Effects of Local Injection of Steroids in Treatment of Posttraumatic Temporalis Muscle Trismus

Abstract

Trauma to the temporalis muscle sometimes associated with the trismus that may interfere with many daily activities like eating, speech and oral hygiene maintenance, so the treatment is necessary. Aims of study: were to evaluate the effects of local injection of steroids triamcinolone in and around the scar in the temporalis muscle to alleviate the trismus. Materials and methods: Thirty patients presented with trauma in Al-Salam teaching hospital to the temporal region. The procedure done by using local anesthetic agent injected by dental syringe around the scar. Then 1 ml of triamcinolone acetonide injected directly in the scar area and the injection site covered by surgical dressing. Jaw stretching exercise start immediately after injection and daily basis exercises. Two injections interval about 3 weeks repeated in the scar area. The exercise done four times daily for 10 minutes and lasting for four weeks. The improvement of mouth opening checked every five days and mean taken by measuring the inter incisal distance by a ruler. The follow up period continues for 3 months after treatment. Results: There is significant post-operative improvement of mouth opening and the range of inter incisal distance became about 2-4 cm, The patients how start treatment within first two months after trauma show significant improvement in comparison with those who start treatment after 3 months were there is a certain relapse in spite of prolong time and frequency of muscle stretching exercise. Conclusions: Post-traumatic trismus can be treated by early management of local steroid injection along with jaw stretching exercise for masticatory muscle if started in proliferating phase of wound healing.