AB227. SOH25_AB_103. Hydro dissection of masseter muscle in temporo-mandibular facial pain: a case series

Background: Temporomandibular joint (TMJ) dysfunction is a prevalent condition, particularly among females. Hydrodissection, a minimally invasive technique involving the injection of fluid to separate fascial layers and release entrapped nerves and tendons, has gained attention as a potential therapeutic option. However, its application for TMJ pain has not been previously documented.

Methods: A case series of six adult patients (mean age 54 years) with refractory TMJ dysfunction is described. Despite comprehensive conservative management, including medication and physical therapy, all patients continued to experience significant TMJ pain.

Results: Intervention: the patients (6, mean age: 54 years) underwent ultrasound-guided hydrodissection of the masseter muscle to target perineural inflammation and nerve entrapment. The procedure involved the administration of a low-concentration (5%) dextrose solution to release tendons from scar tissue and adhesions within the superficial and deep layers of the masseter muscle on the symptomatic side. The intervention was performed in a theatre setting and included the use of 50 IU botulinum toxin. Outcome: post-procedure, patients reported notable reductions in TMJ pain with sustained improvements observed over a two-month follow-up period. Functional outcomes, such as jaw range of motion and daily activity performance, also showed significant enhancement. No complications were observed.

Conclusions: This case series highlights the potential efficacy and safety of dextrose hydrodissection as a minimally invasive treatment for TMJ pain. The findings suggest that hydrodissection may serve as a viable alternative to more invasive interventions and underscore the need for further research to establish its role in TMJ pain management.

Keywords: Hydrodissection; masseter muscle; technique; temporomandibular joint pain (TMJ pain); ultrasound