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关节镜下单入口与双入口手术治疗颞下颌关节紊乱病的前瞻性对比分析

Surgical complications related to temporomandibular joint arthroscopy: a prospective analysis of 39 single-portal versus 43 double-portal procedures.

机构信息

Instituto Português da Face, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.

Instituto Português da Face, Lisboa, Portugal.

出版信息

Int J Oral Maxillofac Surg. 2021 Aug;50(8):1089-1094. doi: 10.1016/j.ijom.2020.07.020. Epub 2021 Jan 22.

Abstract

Temporomandibular joint (TMJ) arthroscopy is a minimally invasive surgical procedure proposed for diverse TMJ intra-articular disorders. A prospective study was designed with the aim of investigating intraoperative and postoperative surgical complications for single and double-portal TMJ arthroscopy. All interventions were performed by one surgeon with the same surgical protocol. A total of 55 patients were enrolled, resulting in 82 TMJ arthroscopies (28 unilateral and 27 bilateral). A total of 39 single portal (47.57%) and 43 double-portal (52.43%) arthroscopies were performed. No severe and irreversible complications were observed. Most complications were resolved after 4 weeks. Double-portal was associated with more complications (n=23) compared with single-portal TMJ arthroscopy (n=14), with a statistically significant difference found between single and double-portal TMJ arthroscopy in two intraoperative complications: intra-articular bleeding (P=0.044) and oedema of the preauricular area (P=0.042). This study confirms the safety of TMJ arthroscopy for single and double-portal procedures, with the authors suggesting a multicentre study, in an effort to minimize any possible bias.

摘要

颞下颌关节(TMJ)关节镜检查是一种微创外科手术,适用于多种 TMJ 关节内疾病。本研究旨在探讨单入口和双入口 TMJ 关节镜检查的术中及术后手术并发症,设计了一项前瞻性研究。所有手术均由同一位医生采用相同的手术方案进行。共纳入 55 例患者,共进行了 82 例 TMJ 关节镜检查(28 例单侧和 27 例双侧)。共进行了 39 例单入口(47.57%)和 43 例双入口(52.43%)关节镜检查。未观察到严重且不可逆转的并发症。大多数并发症在 4 周后得到解决。与单入口 TMJ 关节镜检查(n=14)相比,双入口 TMJ 关节镜检查(n=23)的并发症更多,两种术中并发症(关节内出血,P=0.044 和耳前区水肿,P=0.042)在单入口和双入口 TMJ 关节镜检查之间存在统计学显著差异。本研究证实了 TMJ 关节镜检查用于单入口和双入口手术的安全性,作者建议进行一项多中心研究,以尽量减少任何可能的偏倚。

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