Superficial cervical plexus block on pain control in patients with temporomandibular joint internal derangement with headache: a retrospective cohort study

Abstract

Objectives: Temporomandibular disorders (TMDs) are a group of disorders with varied pathophysiology and clinical manifestations. Masticatory and cervical motor systems have a functional relationship. Superficial cervical muscles have greater hyperactivity in myogenous and mixed TMDs than in healthy individuals, demonstrating an abnormal pattern of contraction. This study aimed to demonstrate the effects of superficial cervical plexus block (SCPB) anesthesia during arthrocentesis in patients with temporomandibular joint (TMJ) internal derangement and headache. Method and materials: This retrospective cohort study included 2 men and 23 women with cervicogenic headache and TMJ internal derangement treated by arthrocentesis, and 40 TMJs with established cervicogenic headaches. The average follow-up period was 9.36 +/- 2.679 months. TMJ and muscle pain during mastication, maximum and non -assisted mouth opening, and lateral excursion were recorded. Pain and dysfunction were determined using the visual analog scale. Patients were monitored before, during, and after arthrocentesis while inducing SCPB anesthesia, and vital findings were recorded. In addition, skin surface temperature was measured. Results: Patients experienced a significant in- crease in their clinical values. Changes in non -assisted mouth opening (mean from 29.65 +/- 6.31 to 33.3 +/- 5.21 mm) (P < .05), assisted mouth opening (mean from 38.98 +/- 7.62 to 43.35 +/- 6.17 mm), right excursions (mean from 7.28 +/- 2.08 to 9.13 +/- 1.86 mm), and left excursions (mean from 7.48 +/- 1.71 to 8.90 +/- 1.82 mm) were statistically significant (P < .05). Patients were relieved after SCPB, resulting in decreased pain and hemodynamic values. Increase in mean temperature after SCPB was statistically significant (P = .002, P < .05). Conclusion: This study presents a straightforward novel protocol, clinically efficient for arthrocentesis on pain control in patients with TMJ internal derangement and cervicogenic headache.