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Temporal Tendinitis Migraine Mimic

Diagnosis and treatment of temporal tendonitis—a very common disorder that is often mistaken for migraine.
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If the temporal tendinitis proves to be the primary condition, and repeated injections of local anesthetic and cortisone or sarapin do not solve the condition, then surgery may well be indicated to solve the complex of pain suffered by the patient. The surgical method developed by the author in 1983, and approved by the American Medical Association in 1986,14 involves utilization of radiofrequency thermoneurolyis (RFTN)—a radio wave modality similar in theory to dental electrosurgery. RFTN has a twenty-five year history of unqualified success in dental medicine and over fifty years of success in medicine.11-18

Technique

The patient is anesthetized intra-orally with local anesthetic at the temporal tendon and, utilizing fluoroscopic monitoring, the radiofrequency probe or needle (see Figure 6) is passed to the tip of the coronoid process. After the probe position is determined to be safely positioned with no sensory nor motor stimulus (see Figure 7), the probe or needle is activated and a RFTN lesion is created. The patient is then released to be seen post-operatively the next day to evaluate the benefit of the RFTN procedure. If possible, the patient should be seen two weeks later to evaluate the TM joint and the dental occlusion to be sure that “normal status" has been achieved for the patient.

Conclusion

The condition described as temporal tendinitis was discovered by this author in 1982-1983, and the RFTN procedure was developed in 1983-1984. Since the initial publication of temporal tendinitis in 1983, many cases of temporal tendinitis have been diagnosed and treated both non-surgically and surgically by dentists and physicians, with resulting successes. It is the author’s hope that this paper will encourage the dentist to consider temporal tendinitis when confronted with dental tooth pain that may be a referred pain rather than a primary dental condition. Nothing is more frustrating than doing a root canal procedure on a molar tooth that is actually a referred site of pain from temporal tendinitis.

Last updated on: December 28, 2011
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