Articles: pain.
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Clin Otolaryngol Allied Sci · Feb 1980
Case Reports'Costen's syndrome'--correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms.
Forty-five patients with temporomandibular joint dysfunction, and otalgia together with other aural symptoms (deafness, tinnitus, pressure/blockage and vertigo) were evaluated clinically and audiometrically. The theoretical mechanisms by which aural symptoms may be produced as a result of temporomandibular joint dysfunction are outlined and discussed in the light of the patients under review. The wide diversity in the incidence of additional aural symptoms apart from otalgia reported in the literature is noted, together with the general lack of full objective audiometric assessment. ⋯ Thus in this series at least 9% of the patients were considered to have other aural symptoms coincidental to temporomandibular joint dysfunction. This is compatible with the relatively common occurrence of both temporomandibular joint dysfunction and aural symptoms in the general population. This study leads us to believe that there is no direct aetiological basis to link temporomandibular joint dysfunction and other aural symptoms apart from otalgia.
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Our experience in treating 10 patients with intractable pain with paraplegia employing percutaneous epidural or dorsal column stimulation is presented. Initial and long-term results in this group are contrasted with those of 9 patients with intractable post-amputation or post-traumatic neuroma pain. The successful results of neurostimulation treatment of peripheral nerve pain contasts with the disappointing results in the treatment of paraplegic pain.
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The effect of local nerve blockade on the relief of postoperative pain is reported in a series of 167 patients who underwent surgery of the arm, knee or foot. In 80% of cases analgesics were not required within 4 hours postoperatively, and in 39% analgesics were not required within 8 hours. Conventional methods of postoperative pain relief are not always effective. Local nerve blockade can be used to provide complete analgesia after limb surgery and is therefore of great value to postoperative care.
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Transcutaneous electrical nerve stimulation (TENS) was evaluated as a postoperative analgesic. Patients undergoing lumbar spine operations, hip surgery, and gynecological laparotomies were studied. ⋯ Results from 46 experimental patients demonstrated that TENS could reduce the demand for postoperative narcotics in a group of patients who had not used narcotic analgesics before operation. No significant benefit was observed for patients who had used narcotics prior to operation.