Kim Young-Kyun, Im Jae-Hyung, Chung Hoon, Yun Pil-Young
Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Seoul, Korea.
J Oral Maxillofac Surg. 2009 May;67(5):1039-45. doi: 10.1016/j.joms.2008.12.040.
The purpose of this study was to evaluate the treatment outcome of temporomandibular joint (TMJ) lysis and lavage using ultrathin TMJ arthroscopy.
Closed lock patients who had not shown response to the conservative treatment for more than 3 months were included in this study. The clinical data were collected using standard protocol including questionnaire. Under the informed consent, TMJ lysis and lavage were performed using ultrathin arthroscopy. For the evaluation of the treatment outcome, maximum mouth opening (MMO) and visual analog scale (VAS) were used.
A total of 15 patients were included in this study. Concerning arthroscopic findings, fibrillation and adhesion were detected in 9 patients. Synovial hyperemia and ecchymosis was detected in 6 patients. There were no complications related with arthroscopic procedure in this study. Improvement of mouth opening more than 5 mm was detected in 14 patients. VAS score was reduced more than 60%, and VAS was recorded no more than 2 postoperatively in 12 patients. Good outcome was obtained in 12 patients (80%) from the total 15 patients.
From the clinical outcomes, TMJ lysis and lavage using ultrathin TMJ arthroscopy could be considered as an alternative treatment for the closed lock patients.
本研究旨在评估使用超薄颞下颌关节镜进行颞下颌关节（TMJ）松解和灌洗的治疗效果。
本研究纳入了对保守治疗3个月以上无反应的闭口锁患者。使用包括问卷在内的标准方案收集临床数据。在获得知情同意后，使用超薄关节镜进行TMJ松解和灌洗。为评估治疗效果，采用最大开口度（MMO）和视觉模拟量表（VAS）。
本研究共纳入15例患者。关节镜检查发现，9例患者存在纤维性变和粘连。6例患者出现滑膜充血和瘀斑。本研究中未发生与关节镜手术相关的并发症。14例患者的开口度改善超过5mm。12例患者的VAS评分降低超过60%，术后VAS评分不超过2分。15例患者中有12例（80%）获得了良好的治疗效果。
从临床结果来看，使用超薄TMJ关节镜进行TMJ松解和灌洗可被视为闭口锁患者的一种替代治疗方法。
