Single portal arthroscopic temporomandibular joint discopexy: Technique and results.

Autor: Martínez-Gimeno C; Department of Oral and Maxillofacial Surgery, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Head of Department of Oral and Maxillofacial Surgery, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. Electronic address: ortomaxi@yahoo.es., García-Hernández A; Department of Oral and Maxillofacial Surgery, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. Electronic address: algarciher@gmail.com., Martínez-Martínez R; Department of Oral and Maxillofacial Surgery, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. Electronic address: ricardomartinezmartinez92@gmail.com.
Jazyk: angličtina
Zdroj: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2021 Mar; Vol. 49 (3), pp. 171-176. Date of Electronic Publication: 2021 Jan 19.
DOI: 10.1016/j.jcms.2021.01.004
Abstrakt: The aim of the present study is to assess the outcomes of monoportal arthroscopic disc repositioning (discopexy) for disc displacement of the temporomandibular joint. A retrospective, single-institutional clinical study included patients with temporomandibular joint internal derangements diagnosed and treated by monoportal discopexy. Each patient was diagnosed as having anterior disk displacement with or without reduction. The arthroscopy treatment consists of one portal approach fixing the disc with a 3/0 nylon to the tragus cartilage without anterior liberation. Arthroscopy surgery was carried out with a 1.9-mm 0° arthroscope and only one simple cannula. We use a needle to pierce of the disc through the skin and retrieve the suture inside the joint using a blind method through the arthroscopic cannula. The evaluated variables included the maximum interincisal opening, the presence of clicking and pain score. A total of 19 patients, 21 joints, were included in the present study. Of the 21 joints, 16 were classified as disc displacement with reduction and 5 without. Visual analogue scale (VAS) values (0-10) decreased from 5.5 to 1.26 (p < 0.0001) 1 year after surgery. At the first review, all patients had a VAS of at least 4 points less than before the surgery, four patients showed a VAS of 0, and nine patients near to 1. Mouth opening increased from 36.6 (±8.09) mm to 39.37 (±4.35) mm, and no significant limitations in the mouth opening range were seen (p < 0.12) 1 year after surgery. Clicking disappeared in all patients and remained stable after 12 months of follow-up. Postoperative magnetic resonance imaging demonstrated a correct or improved position of the disc in all but one patient. A minimally invasive single portal arthroscopic discopexy is an effective technique to improve function and pain reduction in patients with anterior disk displacement with or without reduction.
Competing Interests: Declaration of competing interest The authors report no competing interests.
(Copyright © 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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