A recent study in the journal Anesthesia Progress presents a new technique for treating dislocation of the TMJ (temporomandibular joint) using a deep temporal nerve block.
Hypermobility and/or dislocation of the TMJ, usually as the result of yawning widely, are widespread across the United States. According to the TMJ Association, these conditions affect more than 10 million people at any given time. They are especially prevalent in children and in women of childbearing age.
Traditional treatment has been limited to the application of force, where the jaw is forced back and down into the joint, and in severe cases, general anesthesia alone or combined with surgery is required. However, muscle spasms, reflexive muscle guarding and intolerable pain present severe obstacles to the manual reduction method.
Muscle relaxants may be used to alleviate these problems. But they are usually given in the form of a pill, which is hard to swallow when the jaw is in locked position.
For the new treatment, lidocaine and epinephrine are combined and administered to the deep temporal nerve, reducing the sensation of pain and muscle spasms.
The anesthesia is easy to administer because the temporal nerve runs along the jaw bone, so the needle is inserted near the mandibular notch until the sphenoid bone is encountered, which takes away uncertainty about positioning and muscle versus nerve application. Manual reduction can then be accomplished with relative ease.
This method is safe and simple, and improves the success of the manual reduction procedure. This reduces pain and the need for more invasive procedures.
To read the entire study, "Use of Masseteric and Deep Temporal Nerve Blocks for Reduction of Mandibular Dislocation," visit temporal nerve blocks.
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