Cooper, B.: Recognition and Management of Craniomandibular Disorders. in Otolaryngologic Clinics of North America (Otolaryngologic Office Evaluation and Management issue), Kimmelman, C.P. ed., Philadelphia, W.B.Saunders Company, 25(4) 867-887, August 1992
Craniomandibular disorders are alterations in the morphology or physiology of the mandible with relation to both its articulation to the skull and its neuromuscular apparatus. These disorders are known by a variety of names including temporomandibular joint (TMJ) disorders, myofacial pain dysfunction (MPD), and Costen's syndrome.
Craniomandibular disorders can involve the internal structures of the TMJ (intrinsic disorders): the neuromuscular apparatus, which operates the mandible and the craniocervical complex (extrinsic disorders); or a combination of both. For the examining otolaryngologist, the differentiation is not essential in making a clinical diagnosis. Patients suffering from craniomandibular disorders most often present initially to the otolaryngologist because symptoms appear to be related to the ears, nose and sinuses. Proper initial diagnosis permits the otolaryngologist to make a timely referral to qualified dentists or physicians who can make a definitive diagnosis and institute necessary therapy.
Early diagnosis and prompt treatment can often obviate the need for more extensive therapy. In addition, timely and effective therapy can prevent the occurrence of a chronic pain state, often an unfortunate sequela of an undiagnosed, untreated, or improperly treated pain syndrome.
