Utilização de terapias minimamente invasivas para o tratamento de desordens temporomandibulares de uma paciente portadora de torcicolo muscular congênito: um relato de caso

Abstract

Temporomandibular disorders (TMDs) are a group of pathological conditions that can cause pain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJs) and associated structures. They may be present in patients with congenital Muscular Torticollis, a musculoskeletal condition, detected at or soon after birth, which occurs due to the shortening and contraction of the sternocleidomastoid muscle (LOPES et.al, 2009). Therefore, it is of extreme relevance to trace a correct diagnosis and adequate strategies to plan and implement a therapy, whether conservative and/or minimally invasive. The aim of this study was to conduct, therapeutically, the clinical case of an adult participant diagnosed with congenital muscular torticollis and referred for treatment of some TMD in order to test whether conservative therapy (counselling, physiotherapy, pharmacotherapy and stabilizing plate) is efficient in ensuring beneficial results, without the need for minimally invasive therapies (arthrocentesis and viscosupplementation with hyaluronic acid). After the clinical examination and the analysis of the requested imaging exams, multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), the participant was diagnosed with myalgia, myofascial pain with reference, arthralgia, disk displacement without reduction of the right TMJ and degenerative disorder also in the right TMJ . Initially a conservative therapy was proposed in order to obtain positive results regarding the increase of mouth amplitude and decrease of painful symptomatology. After 4 months of implementation of conservative, non-invasive therapy, the participant did not show significant improvement, and a minimally invasive procedure was chosen, where the participant showed improvement after the first month of application. It is concluded that in more evolved cases, conservative therapies may not present the desired results, making it necessary to use minimally invasive therapies as a second treatment option.