Sindrom karpalnog tunela u stomatološkoj ordinaciji

master's thesis

• Title (english): The Carpal Tunnel Syndrome In The Dental Practise
• Author: Nikola Matijević
• Mentor: Aljoša Matejčić (mentor)
• Committee member: Aljoša Matejčić (predsjednik povjerenstva)
• Committee member: August Mijić (član povjerenstva)
• Committee member: Dinko Vidović (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Surgery); Zagreb
• Defense date and country: 2020-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Doktor dentalne medicine svoj posao obavlja koristeći šaku u različitim položajima duže ili kraće vrijeme. Najčešće je to položaj pri kojemu se u ruci drže instrumenti pri čemu je šaka u fleksiji. S obzirom na učestalost ponavljajućih kretnji može doći do oštećenja uključenih anatomskih struktura i pada u stupnju funkcionalnosti šake.
Sindrom karpalnog tunela (SKT) najčešći je sindrom prenaprezanja gornjih ekstremiteta uzrokovan ponovljenim preopterećivanjem tetiva fleksora šake. Učestalim naprezanjem u kombinaciji s vibracijama proizvedenim stomatološkim ručnim instrumentima može doći do upale i oticanja tetiva i njihovih ovojnica (tenosinovitis) karpalnog tunela. Sam karpalni tunel zatvoreni je prostor u kojemu prilikom povećavanja volumena sadržanih struktura dolazi do porasta tlaka. To rezultira pritiskom na sam nervus medianus i pratećom boli u ručnom zglobu. Koliko će simptomi biti izraženi, ovisi o trajanju i jačini pritiska na živac. Učestalost sindroma u općoj populaciji iznosi od 0.05% do 0,15%, dok kod stomatološkog osoblja taj broj iznosi od 19% do 33 %. Povećana je incidencija nakon 30. godine života te je tri puta češći kod žena nego kod muškaraca. Najčešće se očituje kao trnjenje, pečenje ili mravinjanje u području inervacije nervusa medianusa, dok u najtežim slučajevima može doći do potpune anestezije. Od dijagnostičkih metoda najčešće su Phalenov test i kompresijski test po Durkanu. Zlatni standard za dijagnostiku predstavlja elektroneurofiziološka dijagnostika, dok se promjene mogu dokazati i elektromioneurografijom, elektromiografijom, ultrazvukom i magnetskom rezonancom. Kao i kod svake bolesti bitno je reagirati što ranije prilikom pojave prvih simptoma. Liječenje može biti konzervativno ili kirurško, ovisno o jačini i trajanju simptoma.

Abstract (english)

While working, a dentist uses his hands in different positions for longer or shorter periods of time. Most often it is the position in which instruments are being held – hand in flexion. Considering the frequency of the repetitive hand movement, anatomical structures involved tend to suffer damage which can result in loss of function of the hand.
Carpal tunnel syndrome (CTS) is the most often overstrain syndrome of upper limbs, caused by repetitive overstraining of hand flexor tendons. Frequent strain in combination with dental handpiece instrument vibrations can lead to inflammation and edema of tendons and their sheaths (tenosynovitis) in the carpal tunnel. Carpal tunnel is a contained space in which an increase in volume of anatomical structures leads to a rise in pressure. This results in pressure on the median nerve and consequential pain in the wrist. The severity of symptoms depends on the duration and intensity of pressure on the nerve. The syndrome affects 0,05% to 0,15% of the general population, but 19% to 33% of dental professionals. There is a higher occurrence in individuals older than 30 and it is three times more common in women than men. Most common symptoms are numbness, burning sensation or tingling in the area innervated by the median nerve, while in the most severe cases anesthesia can occur. Phalen’s test and Durkan’s compression test are most commonly used diagnostic methods. Golden standard diagnostic is electrodiagnostic testing, while alterations can also be diagnosed with electromyoneurography, electromyography, ultrasonography and magnetic resonance imaging. It is important to react as soon as the first symptoms occur. Therapy can either be conservative or surgical, depending on the severity and duration of symptoms.

• Keywords: sindrom karpalnog tunela; tetive; stomatolozi
• Keywords (english): Carpal Tunnel Syndrome; Tendons; Dentists
• Language: croatian
• URN:NBN: urn:nbn:hr:127:054328
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-11-30 13:04:11