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颞下颌关节镜治疗颞下颌关节滑膜软骨瘤病病例的成功比较评估:病例系列

Comparative Evaluation of Success in Cases of Synovial Chondromatosis of Temporomandibular Joint Treated with Temporomandibular Joint Arthroscopy: A Case Series.

作者信息

Satyanarayan P, Roy I D, Issar Yuvraj, Tomar Kapil, Jakka Sabareesh

机构信息

Division of Oral and Maxillofacial Surgery, AFMC, Solapur road, Pune, Maharashtra 411040 India.

Department of Dental Surgery & Oral Health Sciences, AFMC, Pune, India.

出版信息

J Maxillofac Oral Surg. 2022 Dec;21(4):1227-1232. doi: 10.1007/s12663-021-01640-y. Epub 2021 Sep 25.

Abstract

INTRODUCTION

Synovial chondromatosis of the temporomandibular joint (TMJ) is characterized by the formation of multiple nodules of cartilage with varying sizes due to metaplastic development of the synovial membrane. Aetiology revolves with primary lesion, and pathogenesis is still unknown with multiple factors, which includes low-grade trauma or internal derangement. This condition remains undiagnosed and leads to therapeutic challenges from clinical manifestations which are non-specific and needs various tools to diagnose with combination of radiologic and histopathological examination.

MATERIALS AND METHOD

We report a case series of five cases which were diagnosed as cases of TMD of the temporomandibular joint. Diagnostic arthroscopy including lysis and lavage with Ringers lactate, hyaluronic acid was carried out. Intra-operative findings were suggestive of synovial chondromatosis. Sample taken for histopathological examination confirmed the diagnosis of synovial chondromatosis of TMJ. Postoperative status of mouth opening and pain was assessed at 15 days, one month, 3 months, 6 months and one year during the review to evaluate the success of arthroscopy of TMJ.

RESULTS

All patients reported success with the modality of arthroscopy lysis and lavage at 12 months of follow-up with improvement at every follow-up visit in terms of range of motion and reduction of pain score on VAS. Hence, arthroscopy with lysis and lavage came out to be a promising alternative for open joint surgery in cases of synovial chondromatosis of the TMJ with same outcomes in relieving patients who complain of reduced maximum inter-incisal opening and pain.

CONCLUSION

Thus, arthroscopic procedures can be considered an alternative and effective modality for successful management of cases of synovial chondromatosis of temporomandibular joint.

摘要

引言

颞下颌关节滑膜软骨瘤病的特征是由于滑膜的化生发展而形成多个大小不一的软骨结节。病因与原发性病变有关,发病机制仍不明,涉及多种因素,包括低度创伤或内部紊乱。这种情况常难以诊断,因其临床表现不具特异性,需要借助多种工具,结合放射学和组织病理学检查来确诊,从而带来了治疗挑战。

材料与方法

我们报告了一组五例被诊断为颞下颌关节颞下颌紊乱病的病例。进行了诊断性关节镜检查,包括用乳酸林格氏液和透明质酸进行松解和灌洗。术中发现提示为滑膜软骨瘤病。所取样本的组织病理学检查证实了颞下颌关节滑膜软骨瘤病的诊断。在复查期间,于术后15天、1个月、3个月、6个月和1年评估张口和疼痛的术后状况,以评估颞下颌关节镜检查的成功率。

结果

所有患者在随访12个月时均报告关节镜松解和灌洗治疗成功,每次随访时在活动范围和视觉模拟评分法疼痛评分降低方面均有改善。因此,对于颞下颌关节滑膜软骨瘤病,关节镜松解和灌洗对于开放性关节手术而言是一种有前景的替代方法,在缓解主诉最大切牙间开口减小和疼痛的患者方面能取得相同效果。

结论

因此,关节镜手术可被视为成功治疗颞下颌关节滑膜软骨瘤病病例的一种替代且有效的方法。

相似文献

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