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Wirksamkeit medikamentöser und myofunktioneller Therapiekonzepte beim chronischen Gesichtsschmerz

Efficacy of drug and myofunctional therapy concepts in chronic facial pain

Patrick Schöne
Doctoral thesis
Date of Examination: 2016-07-06
Date of issue: 2016-06-13
Advisor: Rustemeyer, Jan Prof. Dr. Dr.
Referee: Rustemeyer, Jan Prof. Dr. Dr.
Referee: Petzke, Frank Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0028-877A-2

 

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Abstract

English

The aim oft the present study was to evaluate the epidemiology, clinical diagnosis, treatment and its success of the four most frequently occuring forms of facial pain (myoarthropathy, trigeminal neuralgia, trigeminal neuropathy and persistent idiopathic facial pain) to draw action-oriented conclusions. 226 patients were analysed, that were treated conservative between 2002 and 2011. Myoarthropathic patients were preponderantly female (95%) with a median discomfort duration of 6.5 month. Most common anamnestic risk facor were psychiatric disorders (31,67%). With our conservative therapy 76,66% of the patients were successfully treated.  Patients with trigeminal neuralgia were also mainly female (65,52%) with a median discomfort duration of 24 month. There was a higher frequence of the right side of the face (62,07%) and in the area of V3 (36,21% and V2 and V3 in combination (29,31%). Common risk factors were previous operations (22,41%) and psychiatric disorders (13,79%). The conservative treatment was successfull in 91,37%. Patients with trigeminal neuropathy were also dominantly female (75%). While the median discomfort duration in this subgroup was 17 month, patients with a shorter duration of disorders had a significantly better outcome (p=0,049). It was predominant at the left side of the face (46,15%) and in the are of V2 (61,54%) and V3 (21,16%). Most frequent risk factors were previous operations (80,77%) and dental interventions (15,39%). 73,07% of the patients were treated successfully. Because patients treated with non – opioid analgetics had a significantly worse outcome (p=0,01), the use should be reassessed giving therapy to this kind of disorder. Patients with persistent idiopathic facial pain had also a higher rate of females (64,29%). The median discomfort duration was 36 month with a predominent incidence on the left side of the face (42,86%). Most common anamnestic risk factors were previous operations (58,93%) and psychiatric disorders (55,36%). With our conservatice therapy 58,93% were treated successfully. Patients with comorbidities had a significant worse outcome (p=0,01), especially psychiatric dosorders had even a more worse success rate (p=0,002). Summarizing we had a positive outcome in 75,22% with our conservatice treatment. 
Keywords: facial pain; myoarthropathy; trigeminal neuralgia; trigeminal neuropathy; persistent idiopathic facial pain
Schlagwörter: Gesichtsschmerz; Myoarthropathie; Trigeminusneuralgie; Trigeminusneuropathie; anhaltender idiomatischer Gesichtsschmerz
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