Academic literature on the topic 'Costen's syndrome'

Although James Costen was not the first to ascribe ear pain, tinnitus, impaired hearing, and even dizziness to temporomandibular joint dysfunction, he developed an integrated and systematic approach ascribing the symptoms to dental malocclusion. He wrote extensively on it, and a few years after his original article, the term Costen's syndrome came into general use. Recently, the use of the eponym has decreased, as dental malocclusion has assumed a lesser role in explaining many of the symptoms formerly ascribed to it.

Introduction. The relevance of the study is due to the complexity of the differential diagnosis of Kosten's syndrome and meningioma in the area of the cerebellar bridge angle of the brain, as well as the severe suffering of patientsThe purpose of our study: development of an algorithm for the approach to the differential diagnosis of meningioma of the cerebellar angle and Kosten's syndrome.Materials and methods. To accomplish the set tasks, we examined 22 patients who complained of headache, hearing impairment, sensation of tinnitus, pain and crepitus in the temporomandibular joint during movements of the lower jaw, paresthesia of the oral and nasal mucosa. All patients were assigned studies: cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the TMJ according to indications.Results. Since complaints can lead patients to see doctors of various specialties, it is necessary to be able to differentiate between Costen's syndrome and a tumor of the cerebral pons-cerebral angle. In Costen's syndrome, the pain most often has an aching character, in contrast to the volumetric formations of the brain, in which the pain is burning, spreading along the branches of the facial or trigeminal nerve. One of the main methods of excluding a brain tumor is magnetic resonance imaging.Conclusions. The most significant modern method for diagnosing Costen's syndrome and meningioma of the cerebellopontine angle is magnetic resonance imaging (MRI) of the TMJ and the brain. Differential signs of Costen's syndrome are distal displacement of the head of the lower jaw, diagnosed by CBCT and MRI, as well as displacement of the articular disc (determined by MRI). A meningioma of the cerebellopontine angle is indicated by the burning nature of pain in half of the face, as well as confirmation of the diagnosis by magnetic resonance imaging of the brain.

Relevance. Our study aimed to determine the main differential diagnosis criteria for temporomandibular joint (TMJ) pain dysfunction syndrome (temporomandibular disorders, Costen's syndrome) and cerebellopontine angle tumours.Materials and methods. We examined 22 people (19 women and three men), aged 21 to 74 years (mean age 37.2 ± 5.1 years), who presented to the prosthodontic clinic with facial pain.Results. The study proposed the following differential diagnostic criteria for TMJ pain dysfunction syndrome and brain tumors: different nature of pain, unilateral ear noise; distal displacement of the mandibular head diagnosed by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), as well as articular disc displacement (detected by MRI) in temporomandibular disorders. Unilateral facial burning pain indicated meningioma of the cerebellopontine angle, which head MRI confirmed.Conclusion. The proposed table for evaluating clinical and paraclinical study methods for patients with facial pain helps to differentiate the cause of pain properly and proceed with the optimal treatment method.

