David Shirazi, DDS https://orcid.org/0000-0002-4090-7614 Adam Del Torto, DC https://orcid.org/0000-0002-7737-994X Charles Blum, DC https://orcid.org/0000-0002-1333-390X


Objective: A 48-year-old male presented for care due to complaints of a deviated septum, headaches, and temporomandibular (TMJ) dysfunction.

 Clinical Features: The patient noted occluded nasal breathing rated at 1-2 on a 1-10 scale with full airway function at a 10 (10 representing full airway function).  He also had right-sided suboccipital migranous headaches occurring once-a-week, lasting 24-48 hours.  The headaches were relatively unresponsive to medication and rated at an 8 on a pain scale of 1-10 with 10 being most painful possible. Visual inspection revealed a left nose deviation and TMJ deflection with crepitus.

 Intervention/Outcome: The patient’s initial chiropractic care included 17 cranial facial release (CFR) nasocranial balloon treatments, sacro occipital technique (SOT), and a  sacroiliac joint (SIJ) support belt.  The dentist prescribed a temporomandibular/obstructive sleep apnea (TMD/OSA) night and daytime appliances, acupuncture, and cold laser therapy.  The patient was referred to another chiropractor for SOT cranial and chiropractic manipulative reflex technique (CMRT) care (6 office visits). The patient responded favorably to the interdisciplinary care and noted increased/improved nasal breathing rated at 7 with associated significant reduction in headache frequency/intensity. 

 Conclusion: Two chiropractors (CFR, SOT, Cranial, and CMRT) and a dentist/acupuncturist treated this patient leading to improved nasal breathing and reduced TMD/headaches.

 Key Indexing Terms:  Headaches, Deviated Septum, Temporomandibular Joint, TMJ, Sacro Occipital Technique, SOT, Craniofacial Release Technique, CFR, Dental Chiropractic Co-managed Care.