Study design: Randomized clinical trial.
Explore This IssueApril 2012
Setting: School of Dental Medicine, University of Erlangen-Nuremberg, Erlangen, Germany; Department of Surgery, William Osler Health Center Etobicoke Campus, Toronto, Canada; Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden Medical School, Germany.
Synopsis: Twenty patients with idiopathic BMS were randomly assigned to receive clonazepam (0.5 mg/day, n = 10) or placebo (lactose, n = 10) for a nine-week period. The drugs were well tolerated by all participants, and the medication had no significant effect on either Zerssen Mood Scale or Beck Depression Inventory (BDI) scores, indicating that clonazepam produced no major change in psychological states. The taste test score increased in both groups over time, but there was no difference in increase between the two groups. Similar findings were made for salivary flow. Importantly, there was significant improvement in pain ratings over sessions and the improvement was more pronounced in patients receiving clonazepam compared with those receiving placebo. Neither maximal effect nor compliance appeared to be dose related; both were observed at the lower dose range. Nothing is known regarding long-term benefits beyond the nine-week length of the trial.
Bottom line: Clonazepam has a positive effect on pain in BMS patients.
Reference: Heckmann SM, Kirchner E, Grushka M, et al. A double-blind study on clonazepam in patients with burning mouth syndrome. Laryngoscope. 2012;122(4):813-816.
—Reviewed by Sue Pondrom
Ultrasonic Bone Aspirator for Removal of Frontal Sinus Osteoma
Can the ultrasonic bone aspirator (UBA) be successfully employed to remove exostotic skull osteomas without injury to adjacent vital structures?
Background: Most osteomas, bony outgrowths of skeletal structures that develop through intramembranous ossification, arise in the skull. They affect the cranial vault, facial skeleton, paranasal sinuses and, most frequently, the skull base. Rarely malignant, osteomas grow slowly, blocking or compressing adjacent structures and frequently causing aesthetic deformity. Additionally, they may obstruct mucosal outflow, resulting in orbital compression or auditory dysfunction. Open forehead ostectomy is performed under direct visualization with a chisel or burr, although this procedure may be associated with complications. The UBA uses ultrasonic waves to emulsify bone without damaging surrounding soft tissue.
Study design: “How I Do It” case study.
Setting: Department of Otolaryngology-Head and Neck surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia; Ursinus College, Collegeville, Pennsylvania.