González-García R, Rodríguez-Campo F J, Monje F, Sastre-Pérez J, Gil-Díez Usandizaga J L
Department of Maxillofacial-Head and Neck Surgery, University Hospital La Princesa, Madrid, Spain.
Int J Oral Maxillofac Surg. 2008 Sep;37(9):790-6. doi: 10.1016/j.ijom.2008.04.022. Epub 2008 Jun 25.
Arthroscopic surgery has been reported to decrease pain in relation to the TMJ, improving maximal interincisal opening (MIO). The aim of the present study was to report the clinical outcome of arthroscopic surgery for the treatment of chronic closed lock (CCL) of the TMJ. Five hundred consecutive patients (670 joints) with TMJ derangement who underwent arthroscopy between 1995 and 2004 were retrospectively analysed. All were classified as II-V according to Wilkes. Within the series, various arthroscopic procedures were performed. The inclusion criteria for CCL of the TMJ were met by 257 patients (344 joints). The mean age was 30.24 years; 237 (92%) were female and 20 (8%) male. Mean preoperative visual analogue scale score for evaluation of TMJ pain was 53.21+/-23.02. Mean MIO was 24.75+/-4.89 mm. Following arthroscopy, a significant decrease in TMJ pain was achieved (p<0.0001). For MIO, mandibular protrusion and lateral excursion movements, a significant increase in mean values was observed following surgery (p<0.0001). No statistical differences were observed between arthroscopic lysis and lavage and operative arthroscopy in relation to postoperative pain or MIO at any stage of the follow-up period. Arthroscopy should be considered as a first-line treatment for CCL of the TMJ.
据报道，关节镜手术可减轻颞下颌关节相关疼痛，改善最大切牙间开口度（MIO）。本研究的目的是报告关节镜手术治疗颞下颌关节慢性闭锁性锁结（CCL）的临床结果。对1995年至2004年间接受关节镜检查的500例连续颞下颌关节紊乱患者（670个关节）进行回顾性分析。所有患者均根据威尔克斯分类为II - V级。在该系列中，进行了各种关节镜手术。257例患者（344个关节）符合颞下颌关节CCL的纳入标准。平均年龄为30.24岁；237例（92%）为女性，20例（8%）为男性。术前评估颞下颌关节疼痛的视觉模拟量表平均评分为53.21±23.02。平均MIO为24.75±4.89毫米。关节镜检查后，颞下颌关节疼痛显著减轻（p<0.0001）。对于MIO、下颌前伸和侧方运动，术后观察到平均值显著增加（p<0.0001）。在随访期的任何阶段，关节镜下松解冲洗术与手术关节镜检查在术后疼痛或MIO方面均未观察到统计学差异。关节镜检查应被视为颞下颌关节CCL的一线治疗方法。
