Effect of Single dose of Methylprednisolone Injection at Stylomandibular Ligament Insertion on Pain and Various Mandibular Movements Among Patients with Ernest Syndrome: A Pilot Study

Saubhik Dasukil; Ashok Kumar Jena; Geetanjali Arora; Kiran Kumar Boyina; Sujeeth Kumar Shetty; Saikrishna Degala

doi:10.1007/s12070-023-03897-w

Effect of Single dose of Methylprednisolone Injection at Stylomandibular Ligament Insertion on Pain and Various Mandibular Movements Among Patients with Ernest Syndrome: A Pilot Study

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3047-3052. doi: 10.1007/s12070-023-03897-w. Epub 2023 Jun 7.

Authors

Saubhik Dasukil¹, Ashok Kumar Jena¹, Geetanjali Arora², Kiran Kumar Boyina¹, Sujeeth Kumar Shetty³, Saikrishna Degala³

Affiliations

¹ All India Institute of Medical Sciences, Bhubaneswar, India.
² Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Delhi, India.
³ Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, India.

PMID: 37974820
PMCID: PMC10646056 (available on 2024-12-01)
DOI: 10.1007/s12070-023-03897-w

Abstract

Insertion tendinosis of stylomandibular ligament or Ernest syndrome is a rarely encountered cause of orofacial pain. The pain in this disorder originates from the stylomandibular ligament insertion site and radiates to the temporomandibular joint (TMJ), neck, shoulder, and periauricular region. Ten subjects who had undergone surgery for mandible fractures diagnosed with Ernest syndrome were considered for the present study. The origins and insertions of the stylomandibular ligament were marked and palpated using fingertip and blunt probe. The Ernest syndrome was confirmed by injecting diagnostic local anesthesia injection. A single dose of 2 ml methylprednisolone (40 mg/ml) was injected at the insertion site of a stylomandibular ligament in each subject. The effect of methylprednisolone injection on pain and various jaw movements were assessed at 1-month and 6-months after the injection. The mean pain value ranks during rest & while mouth opening in the visual analogue scale (VAS) reduced significantly after single injection (P < 0.001). The mean mouth opening increased significantly from 23.3 ± 3.94 mm before the treatment to 36.1 ± 3.07 mm at 1-week and 35.4 ± 2.17 mm at 6-months after the treatment (P < 0.001). The mandible protrusive movement increased from 4.07 ± 0.74 mm before treatment to 5.06 ± 0.62 mm at 1-week and 4.94 ± 0.62 mm at 6-months after the injection, respectively. Single dose of methylprednisolone injection at the insertion site of the stylomandibular ligament was proved effective on pain and various mandibular movements among patients with Ernest syndrome.

Keywords: Ernest syndrome; Mandibular movements; Methylprednisolone injection; Stylomandibular ligament.

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