Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Temporomandibular Disorder and Disuse Atrophy of the Masticatory Muscles after Surgical Resection of a Schwannoma: A Case Report

  • Lee, Yeon-Hee (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital) ;
  • Park, Hye-Ji (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital) ;
  • Hwang, Mi-Jin (Department of Orofacial Pain and Oral Medicine, Seongnam Ye Dental Hospital) ;
  • Auh, Q-Schick (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital)
  • Received : 2018.11.15
  • Accepted : 2018.12.12
  • Published : 2018.12.30
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Abstract

Disuse atrophy involves gradual muscle weakening due to inadequate usage and can cause temporomandibular disorder (TMD). A 45-year old man with TMD symptoms on the left side, who had disuse atrophy of the masticatory muscles on the right side following surgical removal of a trigeminal schwannoma on the right side, first visited the Department of Orofacial Pain and Oral Medicine at Kyung Hee University Dental Hospital with left jaw pain and difficulty in opening mouth and chewing. He had been experiencing difficulties in cognitive function, decrease in visual acuity, impaired speech, and writing deficits after brain surgery. Furthermore, he complained of abnormal occlusion on the right side, which interfered with his ability to chew comfortably and open his mouth effectively. Herein, we describe a contralateral TMD case due to ipsilateral disuse atrophy after brain surgery for a trigeminal schwannoma and our successful treatment with medication, physical therapy, and stabilization splint.

Keywords

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Fig. 1. Magnetic resonance imaging images of temporomandibular joints: (A) right and (B) left, sagittal T2 weighted images in closed mouth position.

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Fig. 2. Results of the quantitative sensory tests: (A) two-point discrimination test, (B) static light touch discrimination test, and (C) directional discrimination test (brush directional stroke test). Tests B and C showed that sensitivity of the right side in the V1, V2, and V3 regions (maxilla and mandible) was lower than that of the left. Tests A and C did not check the chin area.

Table 1. EMG score of each masticatory muscle during initial examination

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