Navegando por Palavras-chave "Síndrome Da Disfunção Da Articulação Temporomandibular"

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    Acesso aberto (Open Access)
    Agulhamento seco do músculo masseter: efeito na percepção do zumbido de pacientes com DTM
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Miyashiro, Katia Sirikaku [UNIFESP]; Onishi, Ektor Tsuneo [UNIFESP]; Guimarães, Thatiana Bastos; http://lattes.cnpq.br/6007522222917898; http://lattes.cnpq.br/9383669632593200; http://lattes.cnpq.br/4366221118642727; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the effect of dry needling of trigger points on the masseter muscle and the effect on tinnitus perception in TMD patients of muscular origin. Method: A double-blind randomized clinical trial was performed. After the otorhinolaryngological evaluation, the screening questionnaire for orofacial pain and temporomandibular dysfunction recommended by the American Academy of Orofacial Pain was applied. Patients who fit the inclusion criteria and agreed to participate in the study had a diagnosis of temporomandibular dysfunction confirmed by the Research Diagnostic Criteria for Temporomandibular Disorders. The sample consisted of 25 participants randomly assigned to the study group (n = 13) and the control group (n = 12). The inclusion criteria were: patients with tinnitus (constant or intermittent) for at least 6 months; modulation of tinnitus in at least one trigger point (active or latent) during bilateral palpation of the masseter muscle, age between 18 and 60 years, patients with normal audiometric thresholds, or mild sensorineural hearing loss. All study participants received guidance and advice on temporomandibular dysfunction. The needling procedure (dry and sham) was performed in 3 sessions. The study group received the dry needling and the control group received the sham (placebo) needle. Participants were evaluated using the Visual Analogue Scale for the intensity of pain and tinnitus and annoyance caused by tinnitus and total Tinnitus Handicap Inventory, both before and at the end of treatment, and at 30, 60 and 90 days after the end of the treatment. Results: After three treatment sessions, in the study group there was an improvement in pain intensities in 84.6% of the participants, and 76.9% showed improvement in tinnitus intensity, discomfort, and reduction in total THI. In the control group, 91.7% of the participants presented improvement in pain intensity, 66.7% had an improvement in tinnitus intensity and a reduction in total THI, and 58.3% reported an improvement in the annoyance caused by tinnitus. After 90 days of treatment completion, in the study group, 84.6% maintained improvement in pain intensity and reduction in THI score, and 69.2% reported improvement in both intensity and distress provoked by tinnitus. In the control group, 75% achieved improvement in pain intensity, 33.2% maintained improvement in tinnitus intensity, and 41.7% maintained improvement in the nuisance and total THI. In the mid-term, there were no differences between the groups in the pain (p = 0.645), intensity (p = 0.073) and distress (p = 0.165) groups and in the total score of the Tinnitus Handicap Inventory only the study group presented improvement (p = 0.041). Conclusion: Dry needling combined with counseling was associated with improvement in the intensity of pain, intensity and discomfort caused by tinnitus and in the reduction of total THI score in the short term. Patients who received dry needling as part of the treatment had a significant improvement in the total score of the Tinnitus Handicap Inventory in the mid-term.
