The Temporo-Masseteric Nerve Block (TMNB) for Alleviating Acute Postextraction Masticatory Myalgia: A Case Series

This case series describes the ability of the temporo-masseteric nerve block (TMNB) to expeditiously relieve acute postextraction myogenous pain of masseteric or temporalis origin. In addition, the TMNB injection technique is also briefly reviewed. Briefly, 4 patients with no baseline temporalis or masseter muscle pain developed severe masseteric/temporalis pain during the first postoperative week on the side(s) of their dental extraction(s). The pain was accompanied by trismus. Both the pain and limitation in mouth opening were relieved by the TMNB injection, and symptom alleviation persisted beyond the brief duration of action of the administered local anesthetic. In conclusion, the TMNB injection can potentially serve as a valuable nonopioid adjunct to manage acute postextraction pain of masseteric or temporalis origin. It may be important to delineate acute myogenous postextraction pain from surgical site pain to optimize postoperative pain management and best alleviate trismus. Systematic validation of the TMNB’s utility in postextraction pain management is warranted.