Pterygoid hamulus bursitis: One cause of craniofacial pain

doi:10.1016/S0022-3913(96)90100-6

The Journal of Prosthetic Dentistry

Volume 75, Issue 2, February 1996, Pages 205-210

https://doi.org/10.1016/S0022-3913(96)90100-6 Get rights and content

Abstract

Craniofacial pain disorders are frustrating to the doctor and the patient. Diagnosis is often difficult because the anatomy of the head and neck region is complex, grossly and neurologically. Frequently, several pain syndromes exhibit similar symptoms. One such disorder is bursitis of the pterygoid hamulus. This type of bursitis may produce symptoms of soft palatal, ear, and throat pain, maxillary pain, and difficulty and pain on swallowing. This disorder is often misdiagnosed as otitis media. Treatment may be conservative or surgical. This article discusses the anatomy, symptoms, diagnosis, and treatment of bursitis of the hamular process.

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Cited by (17)

Pterygoid hamulus elongation syndrome
2021, International Journal of Surgery Case Reports
Citation Excerpt :
However, there is another syndrome termed pterygoid Hamulus bursitis (PHB), Bursae are fluid-filled compacted sacs with synovial fluid that acts as a cushion between bones, tendons, joints, and muscles [11,3]. Thereby, (PHB) is due to Bursitis of the tensor veli palatini while in pterygoid hamulus elongation, there is an osteophyte elongation of the pterygoid hamulus [12,1]. The pain may spread to the temporal region or neck simulating tension headache or imitating dental disease [13,9].
Pain in the soft palate and pharynx can originate from numerous related anatomical structures. Therefore, the diagnosis of patients who complain of pain in these areas is also difficult and challenging. One of the anatomic disorders that causes pain and discomfort in this region is pterygoid hamulus elongation syndrome.
We report a rare case of pterygoid hamulus elongation with persistent sharp localized pain in the hamular region radiating to the temporal area for four years that was treated successfully by surgical resection of elongated hamulus.
Pterygoid Hamulus elongation syndrome is a unique disease presenting many symptoms in the palatal and pharyngeal areas. May caused by injury, infection, or a pre-existing condition. The diagnosis of hamular elongation should be based on detailed history, clinical examination, and correlation with radiographic imaging.
Due to the rarity, PHE syndrome should be diagnosed accurately. Management of hamular elongation is either surgical or conservative but resection of the pterygoid hamulus is usually preferred.
A rare cause of oral pain: The pterygoid hamulus syndrome
2015, Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Le syndrome de l’hamulus ptérygoïdien (SHP) est une cause peu connue de douleurs orofaciales et oropharyngées, source d’un important nomadisme médical. Le SHP peut être associé à une hypertrophie de l’hamulus ou à une bursite du tenseur du voile, mais il n’a pas toujours de substrat anatomique.
Une patiente de 36 ans a consulté pour des douleurs palatines postérieures constantes irradiant vers l’oropharynx, majorées lors de la déglutition et évoluant depuis plus de 6 mois. L’examen clinique montrait un érythème de la muqueuse du voile du palais en dedans de l’hamulus. La palpation de la région de l’hamulus déclenchait une aggravation des douleurs préexistantes et objectivait la présence de 2 crochets osseux proéminents en regard des processus ptérygoïdiens médiaux. Ce tableau était en faveur d’un syndrome de l’hamulus ptérygoïdien bilatéral.
Notre observation est typique d’un SHP. Nous proposons une revue de la littérature sur ce syndrome mal connu. Le traitement est initialement conservateur (anti-inflammatoires non stéroïdiens) mais un geste chirurgical peut être proposé en cas d’anomalie morphologique de l’hamulus.
Pterygoid hamulus syndrome (PHS) is a rare cause of orofacial and oropharyngeal pain. PHS can be associated with a hamulus hypertrophy or with a bursitis of the palatosalpingeus but it has not always an anatomic cause.
A 36-year-old woman was seen for a constant posterior palatal pain spreading towards oropharynx, increasing during swallowing and lasting for more than 6 months. Physical examination showed an erythema of the soft palate, medially to the hamulus. Hamulus palpation was painful and revealed hamulus hypertrophia on both sides. A bilateral PHS was evocated.
This observation is typical of a PHS. We propose a review of the literature of this little-known syndrome. Treatment is initially conservative (corticosteroids) but surgery can be proposed in case of morphological anomalies of the hamulus.
Annual review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry
1997, Journal of Prosthetic Dentistry
Hamular bursitis as a cause of orofacial pain. A case report
2023, Journal of Clinical and Experimental Dentistry
Radiomorphometric assessment of the pterygoid hamulus as a factor promoting the pterygoid hamulus bursitis
2020, Folia Morphologica (Poland)
Pterygoid hamulus syndrome: A case report
2020, Journal of Oral Medicine and Oral Surgery

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^☆: Presented at the 40th annual meeting of the American Equilibration Society, Chicago, Ill., February 1995.

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Clinical sciencePterygoid hamulus bursitis: One cause of craniofacial pain☆

Abstract

J Allergy Clin Immunol

J Am Dent Assoc

Oral Surg

Br J Oral Surg

J Am Dent Assoc

Oral Surg

Fundamentals of oral histology and embryology

The styloid process

Trans Am Laryngol Rhinol Otol Assoc

Headache and head pain

Parotid gland carcinoma simulating signs and symptoms of craniomandibular disorders—a case report

J Craniomand Pract

The relationship between craniomandibular disorders and otitis media in children

J Craniomand Pract

Orofacial pains: classification, diagnosis and management

Clinical science
Pterygoid hamulus bursitis: One cause of craniofacial pain☆