Smolka Wenko, Yanai Chie, Smolka Koord, Iizuka Tateyuki
Department of Cranio-Maxillofacial Surgery, University of Berne, Inselspital, Berne, Switzerland.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Sep;106(3):317-23. doi: 10.1016/j.tripleo.2007.12.007. Epub 2008 Jan 15.
To compare the outcome of arthroscopic lysis and lavage of TMJ with internal derangement of Wilkes stages II, III, IV, and V.
Arthroscopic lysis and lavage was performed in 45 TMJ of 39 patients with internal derangement. The cases were divided into 4 groups corresponding to Wilkes stages II, III, IV, and V. Two parameters were compared pre- and postoperatively: pain and mouth opening. Statistical significance was determined using the chi(2) test.
Overall success rate was 86.7% (Wilkes stage II 90.9%, Wilkes stage III 92.3%, Wilkes stage IV 84.6%, Wilkes stage V 75%). There were no statistically significant differences between the success rates for Wilkes stages II, III, IV, and V.
Arthroscopic lysis and lavage should be performed as a standard operation for internal derangement of the TMJ after failure of conservative treatment in all Wilkes stages.
比较关节镜下颞下颌关节松解及灌洗术治疗威尔克斯II、III、IV和V期颞下颌关节内紊乱的疗效。
对39例颞下颌关节内紊乱患者的45个颞下颌关节进行关节镜下松解及灌洗术。病例分为与威尔克斯II、III、IV和V期相对应的4组。比较术前和术后的两个参数：疼痛和开口度。采用卡方检验确定统计学意义。
总体成功率为86.7%（威尔克斯II期90.9%，威尔克斯III期92.3%，威尔克斯IV期84.6%，威尔克斯V期75%）。威尔克斯II、III、IV和V期的成功率之间无统计学显著差异。
对于所有威尔克斯期颞下颌关节内紊乱，在保守治疗失败后，关节镜下松解及灌洗术应作为标准手术进行。
