Term Paper: Temporomandibular Joint Surgery: A Comparison

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[. . .] (8)

Similarly, arthroscopy permits the introduction of holmium YAG laser treatment of inflamed synovial tissues, as well as an anterior capsular release, which can also be performed in a more traditional fashion, via incision through the arthroscope.

Like other (even minimally) invasive surgical procedures, arthroscopy carries with it certain risks and potential complications such as post-operative infection, which is always a possibility anytime a 2.0mm or 3.0mm instrument is introduced interarticularly.

Despite its proven diagnostic value and multitude of uses, it allows only a very narrow view and requires considerable care and practiced skill on the part of the surgeon to avoid disrupting delicate structures and blood vessels. In particular with respect to temporomandibular repairs, these risks include disruption of the superficial temporal artery, intracapsular bleeding, neurological injury such as a middle cranial fossa perforation, in addition to otologic complications including ear drum perforation.(9)

To a large degree, these risks can be minimized by the adoption of proper surgical technique, cranial positioning, and through the use of careful pre-operative probing, use of blunt arthroscopic instruments wherever possible, and strict attention to proper interarticular puncture depth. (10)

In patients properly selected for arthroscopic surgery, satisfactory relief can be expected in approximately 80% of cases, accounting for its popularity wherever less invasive procedures fail to provide relief, or where arthroscopy is appropriately indicated initially by pre-operative diagnosis and symptom evaluation. (11)

Works Cited

Dimitroulis G, Dolwick MF, Martinez A (1995). Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow up study. Brit Journal of Oral and Maxillofacial Surgery 33:23-26

Fridrich KL, Wise JM, Zeitler DL (1996). Prospective comparison of arthroscopy and arthrocentesis for temporomandibular disorders. Journal of Oral and Maxillofacial Surgery 54:816-820

Hoffman DC, Cubillos L (1994) The effect of arthroscopic surgery on mandibular range of motion. Cranio 12:11-18

Kaminishi R, Davis C: Soft tissue pathology-intracapsular fibrosis of the superior compartment of the temporomandibular joint. Philadelphia: WB Saunders Co; 1991:235-247.

Kuwahara T, Bessette RW, Maruyama T (1994). A retrospective study on the clinical results of temporomandibular joint surgery. Cranio 12:179-183

Nitzan DW: Arthrocentesis for management of severe closed lock of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:245-247.

Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269

Sanders B, Buconcristiani RD: Surgical arthroscopy. In: Sanders B, Murakami K, Clark GT, Eds. Diagnostic and Surgical Arthroscopy of the Temporomandibular Joint. Philadelphia: WB Saunders Co; 1989.

Stohler C: Disk-interference disorders. In: Zarb G, Carlsson G, Sessle B, Mohl N, Eds. Temporomandibular Joint and Masticatory Muscle Disorders. Copenhagen: Munksgaard; 1992:271-276

Tarro AW (1991). TMJ arthroscopic diagnosis and surgery: clinical experience with 152 procedures over a 2 1/2-year period. Cranio 9:107-119

Tarro AW: Disc-stabilizing techniques. In: Thomas M, Bronstein S, Eds. Arthroscopy of the Temporomandibular Joint. Philadelphia: WB Saunders Co; 1991:206-212

Bibliography

1. Tarro AW (1991). TMJ arthroscopic diagnosis and surgery: clinical experience with 152 procedures over a 2 1/2-year period. Cranio 9:107-119

2. Dimitroulis G, Dolwick MF, Martinez A (1995). Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow up study. Brit Journal of Oral and Maxillofacial Surgery 33:23-26

3. Nitzan DW: Anthrocentesis for management of severe closed lock of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:245-247.

4. Sanders B, Buconcristiani RD: Surgical arthroscopy. In: Sanders B, Murakami K, Clark GT, Eds. Diagnostic and Surgical Arthroscopy of the Temporomandibular Joint. Philadelphia: WB Saunders Co; 1989.

5. Fridrich KL, Wise JM, Zeitler DL (1996). Prospective comparison of arthroscopy and arthrocentesis for temporomandibular disorders. Journal of Oral and Maxillofacial Surgery 54:816-820

6. Kaminishi R, Davis C: Soft tissue pathology-intracapsular fibrosis of the superior compartment of the temporomandibular joint. Philadelphia: WB Saunders Co; 1991:235-247.

7. Stohler C: Disk-interference disorders. In: Zarb G, Carlsson G, Sessle B, Mohl N, Eds. Temporomandibular Joint and Masticatory Muscle Disorders. Copenhagen: Munksgaard; 1992:271-276

8. (1) Tarro AW: Disc-stabilizing techniques. In: Thomas M, Bronstein S, Eds. Arthroscopy of the Temporomandibular Joint. Philadelphia: WB Saunders Co; 1991:206-212

2) Hoffman DC, Cubillos L (1994). The effect of arthroscopic surgery on mandibular range of motion. Cranio 12:11-18

9. Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269

10. Sanders… [END OF PREVIEW]

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