Temporomandibular joint disease (TMJ) is one of the most pressing problems of modern dentistry, on the one hand, the frequency of pathology of the temporomandibular joint, and on the other hand - the complexity of diagnosis. In the medical specialty "dentistry" there is no section where there would be as many debatable and unresolved issues as in the diagnosis and treatment of diseases of the temporomandibular joints. Aim of the research. Based on the analysis of sources of scientific and medical information to determine the role and place of "Costen's syndrome" in the pathology of the temporomandibular joints. Results and discussion The term TMJ dysfunction has up to 20 synonyms: dysfunction, muscle imbalance, myofascial pain syndrome, musculoskeletal dysfunction, occlusal-articulation syndrome, cranio-mandibular TMJ dysfunction, neuromuscular and articular dysfunction. Finally, in the International Classification of Diseases (ICD-10), pain dysfunction of the temporomandibular joint has taken its place under the code K0760 with the additional name "Costen's syndrome", which is given in parentheses under the same code. Thus, such a diagnosis as "Costen's syndrome" is not excluded in the International Classification of Diseases. The first clinical symptoms and signs of TMJ were systematized in 1934 by the American otorhinolaryngologist J. Costen and included in the special literature called "Costen's syndrome". This syndrome includes: pain in the joint, which often radiates to the neck, ear, temple, nape; clicking, crunching, squeaking sound during movements of the lower jaw; trismus; hearing loss; dull pain inside and outside the ears, noise, congestion in the ears; pain and burning of the tongue; dizziness, headache on the side of the affected joint, facial pain on the type of trigeminal neuralgia. The author emphasized the great importance of pain and even singled out "mandibular neuralgia." The criteria proposed by McNeill (McNeill C.) in 1997 are somewhat different from those described in ICD-10: pain in the masticatory muscles, TMJ, or in the ear area, which is aggravated by chewing; asymmetric movements of the lower jaw; pain that does not subside for at least 3 months. The definition of the International Headache Society is similar in content. Anatomical and topographic study of the corpse material suggested the presence of a structural connection between the TMJ and the middle ear. According to some data, in 68% of cases the wedge-shaped mandibular ligament reaches the scaly-tympanic fissure and the middle ear, and in 8% of cases it is attached to the hammer. In addition, several ways of spreading inflammatory mediators from the affected TMJ to the middle and inner ear, which causes otological symptoms, have been described. It should be noted that there are certain prerequisites for the mutual influence of the structures of the cervical apparatus, middle and inner ear and upper cervical region at different levels: embryological, anatomical and physiological. At the embryological level. It is confirmed that from the first gill arch develops the upper jaw, hammer and anvil, Meckel's cartilage of the lower jaw, masticatory muscles, the muscle that tenses the eardrum, the muscle that tenses the soft palate, the anterior abdomen of the digastric muscle, glands, as well as the maxillary artery and trigeminal nerve, the branches of which innervate most of these structures. At the anatomical level. Nerve, muscle, joint and soft tissue structures of this region are located close enough and have a direct impact on each other. The location of the stony-tympanic cleft in the medial parts of the temporomandibular fossa is important for the development of pain dysfunction. At the physiological level. A child who begins to hold the head, the functional activity of the extensors and flexors of the neck gradually increases synchronously with the muscles of the floor of the mouth and masticatory muscles, combining their activity around the virtual axis of the paired temporomandibular joint. In addition, the location of the caudal spinal nucleus of the trigeminal nerve, which is involved in the innervation of the structures of the ear, temporomandibular joint and masticatory muscles at the level of the cervical segments C1-C3 creates the possibility of switching afferent impulses from the trigeminal nerve to the upper cervical system. Innervate the outer ear, neck muscles and skin of the neck and head. Also important are the internuclear connections in the brainstem, which switch signals between the vestibular and trigeminal nuclei. That is why the approach to the treatment of this pathology should be only comprehensive, including clinical assessment of the disease not only by a dentist or maxillofacial surgeon, but also a neurologist, otorhinolaryngologist, chiropractor, psychotherapist with appropriate diagnostic methods and joint management of the patient.

AbstractObjective:Otological symptoms (otalgia, subjective hearing loss, blocked ear sensation, tinnitus and vertigo) associated with temporomandibular disorders are documented features of Costen's syndrome. However, the origin of these symptoms and the causes of hearing loss are unknown. This study aimed to characterise hearing loss in a large number of patients with temporomandibular disorders. The causes of these symptoms were explored in patients with otological symptoms and normal audiometric findings.Methods:A prospective case study and literature review were performed. The audiometric features of 104 temporomandibular disorder patients were compared with those of 110 control participants.Results:A large proportion of temporomandibular disorder patients had several otological symptoms. Twenty-five per cent of unilateral or bilateral temporomandibular disorder patients had either unilateral (ipsilateral) or bilateral hearing loss; respectively, which was usually mild (p = 0.001). Hearing loss was predominantly sensorineural.Conclusion:The main cause of otological symptoms (apart from otalgia) and of audiometric findings in temporomandibular disorder patients is postulated to be an altered middle-ear to inner-ear pressure equilibrium.

Abstracts Title: Craniomandibular Syndrome - Diagnosis and Therapy from the Perspective of a Physiotherapist Objectives: The thesis deals with problems of diagnosis and therapeutic intervention in pain, that originates in craniomandibular area from the perspective of the physiotherapist, and especially functional disorders of myofascial substrate. The goal was to determine whether and to what extent can be the pain relieved, through selected therapeutic methods (soft tissue techniques, mobilization techniques, positive thermotherapy, individual LTV). Further more, if the pain control (to alleviate its intensity) is effective and whether it is achieving lasting effects even in periods without therapy. Another question was whether the method of pressure algometrie (PPT) correlates with subjective pain level marked on the VAS scale. Methods: The study itself was elaborated in qualitative form. The examined group consisted of 10 consenting women with pain in the craniomandibular area, who had no diagnosis by neurologist, a dentist and an otolaryngologist. The comparison group was not established, since it was not a comparison of different therapies, but the effect of therapeutic techniques on pain reduction, thus subjects with pain could not remain untreated. The results were compared and evaluated within a...