Speculative explanation of scalenus peripheral nerve entrapment syndrome after TMJ arthroplasty

This essay gives information gathered in two reported cases in which secondary craniocervical and upper extremity small vessel entrapment developed after the completion of the temporomandibular joint (TMJ) arthroplasty procedure. A clinical hypothesis has been proposed addressing the etiology of the pain syndrome. From the information studied, the cause would seem to be related to biomechanical changes that were cervical adaptations in response to the loss of the vertical dimension in the TM joint and the resulting alteration of the occlusal plane. This pain phenomenon appeared to be best treated with a comprehensive multidisciplinary program. With a combination of medical, dental, and physical therapy work, a resolution of the biomechanical and musculoskeletal dysfunctions can be achieved.