KOSTENA SYNDROME (J. Century of Costen, amer. otorhinolaryngologist, sort. in 1896; synonym syndrome of malocclusion) — the arthrologic and neurologic symptom complex which is shown clicking, a crunch, rigidity of a temporal and mandibular joint, joint pain with irradiation in a face, an ear, an oral cavity. The syndrome is for the first time described by Kosten in 1934
the Aetiology is not established; major importance is attached to inflammatory processes in temporal and mandibular joint (see), to disturbances of mineral metabolism, collagenic diseases, etc. To. the page can be caused by change of load of a joint owing to partial or total loss of teeth, decrease in a bite at the increased erasability or mobility of teeth, the wrong design of a denture.
the Symptom complex develops during the weakening of the copular device, accumulation of inflammatory exudate in cavities of a joint because of what the disk leaky adjoins to an articular head and at the movement there is a clapping sound, in connection with the deformation of articular heads caused by adjournment of salts; at collagenic diseases rigidity of a joint and the phenomena accompanying it are caused by destructive processes in connecting fabric. According to Kosten, at the movements of the changed articular head the prelum of an acoustical pipe, pressure upon an ear and temporal nerve and a drum string is possible.
The clinical picture
the Clinical picture is characterized by clicking, a crunch, the aching pains with irradiation in a face, a neck, an ear, rigidity of a temporal and mandibular joint, a hyperesthesia of skin. Gradually the hearing impairment develops, dizziness and a headache in parietal and occipital areas, dryness of a mucous membrane of an oral cavity and nose, burning sensation in language and a nasopharynx, a food faddism develops. Not all from the specified symptoms are more often observed. Sometimes habitual dislocation of a joint develops.
the Diagnosis is based on characteristic complaints of the patient, rentgenol. research of a temporal and mandibular joint, detection of system diseases (polyarthritis). Lack of smoothness of sliding of heads and clicking in a joint are defined by introduction of index fingers to outside acoustical passes, at the same time the patient makes the movements by a mandible. Radiological change of width of a joint crack and lack of the sliding progress in a joint comes to light.
Treatment is directed to elimination of a basic disease and normalization of function of a joint. In cases of malocclusion apply orthodontic methods of treatment (see), denture. If habitual dislocation developed, dentures with special devices are recommended.
Forecast depends on an outcome of a basic disease.
See also Bite .
Bibliography: Rabukhina N. A. Recognition of degenerative defeats of a temporal and maxillary joint by method of a layer-by-layer X-ray analysis, Stomatology, No. 2, page 27, 1960; L. R. and Shargorodsky L. E. Sindrom's Rubin of malocclusion, in the same place, No. 2, page 75, 1965; Coste n J. Century of Syndrome of ear and sinus symptoms dependent upon disturbed function of temporomandibular joint, Ann. Otol. (St Louis), v. 43, p. 1, 19 34; it, Mechanism of trismus and its occurrence in mandibular joint dysfunction, ibid., v. 48, p. 499, 1939.
V. D. Shorin.