ROLE OF PHARMACOTHERAPY AS DIAGNOSTIC THERAPEUTIC TEST IN MANAGEMENT OF PERSISTENCE OF PAIN ASSOCIATED WITH MYOFASCIAL PAIN DYSFUNCTION SYNDROME IN PATIENTS WITH ELONGATED STYLOID PROCESS

Objectives: Study the response of cases with myofascial pain dysfunction syndrome (MPDS) associated with elongated styloid process to pharmacotherapy. Patients and Methods: Thirty patients with 60 styloid process have been involved in the present study. They were suffering from MPDS. Styloid process length, angulation and morphology were assessed from the panoramic view bilaterally. Treatment plan for MPDS was started gradually from simple short period method (pharmacotherapy for two weeks), to conventional long period one (intraoral occlusal splint fabrication and insertion or therapeutic ultrasonic sessions for three months). The response to the treatment was used as diagnostic therapeutic test. Treatment outcome of patients with and without an elongated styloid process were compared using visual analog scale (VAS) and maximum interincisal mouth opening (MIO). Results: Patients group with severely elongated styloid process (mean length 32.95 mm) showed no improvement after two weeks of treatment by drugs; so they subjected to intraoral occlusal splint fabrication or therapeutic ultrasonic sessions. The mean length of styloid process was 28.2 mm and mean angle was 60.73o in both sides of all subjects included in this study. Assessment of the styloid process morphology resulted in; 30 sides showed uninterrupted elongated pattern, 12 sides were psudosegmented and 18 sides were segmented. Conclusions: There was tendency for elongation of styloid process among patients with MPDS. Response of drug treatment in MPDS patients with elongated styloid process was questionable in this study, and the diagnostic therapeutic test is useful in detection of such cases. Persistence of pain among MPDS patients could be attributed to the elongation of their styloid process.