Nā maʻi ʻo TMJ

ʻO nā pilikia Temporomandibular ami a me nā mākala (nā maʻi TMJ) he mau pilikia e pili ana i nā mākia a me nā hono e hoʻopili i kou iwi ā lalo i kou iwi poʻo.

Aia he 2 kūlike i nā hono temporomandibular ma kēlā me kēia ʻaoʻao o kou poʻo. Aia lākou i mua o kou mau pepeiao. ʻO ka pōkole "TMJ" e pili ana i ka inoa o ka ami, akā hoʻohana pinepine ʻia ia i nā ʻano maʻi a i ʻole nā ​​hōʻailona o kēia ʻāina.

Hoʻokumu ʻia nā ʻōuli e pili ana i ka TMJ e nā hopena o ke koʻikoʻi koʻikoʻi ma nā hanana a puni o ka ami. Loaʻa kēia mau hale i:

• Kōpae cartilage ma ka ami
• Nā mākala o ka iwi ā, ka maka, a me ka ʻāʻī
• Nā liga kokoke, nā kīʻaha koko, a me nā aʻalolo
• Niho

No nā poʻe he nui me nā maʻi kūlohelohe temporomandibular, ʻike ʻole ʻia ke kumu. ʻAʻole hōʻoia maikaʻi ʻia kekahi mau kumu i hāʻawi ʻia no kēia ʻano. Pākuʻi ʻia lākou:

• ʻO kahi nahu maikaʻi a i ʻole nā ​​kāhili orthodontic.
• Kaumaha a me ka wili ʻana o ka niho. ʻAʻole wili nā poʻe he nui me nā pilikia TMJ i ko lākou mau niho, a he nui nā mea e wili ana i ko lākou mau niho no ka manawa lōʻihi ʻaʻohe pilikia me kā lākou hui temporomandibular. No kekahi poʻe, ʻo ke kaumaha e pili ana i kēia maʻi ke kumu o ka ʻeha, ma ke ʻano he kumu o ka pilikia.

Hiki i ke kūlana maikaʻi ʻole ke lilo i mea nui i nā ʻōuli o TMJ. ʻO kahi laʻana, e paʻa ana i kou poʻo i mua ke nānā nei i kahi kamepiula i ka lā holoʻokoʻa i nā mākala o kou alo a me kou ʻāʻī.

ʻO nā kumu ʻē aʻe e hōʻino ai i nā hōʻailona TMJ me ka ʻai maikaʻi ʻole a me ka hiamoe ʻole.

Pau ka poʻe i ka loaʻa ʻana o nā "helu kuhi." ʻO kēia nā mākala i hana ʻia i kou ā, ā, a me kou ʻāʻī. Hiki i nā kiko kipi ke kuhikuhi i ka ʻeha i nā wahi ʻē aʻe, e hōʻeha ai i ke poʻo, ʻeha ka pepeiao, a ʻehaʻeha paha.

ʻO nā kumu ʻē aʻe e pili ana i ka TMJ e pili ana i nā maʻi o ka maʻi, nā haʻihaʻi, nā dislocations, a me nā pilikia kū i ke ʻano mai ka hānau ʻana.

Nā ʻōuli e pili pū ana me nā maʻi ʻo TMJ:

• ʻO ka nahu ʻana a me ka nau ʻana i ka paʻakikī a me ka hōʻoluʻolu ʻole
• Ke kaomi ʻana, ka pā ʻana a i ʻole ke kani ʻana o ke kani i ka wā e wehe a pani ana paha ka waha
• Puʻupuʻu, ʻeha ka ʻeha i ka maka
• ʻEha pepeiao
• ʻEha poʻo
• ʻEha ʻeha a palupalu paha o ka iwi ā
• Laka ʻia o ka iwi ā
• Ka paʻakikī e wehe a pani ana paha ka waha

Pono ʻoe e ʻike ma mua o hoʻokahi kauka lapaʻau no kāu ʻeha a me nā hōʻailona TMJ. Pākuʻi paha kēia i kahi mea mālama olakino, kahi kauka niho, a pepeiao paha, ihu, a ʻāʻī (ENT), kaukaʻi ʻia i kāu mau ʻōuli.

