rigidity.

Exteroceptive suppression of the masseter and temporalis muscles, produced by electrical stimulation of the mental nerve, was studied in 40 patients with Parkinson's disease (PD) and 18 age-matched control subjects. Prior to the stimulation, background electromyographic activity showed no difference between the normal subjects and patients with PD. The latency in the patients with PD did not differ from that in the normal subjects. The duration and degree of suppression were lower in the patients with PD when compared with the normal subjects. The low level of degree was more obvious in patients with severe rigidity in the neck. A low degree of exteroceptive suppression might play a partial role in causing rigidity.

Adult↗
PubMed2006

The effect of age on the function of the masticatory system--an electromyographical analysis.

BACKGROUND: Old age is the last stage of human life and, unfortunately, the ageing rhythm of the oral cavity and masticatory system seems to be rather accelerated. Hence, there is a reduction in the amount of food ingested, establishing the imbalance of nutritional phenomena. OBJECTIVE: To assure a better quality of life for the elderly, it is necessary to understand their masticatory system. MATERIALS AND METHODS: An electromyographical analysis of the masticatory system in 10 individuals aged between 60-75 years (group 1) and 10 between 23-30 years old (group 2) was carried out. The analysis was performed using a MyoSystem-Br1 electromyographer with differential active electrodes. The test was registered during positioning and functional conditions, such as chewing, and the muscles assessed were the temporalis and masseter. Data were normalised by maximum voluntary contraction (MVC), and the results were analysed statistically using independent t-test during the comparison between groups. RESULTS: Statistical significance (p < or = 0.05) was found in the analysis of various activities, in which the elderly showed greater electromyographical activity values relative to their MVC during the different mandibular positions, such as left laterality. While the elderly subjects revealed values of 30% relative to their MVC, the young revealed 10%. However, during masticatory activities, the elderly revealed values of up to 79%, and the young of 108%, relative to their MVC, such as when they are chewing peanuts. CONCLUSION: It could be concluded that the elderly show hyperactivity of masticatory musculature during posture maintenance and a slight hypoactivity of this musculature during chewing when analysed side by side with young individuals.

Adult↗
PubMed1980

Jaw muscle silent periods: the effect of acrylic splints.

Jaw muscle silent periods were recorded in response to a chin tap during maximal clench in asymptomatic subjects. The insertion of a palatal splint did not change the silent period duration. However, an occlusal splint, or part of it, caused a significant increase in the duration of the silent period.

Acrylic Resins↗
PubMed1988

The temporalis muscle flap for intraoral reconstruction: technical modifications.

For three years we have used the temporalis muscle flap for reconstruction of intraoral defects. Advantages of this flap are that it is non-hair-bearing, nonbulky, pliable, durable, proximal to intraoral defects, and it results in better articulation and deglutition. We have modified our original technique so that we facilitate transference of the flap by a more anterior transection through the zygomatic arch, we improve the aesthetic reconstruction by use of the transected coronoid process, we produce better function by preventing adhesions and granulation tissue, and we enhance definition of the lingual sulcus by splinting.

Ear↗