Correlation Between Prolonged Nasogastric Feeding and Temporomandibular Joint Dysfunction

Abstract

Background: Nutrition is administered via enteral feeding in the form of fluid supplements to overcome malnutrition in hospitalized patients, or enteral tubes are intubated into the stomach and small bowel if the patient is unable to feed orally. The most common procedure performed by doctors across all medical specialties is nasogastric intubation. However, it has its own complications such as nasopharyngeal pain, aspiration, and trauma while insertion of the tube, but the impact of prolonged nasogastric tube feeding on temporomandibular joint (TMJ) is unknown. There is paucity of literature focusing on the TMJ; therefore, this study focuses on the correlation of prolonged nasogastric tube feeding and temporomandibular joint dysfunction. Materials and Methods: This was an observational study conducted among 59 participants. Patients undergoing nasogastric feeding for more than a week and having pain during mouth opening and left right lateral excursion were included in the study. Subjects with previous trauma to TMJ were excluded from study. Patients who were unconscious or uncooperative, had previous trauma to TMJ, and had facial surgery were excluded from the study. Result: Multivariate analysis revealed that there was no significant limitation of range of motions (ROMs; mouth opening [P = 0.232, t = 8.800], protrusion [P = 0.315, t = 17.130], right lateral excursion [P = 0.511, t = 16.768], and left lateral excursion [P = 0.5108, t = 18.143]) when compared to the ROMs at the time of insertion of nasogastric tube and 5–14 days after the removal of nasogastric tube. Also, there was significant TMJ pain. Conclusion: The study concludes that there was a significant correlation between duration of intubation and pain in masticatory muscles such as the temporalis and masseter, and medial and lateral pterygoid muscles and weak correlation between prolonged nasogastric intubation and TMJ movements.