Knibbe M A, Carter J B, Frokjer G M
Anesth Prog. 1989 Jan-Feb;36(1):21-5.
Internal derangements, myofascial pain dysfunction, and chronic dislocation of the temporomandibular joint (TMJ) are three common sequelae resulting from mandibular trauma. Etiologic factors include prolonged dental and otolaryngologic procedures, and intraoperative use of the laryngoscope and bronchoscope. Three cases are reported to document postanesthetic TMJ dysfunction arising from normal preoperative joints. Four types of TMJ dysfunction are discussed: anterior meniscus dislocation with reduction, anterior meniscus dislocation without reduction, dislocation/subluxation of the mandibular condyle, and myofascial pain dysfunction syndrome. Preoperative screening of mandibular function is recommended in identifying patients as either normal or having potential TMJ dysfunction. Failure to recognize postoperative TMJ dysfunction can lead to long-term symptoms that are difficult to alleviate. Litigation is a common sequel in these cases.
颞下颌关节(TMJ)内部紊乱、肌筋膜疼痛功能障碍和慢性脱位是下颌骨创伤导致的三种常见后遗症。病因包括长时间的牙科和耳鼻喉科手术,以及术中使用喉镜和支气管镜。报告了三例术前关节正常但术后出现TMJ功能障碍的病例。讨论了四种TMJ功能障碍类型:可复性盘前移位、不可复性盘前移位、下颌髁突脱位/半脱位和肌筋膜疼痛功能障碍综合征。建议对下颌功能进行术前筛查,以确定患者下颌功能正常或有潜在的TMJ功能障碍。未能识别术后TMJ功能障碍可能导致难以缓解的长期症状。在这些病例中,诉讼是常见的后续情况。