This disk distributes the forces of chewing throughout the joint space. This disk absorbs shock to the temporomandibular joint from chewing and other movements. To keep this motion smooth, a soft disk of cartilage lies between the condyle and the temporal bone. The condyles slide back to their original position when you close your mouth.
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When you open your mouth, the rounded ends of the lower jaw (condyles) glide along the joint socket of the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joint and its movement. The coordination of this action also allows you to talk, chew, and yawn. The jawbone itself, controlled by the TMJ, has two movements: rotation or hinge action, which is opening and closing of the mouth, and gliding action, a movement that allows the mouth to open wider. Muscles involved in chewing (mastication) also open and close the mouth. You have two TMJs, one on each side of your jaw. The TMJ is comprised of muscles, blood vessels, nerves, and bones. Overall, more women than men have TMJ syndrome. The temporomandibular joint syndrome is also referred to as the temporomandibular joint disorder. Problems in this area can cause head and neck pain, facial pain, ear pain, headaches, a jaw that is locked in position or difficult to open, problems with biting, and jaw clicking or popping sounds when you bite. Certain facial muscles that control chewing are also attached to the lower jaw. The TMJ connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear. Temporomandibular joint (TMJ) syndrome is a pain in the jaw joint that can be caused by a variety of medical problems. Patients undergoing surgery with dissection and/or manipulation in these anatomical sites and structures should be thoroughly counseled about the risk of developing FBS.Picture of Temporomandibular Joint (TMJ) Syndrome The strongest independent risk factors for FBS are PPS dissection, deep lobe of parotid resection, and sympathetic chain sacrifice. No treatment consistently provided effective symptomatic relief. Of 45 FBS patients, 15 (33%) underwent at least one type of treatment for symptomatic relief. Partial resolution of FBS symptoms occurred in 69% and complete resolution in 12%.
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FBS developed in 48.6% of patients undergoing sympathetic chain sacrifice, 22.4% of patients undergoing PPS dissection, 38.4% of patients undergoing isolated deep lobe parotid resection, and 0.8% of patients undergoing total parotidectomy. 001), and resection of only the deep lobe of the parotid gland (OR, 4.2 P =. On multivariate analysis, three variables were significant independent risk factors for FBS: sympathetic chain sacrifice (odds ratio, 4.7 P =. Results:įBS developed in 45 patients (incidence, 9.6%), at a mean time of 97 (range, 6–877) days from surgery. Patients developing FBS were interviewed to assess the efficacy of various treatment modalities. Univariate analyses and multivariate logistic regression were used to identify independent risk factors for FBS.
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Incidence was calculated using the Kaplan–Meier method. Patient, tumor, and FBS characteristics were analyzed. Minimum follow-up time was 3 months (median, 39 months).
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We reviewed the records of 499 patients (mean age, 50 years range, 12–81 years) undergoing surgery of the deep lobe of the parotid gland, PPS, and/or ITF between 19. We hypothesized that certain clinical and tumor variables independently predict the development of FBS. The incidence, risk factors, treatment options, and outcomes of FBS are poorly understood. 1, 2 It is a potential sequela of surgery involving the infratemporal fossa (ITF), parapharyngeal space (PPS), and/or deep lobe of the parotid gland. First bite syndrome (FBS) refers to facial pain characterized by a severe cramping or spasm in the parotid region with the first bite of each meal that diminishes over the next several bites.