RSS-Feed abonnieren
DOI: 10.1055/a-1829-6134
Temporal Tendinitis in Craniomandibular Dysfunction (CMD) – Does it Really Exist? A Temporomandibular MRI Investigation
Tendinitis temporalis bei kraniomandibulärer Dysfunktion (CMD) – Welche Rolle spielt sie wirklich? Eine MRT-Studie der Temporomandibularregion![](https://www.thieme-connect.de/media/roefo/202211/lookinside/thumbnails/roefo-3682_10-1055-a-1829-6134-1.jpg)
Abstract
Objectives The aim of the study was to analyze the role of temporal muscle and particularly tendon pathology in patients suffering from craniomandibular dysfunction (CMD) using magnetic resonance imaging.
Materials and Methods Retrospective analysis of MRI examinations was carried out with regard to temporal muscle fibrosis and fatty degeneration and particularly temporal tendon rupture, thickening, and degenerative signal alterations. Descriptive statistics and the Mann-Whitney U-test were used for statistical evaluation.
Results Structural lesions of temporal muscle parenchyma were the absolute exception. PD hyperintensity, pronounced contrast enhancement, or peritendinous fluid collections along the temporal tendon were found only to a small extent, and a (partial) rupture occurred in only one case. The tendon diameter showed only slight variability. The Mann-Whitney U-test provided no results indicating a causal connection between degenerative joint or disc disease and temporal tendon pathology.
Conclusion A large sample of 128 magnetic resonance imaging examinations provided no evidence of a major role of temporal tendinitis in clinical CMD syndrome.
Key Points:
-
Retrospective analysis of temporal tendon in CMD patients.
-
Abnormal structural findings along the tendon seen only rarely.
-
Obviously no crucial role of temporal tendon lesions in CMD syndrome.
Citation Format
-
Stimmer H, Grill F, Waschulzik B et al. Temporal Tendinitis in Craniomandibular Dysfunction (CMD) – Does it Really Exist? A Temporomandibular MRI Investigation. Fortschr Röntgenstr 2022; 194: 1242 – 1249
Zusammenfassung
Ziel Ziel der vorliegenden kernspintomografischen Untersuchung ist es, die Bedeutung von Läsionen des Musculus temporalis und insbesondere der Temporalissehne für das klinische Syndrom der kraniomandibulären Dysfunktion (CMD) zu untersuchen.
Material und Methoden In einer retrospektiven Analyse von MRT-Untersuchungen der Kiefergelenke wurden Fibrose und fettige Degeneration des Musculus temporalis und insbesondere Verdickung, degenerative Signalveränderungen und Ruptur der Temporalissehne beurteilt. Zur statistischen Auswertung kamen deskriptive Statistik und der Mann-Whitney-U-Test zur Anwendung.
Ergebnisse Strukturelle Läsionen des Musculus temporalis waren die absolute Ausnahme. Nur vereinzelt wurden ein Signalanstieg in PD-gewichteten Sequenzen, eine vermehrte KM-Aufnahme oder peritendinöse Flüssigkeitsansammlungen entlang der Temporalissehne gefunden, eine (Teil-)Ruptur der Sehne nur in einem Fall. Der Sehnendurchmesser zeigte nur eine geringe Variabilität. Der Mann-Whitney-U-Test erbrachte keine Hinweise auf eine kausale Verbindung zwischen degenerativer Gelenkerkrankung und Läsionen der Temporalissehne.
Schlussfolgerung In einer größeren Stichprobe von 128 MRT-Untersuchungen der Kiefergelenke fanden sich keine Hinweise auf eine wesentliche Rolle der temporalen Tendinitis beim klinischen Syndrom der kraniomandibulären Dysfunktion (CMD).
Kernaussagen:
-
Retrospektive Analyse der Sehne des Musculus temporalis bei CMD-Patienten.
-
Nur selten strukturelle Läsionen der Temporalissehne.
-
Offensichtlich keine wesentliche Rolle von Läsionen der Temporalissehne beim klinischen CMD-Syndrom.
