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关节镜下松解与灌洗治疗颞下颌关节静止性盘移位:MRI关节镜检查结果与临床疗效的比较

Treatment of TMJ static disk with arthroscopic lysis and lavage: a comparison between MRI arthroscopic findings and clinical results.

作者信息

Casares G, Benito C, de la Hoz J L, Benito C

机构信息

TMD Section, University Hospital General Gregorio Marañón in Madrid.

出版信息

Cranio. 1999 Jan;17(1):49-57. doi: 10.1080/08869634.1999.11746077.

Abstract

Arthroscopic surgery using the lysis and lavage technique was performed on 30 temporomandibular joints (TMJs) of 26 patients with the clinical and radiological (pseudodynamic Magnetic Resonance Imaging) diagnosis of static disk (SD). Parameters of condylar movement, position of the disk in relation to the condyle in open and closed mouth positions and mobility of the articular disk were evaluated both clinically and radiologically using pseudodynamic Magnetic Resonance Imaging (MRI) before and after surgery. Subjective parameters of pain and functional limitation were also evaluated clinically. The results showed that all the clinical and radiological parameters analyzed improved significantly in all the patients included in the study. In view of the results, the authors concluded that SD should be added to the existing categories of TMJ internal derangements. Pseudodynamic MRI is the diagnostic technique of choice in these cases and arthroscopic surgery with lysis and lavage followed by active physical therapy is an effective treatment modality in this type of pathology.

摘要

对26例经临床和影像学(伪动态磁共振成像)诊断为静止盘(SD)的患者的30个颞下颌关节(TMJ)进行了采用松解和灌洗技术的关节镜手术。在手术前后,使用伪动态磁共振成像(MRI)从临床和影像学两方面评估髁突运动参数、开口和闭口位时盘相对于髁突的位置以及关节盘的活动度。还从临床角度评估了疼痛和功能受限等主观参数。结果显示,纳入研究的所有患者的所有分析的临床和影像学参数均有显著改善。鉴于这些结果,作者得出结论,SD应被纳入现有的颞下颌关节内紊乱类别。伪动态MRI是这些病例的首选诊断技术,采用松解和灌洗的关节镜手术并辅以积极的物理治疗是这类病理情况的有效治疗方式。

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