Pono ʻoe i kahi hoʻokolohua piha e pili ana:

• ʻO kahi hoʻokolohua niho e hōʻike inā loaʻa ʻole ʻoe i ka hoʻopili ʻana o ka nahu
• Ke manaʻo nei i ka hui a me nā mākala no ka palupalu
• Kaomi ʻana a puni ke poʻo e ʻimi i nā wahi ʻāpono a ʻeha paha
• ʻO ka heʻe ʻana i nā niho mai kekahi ʻaoʻao a i kekahi ʻaoʻao
• Ke kiaʻi ʻana, ka manaʻo, a me ka hoʻolohe ʻana i ka iwi ā hāmama a paʻa
• X-ray, CT scan, MRI, Doppler hōʻike o ka TMJ

I kekahi manawa, ʻano maʻamau nā hopena o ka hoʻāʻo kino.

Pono nō kāu mea e noʻonoʻo e noʻonoʻo i nā kūlana ʻē aʻe, e like me nā maʻi, nā pilikia e pili ana i ke aʻalolo, a me nā ʻeha poʻo e kuhi ana i kāu mau hōʻailona.

Paipai ʻia nā mea lapaʻau maʻalahi a maʻalahi.

• ʻO kaʻai palupalu e hōʻoluʻolu i ka huʻi pū.
• E aʻo pehea e hoʻolōʻihi ai, hoʻomaha ai, a lomilomi hoʻi i nā mākala a puni kou ā. Hiki i kāu mea hāʻawi, kauka niho, a i ʻole ke kauka hoʻoponopono kino ke kōkua iā ʻoe me kēia.
• Hōʻalo i nā hana e kū ai i kāu mau ʻōuli, e like me ka uē ʻana, ka hīmeni ʻana, a me ka nau wahie.
• E hoʻāʻo i ka wela a i ʻole nā ​​ʻeke anu i kou alo.
• E aʻo i nā hana hōʻemi koʻikoʻi.
• Hoʻomaʻamaʻa i nā manawa he nui i kēlā me kēia pule e kōkua iā ʻoe e hoʻonui i kou hiki ke mālama i ka ʻeha.
• Nānā nahu.

E heluhelu e like me ka hiki iā ʻoe e pili ana i ka mālama ʻana i nā maʻi o TMJ, no ka mea, ʻokoʻa ka manaʻo. E kiʻi i nā manaʻo o kekahi mau mea hoʻolako. ʻO ka nūhou maikaʻi e loaʻa i ka hapanui o ka poʻe i kahi mea kōkua.

E noi i kāu mea lawelawe a kauka niho paha e pili ana i nā lāʻau i hiki iā ʻoe ke hoʻohana. Pili pū paha kēia:

• Hoʻohana wā pōkole o acetaminophen a i ʻole ibuprofen, naproxen (a i ʻole nā ​​lāʻau anti-inflammatory nonsteroidal ʻē aʻe)
• Nā lāʻau relaxant Muscle a i ʻole nā ​​antidepressants
• Hoʻokomo ʻia nā injection relaxant Muscle e like me ka botulinum toxin
• Kākaʻikahi wale nō, nā kīkiʻi corticosteroid i ka TMJ e mālama ai i ka mumū

Ua hoʻohana lōʻihi ʻia nā kiaʻi waha a nahu paha, i kapa ʻia hoʻi nā splints a i ʻole nā ​​mīkini, e mālama i nā niho wili, hoʻopaʻi, a me nā maʻi TMJ. Kōkua paha lākou.

• ʻOiai he nui ka poʻe i ʻike he mea pono, ʻokoʻa ka nui o nā pōmaikaʻi. Hiki i ke kiaʻi ke nalo i kona pono ma mua o ka manawa, a i ka wā e hoʻokū ai ʻoe i ke kau ʻana. Hiki i nā poʻe ʻē aʻe ke ʻehaʻeha ʻoi aku ka maikaʻi ke komo lākou i hoʻokahi.
• Aia nā ʻano ʻūlū like ʻole. Kū kekahi ma luna o nā niho o luna, ʻoiai ʻo nā mea ʻē aʻe e komo ma nā niho o lalo.
• ʻAʻole paha e paipai ʻia ka hoʻohana paʻa ʻana o kēia mau mea. Pono ʻoe e kū inā hana lākou i nā loli i kāu nahu.

Inā ʻaʻole holo pono nā mālama conservative, ʻaʻole ia he manaʻo no ka pono o ka lāʻau hoʻomāinoino hou aku. E akahele i ka noʻonoʻo ʻana i nā ʻano hana e hiki ʻole ke hoʻohuli ʻia, e like me nā orthodontics a i ʻole ke ʻoki e hoʻololi mau i kāu nahu.