Key words
temporal tendon - tendinitis - temporomandibular joint (TMJ) - craniomandibular dysfunction (CMD) - magnetic resonance imaging (MRI) - head/neck - MR-imaging - inflammationPublikationsverlauf
Eingereicht: 31. Dezember 2021
Angenommen: 09. April 2022
Artikel online veröffentlicht:
25. Mai 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Bender S. Temporomandibular disorders, facial pain, and headaches. Headache 2012; 52 (Suppl. 01) 22-25
- 2 Köhler AA, Hugoson A, Magnusson T. Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors. Swed Dent J 2013; 37 (01) 1-11
- 3 Dupont JS, Brown CE. The concurrency of temporal tendinitis with CMD. Cranio 2012; 30 (02) 131-136
- 4 Klasser GD, Bassiur J, de Leeuw R. Differences in reported medical conditions between myogenous and arthrogenous TMD patients and its relevance to the general practitioner. Quintessence Int 2014; 45 (02) 157-167
- 5 Fricton J. Myogenous temporomandibular disorders: diagnostic and management considerations. Dent Clin North Am 2007; 51 (01) 61-83
- 6 Ariji Y, Ariji E. Magnetic resonance and sonographic images of masticatory muscle myalgia in temporomandibular disorder patients. Jpn Dent Sci Rev 2017; 53 (01) 11-17
- 7 Khawaja SN, McCall WJr, Dunford R. et al. Infield masticatory muscle activity in subjects with pain-related temporomandibular disorders diagnoses. Orthod Craniofac Res 2015; (Suppl. 01) 137-145
- 8 Benninger B, Lee Bl. Clinical importance of morphology and nomenclature of distal attachment of temporalis tendon. J Oral Maxillofac Surg 2012; 70 (03) 557-561
- 9 Scopel V, Alves da Costa, Urias D. An electromyographic study of masseter and anterior temporalis muscles in extra-articular myogenouis TMJ pain patients compared to an asymptomatic and normal population. Cranio 2005; 23 (03) 194-203
- 10 Bressler HB, Markus M, Bressler RP. et al. Temporal tendinosis: A cause of chronic orofacial pain. Curr Pain Headache Rep 2020; 24 (05) 18 DOI: 10.1007/s11916-20-00851-1.
- 11 Sedlmayr JC, Kirsch CFE, Wisco JJ. The human temporalis muscle: Superficial, deep and zygomatic parts comprise one structural unit. Clin Anat 2009; 22: 655-664
- 12 Lee JY, Kim JN, Kim SH. et al. Anatomical verification and designation of the superficial layer of the temporalis muscle. Clin Anat 2012; 25 (02) 176-181
- 13 Geers C, Nyssen-Behets C, Cosnard G. et al. The deep belly of the temporalis muscle: An anatomical, histological and MRI study. Surg Radiol Anat 2005; 27 (03) 184-191
- 14 Gandy JF, Zouaoui A, Bravetti P. et al. Functional anatomy of the human temporal muscle. Surg Radiol Anat 2001; 23 (06) 389-389
- 15 Ernest EA, Martinez ME, Rydzewski DB. et al. Photomicrographic evidence of insertion tendinosis: The etiologic factor in pain from temporal tendonitis. J Prosthet Dent 1991; 65: 127-131
- 16 Ernest EA. Temporal tendinitis (migraine mimic). Pract Pain Management 2006; 6 (04) 58-64
- 17 Larheim TA. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs 2005; 180 (01) 6-21
- 18 Zanoteli E, Yamashita HK, Suzuki H. et al. Temporomandibular joint and masticatory muscle involcement in myotonic dystrophy: a study by magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 262-271
- 19 Gregor C, Hietschold V, Harzer WA. 31P-magnet resonance spectroscopy study on the metabolism of human masseter in individuals with different vertical facial pattern. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: 406-414
- 20 Okada K, Yamaguchi T, Komatsu K. et al. The influence of tissue blood flow volume on energy metabolism in masseter muscles. Cranio 2005; 23: 166-173
- 21 Sato T, Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia: A new clinical entity of limited mouth opening. Jpn Dent Sci Rev 2016; 52 (02) 41-48
- 22 Shankland WE. Temporal tendinitis: a modified Levandoski panoramic analysis of 21 cases. Cranio 2011; 29 (03) 204-210
- 23 Bressler HB, Friedman T, Friedman L. Ultrasound-guided injection of the temporalis tendon: A novel technique. J Ultrasound Med 2017; 36 (10) 2125-2131
- 24 Gencer ZK, Özkiris M, Okur A. et al. Comparative study on the impact of intra-articular injections of hyaluronic acid, tenoxicam and betametazon on the relief of temporomandibular joint disorder complaints. J Craniomaxillofac Surg 2014; 42 (07) 1117-1121
- 25 Sidebottom AJ, Patel AA, Amin A. Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study. Br J Oral Maxillofac Surg 2013; 51 (03) 199-205
- 26 Karacalar A, Yilmaz N, Bilgici A. et al. Botulinum toxin for the treatment of temporomandibular joint disk disfigurement: clinical experience. J Craniofac Surg 2005; 16 (03) 476-481
- 27 Pons M, Meyer C, Euvrard E. et al. MR-guided navigation for botulinum toxin injection in the lateral pterygoid muscle. First results in the treatment of temporomandibular joint disorders. J Stomatol Oral Maxillofac Surg 2019; 120 (03) 188-195
- 28 Park HU, Kim BI, Kang SM. et al. Changes in masticatory function after injection of botulinum toxin type A to masticatory muscles. J Oral Rehabil 2013; 40 (12) 916-922
- 29 Stimmer H, Ritsch L, Goetz C. et al. What role does synovitis play in craniomandibular dysfunction (CMD)? A 3T-MRI study. Röfo 2019; 191 (10) 924-931
- 30 Sawada E, Kaneda T, Sakai O. et al. Increased apparent diffusion coefficient values of masticatory muscles on diffusion-weighted magnetic resonance imaging in patients with temporomandibular joint disorder and unilateral pain. J Oral Maxillofac Surg 2019; 77 (11) 2223-2229