Intubation Risk Factors for Temporomandibular Joint/Facial Pain

Note: You will need to copy and paste the URL in a browser window to view the abstract online. A subscription is required to view the full text or it can be purchased online.

http://www.anesthesiaprogress.org/perlserv/?SESSID=ac1e90ff2993d8d47a694d63a7ddc60b&request=get-abstract&doi=10.2344%2F0003-3006%282007%2954%5B109%3AIRFFTF%5D2.0.CO%3B2

Intubation Risk Factors for Temporomandibular Joint/Facial Pain
Anesthesia Progress
Volume 54, Issue 3 (Fall 2007)

Michael D. Martin, DMD, MSD, MPH, MA, PhD*, Kory J. Wilson, BS‹, Brian K. Ross, MD, PhD·, Karen Souter, MD·

* Associate Professor, Oral Medicine, University of Washington, Seattle, Washington
‹ Dental Student, School of Dentistry, University of Washington, Seattle, Washington
· Professor, Anesthesiology, University of Washington, Seattle, Washington, and ?Acting Assistant Professor, Anesthesiology, University of Washington, Seattle, Washington

Endotracheal intubation has been proposed as a risk factor for temporomandibular joint dysfunction (TMD) in a limited number of published case reports and systematic studies. Symptoms may result from forces applied with the laryngoscope, or manually in an attempt to complete the intubation, and may be related to the duration in which temporomandibular joint (TMJ) structures are stressed. The objective of this study was to examine risk factors for TMD complaints associated with endotracheal intubation. One hundred twenty-two patients who underwent endotracheal intubation for surgery at the University of Washington Medical Center participated. Exclusions included surgery of the head or neck, cognitive deficit, or emergency surgery. Subjects were assessed presurgically, and at 7 and 14 days postoperatively. Gender, interincisal distance, and age were found to be significantly associated with TMD symptoms lasting as long as 14 days following intubation. For both TMD pain and TMD nonpain symptoms, the most reliable predictor of a complaint following intubation was a history of TMD complaints within a year preoperatively. Any association between endotracheal intubation and the development of short-term TMD symptoms is likely to be found in patients with prior report of such conditions, and we therefore recommend a review of TMD complaint history when planning general anesthesia.

Keywords: Intubation, TMJ, Headache, Facial pain, Mallampati

Received: December 22, 2005; Accepted: May 30, 2007

DOI: 10.2344/0003-3006(2007)54[109:IRFFTF]2.0.CO;2

Address correspondence to Dr Michael D. Martin, Department of Oral Medicine, Box 356370, University of Washington, Seattle, WA 98195; mickeym@u.washington.edu.

© 2007 The American Dental Society of Anesthesiology