A patient's orofacial pain after parotidectomy for the removal of a pleomorphic adenoma - a case study

Orofacial pain occurs in a wide variety of disorders and dysfunctions of the craniomandibular system. Their treatment requires careful clarification by way of differential diagnosis. This paper describes the case of a female patient suffering from facial pain following a parotidectomy for the removal of a pleomorphic adenoma. Analgesic therapy with pregabalin, performed on account of the suspected diagnosis of "neuropathy," did not result in any significant reduction of pain. With the aid of diagnostic filters used in pain psychology, the pain-related impairment of mood and physical well-being were determined. This showed that psychosocial factors played a tendentially more minor role in the continuance of symptoms. In addition to the psychosocial diagnostic filters, a corresponding clinical examination was performed. This resulted in a series of somatic findings, which were classified as temporomandibular dysfunctions. Through the restoration of the lost support areas, the remedying of occlusal dysfunctions and the relief of the affected tissue was gained, continuous improvement of symptoms was achieved, and ongoing freedom from pain obtained. Keywords: diagnostic filters in pain psychology, pleomorphic adenoma, pain chronification, pain therapy, occlusal therapy, interdisciplinary treatment