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Chronic pain after temporomandibular joint surgery: a survey-based study documenting clinical characteristics and
Maya Youness1, David Keith2, Annika Rosén3
1Department of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, College of Dental Medicine, New York, NY, USA.
Objectives:
Patients undergoing temporomandibular joint (TMJ) surgery can develop chronic postsurgical pain (CPSP). This study identifies patient factors and CPSP characteristics after TMJ surgery.
Study Design:
Survey-based study of patients who underwent TMJ surgery at Massachusetts General Hospital between 08/1987-06/2024. Survey evaluates CPSP, comorbidities, and risk factors 6+ months postoperatively.
Results:
Total of 104 patients responded. Male:female ratio 1:12; median follow-up 2.2 years. Total of 74.0% patients report ongoing TMJ pain since last surgery. CPSP noted in 77.3% patients who underwent minimally invasive TMJ surgery and 68.0% patients who underwent open surgery. CPSP is more prevalent in patients with bilateral TMJ surgery as opposed to unilateral surgery (P = .03). No significant difference noted in the mean preoperative pain score among patients with/without CPSP. Pain intensity is mild-moderate and common descriptors are aching, throbbing, and tender. Overall, 13% (n = 10/77) of patients with CPSP had a likely neuropathic component of the pain. Rates of pain interference (P < .001) and pain catastrophizing (P < .001) are higher in patients with CPSP.
Conclusion:
There is a high prevalence of CPSP after TMJ surgery; symptoms resemble myofascial pain, although neuropathic qualities may be present. Patients with CPSP are more likely to have undergone bilateral surgery and experience increased catastrophizing, pain interference, and disability.
