Basics and Pitfalls in TMJ Arthroscopy
Dr. Bo-Yue PENG
彭 伯宇 主任
Head
Division of Oral and Maxillafacial Surgery
Taipei Medical University
Taipei
TAIWAN
In
contemporary concepts, the goals of temporomandibular joints surgeries are
preservation of synovial membrane and fluid, TMJ arthrocentesis and arthroscopic
surgery (lavage, lysis, and manipulation) are popular and used widely. TMJ arthroscope
is powerful tools to accomplish the goal of preservation of TMJ tissue, there
are many indications and advantages: from TMJ internal derangement to
myofascial pain syndromes are indicated for arthroscopic surgery, short time
consuming surgery and admission, tiny scar formation and after-surgery pain. At
the same time, TMJ arthroscope could give surgeon the real time diagnosis of
the patients' TMJ, like perforation, adhesion, chondromalacia, these diagnosis
could not be made in any other diagnostic tool. The contraindications of the TMJ
arthroscope are ankylosis, infection of TMJ, malignant tumor etc., we surgeons
should keep in mind. Finally the complications most occurred of TMJ arthroscopic
surgery are otologic complications: external auditory canal laceration, blood
clotting in external auditory canal, ear fullness, vertigo, even partial
hearing loss, the second often occurred complication is facial nerve injury,
temporary or permanent. In this speech, we will share the experiences in the TMJ
arthroscopic treatments, from LLM (lysis, lavage, and manipulation) to
arthroscopic plication.
