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微创关节镜下前路肌切开术治疗颞下颌关节内紊乱。手术技术的详细描述。

The minimally invasive arthroscopic anterior myotomy in the treatment of internal derangement of the temporomandibular joint. A detailed description of the surgical technique.

作者信息

Muñoz-Guerra M F, Rodríguez-Campo F J, Escorial-Hernández V, Brabyn P J, Fernández-Domínguez M, Naval-Gías L

机构信息

Department of Oral & Maxillofacial Surgery, University Hospital La Princesa (Autónoma University), Madrid, Spain; Department of Oral & Maxillofacial Surgery, University Hospital Montepríncipe San Pablo CEU University, Madrid, Spain.

Department of Oral & Maxillofacial Surgery, University Hospital La Princesa (Autónoma University), Madrid, Spain.

出版信息

J Stomatol Oral Maxillofac Surg. 2021 Feb;122(1):50-55. doi: 10.1016/j.jormas.2020.04.006. Epub 2020 May 4.

Abstract

PURPOSE

The aim of this report is to define a modification of the arthroscopic anterior myotomy that avoids disc suturing procedures for the treatment of advanced internal derangement (I D) of the temporomandibular joint (TMJ).

SURGICAL TECHNIQUE

The minimally invasive arthroscopic anterior myotomy (MIAAM) is based on a partial resection of the superior belly of the lateral pterygoid muscle performed through a small incision of the articular capsule associated with a scarification of the posterior ligament of the TMJ. The high-frequency wave system, called Coblation, is extremely useful to be able to complete the MIAAM.

CONCLUSION

This technique is indicated for patients with ID and Wilkes stages III-IV without response to conservative treatments, and the presence of an integral disc with an appropriate consistency is transcendent for the success of the procedure. Because of the unique characteristics of the MIAAM, it can be considered as an alternative to arthroscopic discopexy procedures.

摘要

目的

本报告旨在定义一种关节镜下前肌切开术的改良方法,该方法避免了用于治疗颞下颌关节(TMJ)晚期内紊乱(ID)的盘缝合手术。

手术技术

微创关节镜下前肌切开术(MIAAM)基于通过关节囊小切口进行翼外肌上半部分的部分切除,并伴有颞下颌关节后韧带的划痕。名为Coblation的高频波系统对于完成MIAAM极为有用。

结论

该技术适用于对保守治疗无反应的ID和威尔克斯III-IV期患者,并且完整盘具有适当的一致性对于手术成功至关重要。由于MIAAM的独特特性,它可被视为关节镜下盘固定术的替代方法。

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