ʻAʻole pono e koi ʻia kahi hana hou o ka iwi ā, a i ʻole ke pani pānaʻi. ʻO ka ʻoiaʻiʻo, ʻoi aku ka maikaʻi o nā hopena ma mua o ka ʻoki ʻana.

Hiki iā ʻoe ke kiʻi hou aku i ka ʻike a loaʻa i nā pūʻulu kākoʻo ma o ka TMJ Syndrome Association ma www.tmj.org.

No nā kānaka he nui, kū nā ʻōuli i kekahi manawa a ʻaʻole lōʻihi. Hele lākou i ka manawa me ka liʻiliʻi a ʻaʻohe lapaʻau. Hiki ke mālama maikaʻi ʻia ka hapa nui o nā hihia.

Hele kekahi o nā hihia o ka ʻeha ma kā lākou iho me ka ʻole o ka lapaʻau. E hoʻi hou paha ka ʻeha e pili ana iā TMJ i ka wā e hiki mai ana. Inā he clenching i ka pō, hiki i ka lapaʻau ke paʻakikī loa no ka mea he ʻano hiamoe ka paʻakikī e kaohi.

ʻO ka wili waha kahi hana maʻamau no ka wili ʻana o nā niho. ʻOiai e hūnā kekahi mau splint i ka wili ʻana me ka hāʻawi ʻana i kahi pālahalaha, a ma luna hoʻi, ʻaʻole paha lākou e maikaʻi i ka hoʻēmi ʻana i ka ʻeha a i ʻole ke kū ʻana i ka paʻa ʻana. Hiki ke hana maikaʻi i nā splints i ka wā pōkole, akā hiki ke lilo i mea liʻiliʻi i ka manawa. Hiki i kekahi splint ke hana i nā hoʻololi nahu inā ʻaʻole i hoʻokau pono ʻia. Hoʻokumu paha kēia i kahi pilikia hou.

Hiki iā TMJ ke kumu:

• ʻEha alo ʻeha
• ʻEha poʻo poʻo

E ʻike koke i kāu mea hāʻawi inā pilikia ʻoe i ka ʻai ʻana a i ʻole ka wehe ʻana i kou waha. E hoʻomanaʻo i nā ʻano he nui i hiki ke hana i nā ʻōuli o TMJ, mai ka maʻi kōpaʻa a i nā hōʻeha whiplash. ʻO nā poʻe loea i hoʻomaʻamaʻa kūikawā ʻia i ka ʻeha o ka helehelena hiki ke kōkua i ka diagnose a mālama iā TMJ.

ʻO nā hana mālama home e mālama i nā pilikia o TMJ hiki ke kōkua i ka pale ʻana i ke ʻano. Aia kēia mau ʻanuʻu i:

• Hōʻalo i ka ʻai ʻana i nā meaʻai paʻakikī a me ka nau ʻana i ka nau.
• E aʻo i nā ʻenehana hōʻoluʻolu e hōʻemi i ke koʻikoʻi holoʻokoʻa a me ka haunaele o nā mākala.
• Mālama i ke kūlana maikaʻi, keu hoʻi inā ʻoe e hana i ka lā holoʻokoʻa ma kahi kamepiula. Hoʻomaha pinepine e hoʻololi i ke kūlana, hoʻomaha i kou mau lima a me kou mau lima, a hoʻomaha i nā mākala koʻikoʻi.
• E hoʻohana i nā hana palekana e hōʻemi ai i ka makaʻi no nā haki a me nā dislocations.

TMD; Nā maʻi kūlike Temporomandibular; Nā maʻi maʻi kūlohelohe Temporomandibular; ʻO Costen's Syndrome; Maʻi Craniomandibular; Ka maʻi ʻo Temporomandibular

Indresano AT, Park CM. Nonsurgical hoʻokele o ka temporomandibular ami maʻi. I: Fonseca RJ, hoʻoponopono. ʻOki kino waha a me Maxillofacial. ʻEkolu huaʻōlelo. St Louis, MO: Elsevier; 2018: chap 39.

Martin B, Baumhardt H, DʻAlesio A, Woods K. Nā maʻi waha. I: Zitelli BJ, McIntire SC, Nowalk AJ, eds. ʻO Zitelli lāua ʻo Davis 'Atlas o ka Pediatric Physical Diagnosis. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 21.

ʻO Okeson JP. Nā maʻi kūlohelohe. I: Kellerman RD, Rakel DP, eds. ʻO Conn's Current Therapy 2020. Piladelapia, PA: Elsevier; 2020: 504-507.

ʻO Pedigo RA, ʻAmelekona JT. Lapaʻau waha. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 60.