The Temporo-Masseteric Nerve Block (TMNB) for Alleviating Acute Postextraction Masticatory Myalgia: A Case Series

Area of Science:

• Oral and Maxillofacial Surgery
• Pain Management
• Anesthesiology

Background:

• Acute myogenous pain of the masseteric or temporalis muscles can occur after dental extractions.
• This pain is often accompanied by trismus, limiting mouth opening.
• Effective management strategies for this specific type of postextraction pain are needed.

Purpose of the Study:

• To describe the efficacy of the temporo-masseteric nerve block (TMNB) in relieving acute postextraction myogenous pain.
• To review the injection technique for the TMNB.
• To evaluate the potential of TMNB as a nonopioid adjunct for managing postextraction pain and trismus.

Main Methods:

• A case series involving 4 patients who developed severe masseteric/temporalis pain post-dental extraction.
• Administration of the temporo-masseteric nerve block (TMNB) to affected patients.
• Assessment of pain relief and improvement in mouth opening post-injection.

Main Results:

• All 4 patients experienced rapid relief from acute masseteric/temporalis pain and trismus following TMNB.
• Symptom alleviation persisted longer than the anesthetic effect of the local anesthetic used.
• The TMNB proved effective in managing pain and improving function.

Conclusions:

• The temporo-masseteric nerve block (TMNB) is a potentially valuable nonopioid adjunct for managing acute postextraction myogenous pain.
• Differentiating myogenous pain from surgical site pain is crucial for optimal postoperative pain management.
• Further systematic validation of TMNB's utility in postextraction pain management is warranted.