Alterations in kinematics of temporomandibular joint associated with chronic neck pain

alexandrossfakianakis shared this article with you from Inoreader Alterations in kinematics of temporomandibular joint associated with chronic neck pain via Journal of Oral Rehabilitation Abstract Background Temporomandibular disorder (TMD) is an umbrella term for pain and dysfunction of the temporomandibular joint (TMJ) and its associated structures. Patients with TMD show changes in TMJ kinematics and masticatory muscle activation. TMD is commonly comorbid with non-specific chronic neck pain (NCNP), which may be one of the risk factors for TMD. Objectives This study aimed to investigate whether patients with NCNP have altered TMJ kinematics and masticatory muscle activity. Methods This was a cross-sectional exploratory study including 19 healthy participants and 20 patients with NCNP but without TMD symptoms. TMJ kinematics was measured during mouth opening and closing, jaw protrusion and jaw lateral deviation. Surface electromyography was used to record the muscle activity of the anterior temporalis, masseter, sternocleidomastoid, and upper trapezius while clenching. Furthermore, cervical posture, cervical range of motion (ROM), and pressure pain threshold of the neck and masticatory muscles were measured. Results Compared with the healthy group, the NCNP group showed significantly reduced upper cervical rotation ROM (p=0.041), and increased condylar path length (p=0.02), condylar translation (opening p=0.034, closing p=0.011), and mechanical pain sensitivity of the upper trapezius (p=0.018). Increased condylar translation was significantly correlated with reduced upper cervical mobility and poor cervical posture (r=−0.322 to −0.397; p=0.012–0.046). Conclusion Increased condylar translation and path length in patients with NCNP may indicate poor control of TMJ articular movement, which may result from neck pain or may be a compensation for limited neck mobility. Evaluation of excessive TMJ translation may be considered in patients with NCNP. View on Web

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A Nomogram to Predict Nodal Response after Induction Chemotherapy for Hypopharyngeal Carcinoma

alexandrossfakianakis shared this article with you from Inoreader A Nomogram to Predict Nodal Response after Induction Chemotherapy for Hypopharyngeal Carcinoma via The Laryngoscope This study is the first to establish and validate a nomogram based on five critical predictors, including tumor differentiation degree (DD), T classification, metastatic lymph node size (LS), number of lymph node metastases (NOL), and cervical nodal necrosis (CNN), to predict the response of metastatic lymph nodes after induction chemotherapy (ICT) for hypopharyngeal carcinoma patients. Our nomogram yielded relatively good accuracy in predicting the regional ICT response, which will be a useful tool to assist clinicians in future decision-making. Background For hypopharyngeal carcinoma, metastatic neck nodes with a low response to induction chemotherapy (ICT) should not be managed with concomitant chemoradiotherapy (CCRT), and the prediction of chemosensitivity before ICT could prevent adverse events from occurring during chemotherapy. In this study, we developed a nomogram to predict the regional response to ICT. Methods A total of 153 hypopharyngeal carcinoma patients with regional metastasis treated with ICT in our institution from January 2010 to September 2020 were retrospectively studied. According to ICT response evaluated by RECIST 1.1, patients were divided into chemo-insensitive (PR < 70%/SD/PD) (group 1) and chemosensitive (CR/PR ≥ 70%) (group 2) groups. Patients' clinical, image, and hematologic data before ICT were collected. The nomogram was built based on multivariate analysis and stepwise logistic regression and was evaluated from the aspects of discrimination and calibration. Results A nomogram based on five critical predictors, namely, tumor differentiation degree, T classification, metastatic lymph node size, number of lymph node metastases, and cervical nodal necrosis, was developed. The areas under the curve (AUC) values were 0.76 and 0.70 after adjusting the results using bootstrap methods. The calibration curve showed relatively good agreement between the predicted and observed probabilities. Conclusions Our nomogram yielded good accuracy in predicting the regional ICT response and will be a useful tool to assist clinicians in decision making. Level of Evidence 4 Laryngoscope, 2022 View on Web

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