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    Acesso aberto (Open Access)
    Características tomográficas da fissura petrotimpânica em pacientes portadores de zumbido
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Moraes, Samuel De Souza [UNIFESP]; Onishi, Ektor Tsuneo [UNIFESP]; http://lattes.cnpq.br/9383669632593200; http://lattes.cnpq.br/2026009278917234; Universidade Federal de São Paulo (UNIFESP)
    Objective: To determine the frequency of PTF types by temporal bones CT in tinnitus patients, and to study the relationship between PTF anatomy and tinnitus. Method: An observational, longitudinal and retrospective analytical study was performed between January 2010 and July 2017. Patients were selected who meet the following inclusion criteria: 1) to have tinnitus 2) performed CT of the temporal bones in Imaging Diagnostic Department (IDD) of the institution, 3) to have a minimum age of 18 years of both sexes. Patients who had the following tomographic changes were excluded from the sample: 1) presence of inflammatory disease of ear and osteodystrophies and / or malformations in the middle ear, 2) Changes in TC compatible with surgical intervention in the middle or inner ear, and 3) TC imaging compatible with degenerative disease in TMJ, and also the patients who took ototoxic medication in the last 3 months were excluded. These patients comprised the study group. The same number of patients was selected to compose the control group with the same criteria. TC were evaluated by three experienced professionals, and the Sato et al (2008) criteria was used. Were are performed measures of PTF lengths and the tomographics changes were scored. The avaliators did not have access to the patients data for both groups. Results: The frequencies for PTF type I, II and III respectively in tinnitus patients were 23.3%, 53.3% and 23.3%, and without tinnitus 6.6%, 40% and 53.33%. PTF type II was more frequent in the study group and Type III in the control group, both with 53.33%. PTF type III in the control group presented a statistically higher frequency with p = 0.039. In the study group, evaluating only ears with tinnitus, types I and II had a frequency of 72.22% and type III 27.78% (p = 0.55), however, considering the ears without the complaint, Type I and II presented a frequency of 83.33% and type III 16.67% (p = 0.021). As to the length in the study group, the values found were lower in relation to the control group, where the mean was 4, 03 mm and 5.61 mm respectively with p <0.001. Hypertrophic DML, mastoid pneumatization, PTF partial ossifications and presence of gaseous contents were the alterations found in patients with tinnitus. Conclusion: From CT, it is possible to analyze the anatomy of PTF, study its dimensions and relationships with TMJ. PTF type III is one less common in tinnitus patients. PTF type I and II had high frequencies, with significant difference in relation to type III, in tinnitus patients. PTF length in patients with tinnitus was significantly lower.
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    Acesso aberto (Open Access)
    Contribuição da psicoterapia de grupo para o estudo de pacientes com disfunção temporomandibular
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Eberlein, Marina Cardoso Smith [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Fiore, Maria Luiza de Mattos [UNIFESP]; http://lattes.cnpq.br/8745307752384207; http://lattes.cnpq.br/6012272319615108; http://lattes.cnpq.br/1514592934381737; Universidade Federal de São Paulo (UNIFESP)
    Objectives: reflect about the experience of group brief psychotherapy impact applied on three sets of patients from Temporomandibular Disorder Clinic at the Hospital São Paulo (UNIFESP) and to examine how such approach can promote raise of their emotional experiences awareness advancing beyond their body expressions. Analyze how this approach can increase the symbolic expression of the affection and which are the most recurrent themes brought into the three groups. Methods: the investigation design is a clinical qualitative retrospective research with three separate brief psychotherapy groups, each one performed with 12 therapy sessions, in a psychodynamic theoretical approach, totaling 18 patients (Group I with 6 participants, Group II with 8 and Group III with 4). The participants were selected by a personal psychological interview after a dentist referral. The sessions were documented and subsequently examined by the most significant and frequent thematic axes. Each group and each individual therapeutic process were analyzed. Results: The author observed a female gender prevalence in 8:1 in relation to male. The age group found was 36 to 77 years, most were professionally inactive (15), predominance of traumatic life stories with losses, abandonments, violence, poverty, fragility of reliable links. It was observed some varied group dynamics, from more structured and organized groups, where a reliable link was built, to less structured and disorganized experiences, where no link was established. It was observed a plurality of individual trajectories, without a homogeneous profile. The majority showed interest to continue the self-knowledge process. The most frequently topics were subjects related to the narcissistic issues like non-differentiation between self and not-self, the trauma, the violence, aggression and the body expression of suffering. Conclusion: The therapeutic group as an embracing model and tie stimulator could develop an experience of psychic integration and differentiation to patients with pain.