Ernest syndrome as a consequence of stylomandibular ligament injury: a report of 68 patients.

A clinical analysis of 68 patients diagnosed as suffering from Ernest's syndrome revealed: Injury to the stylomandibular ligament is a real and frequent disorder causing craniomandibular pain. Ages and sex differences, although variable, correspond to those reported elsewhere in the literature for craniomandibular pain. A diagnosis of Ernest's syndrome may be based on an adequate history, palpation of the insertion of the stylomandibular ligament, and a diagnostic local anesthetic block of the affected ligamentous insertion. Symptoms of Ernest's syndrome, in decreasing order of occurrence, are: TMJ and temporal pain, ear and mandibular pain, posterior tooth sensitivity, eye pain, and throat pain. In addition, shoulder pain may be involved. Of the patients in this study, 77.94% were treated successfully via nonsurgical management of their complaints. Resolution of this disorder is usually accomplished by a combination of a diagnostic injection of local anesthetic at the insertion of the ligament, localized injection of cortisone substitute, and placing the patient on a soft diet. Surgical management, if necessary, is best accomplished by a radiofrequency thermoneurolysis procedure in the involved ligamentous insertion.