Fleckenstein Florian Nima, Voss Jan, Doll Christian, Maleitzke Tazio, Winkler Tobias, Siebert Eberhard, Collettini Federico
Department of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Berlin Institute of Health at Charité Universitätsmedizin, Berlin, Germany.
Cardiovasc Intervent Radiol. 2025 May;48(5):687-693. doi: 10.1007/s00270-025-04008-8. Epub 2025 Mar 24.
To assess the efficacy and safety of transarterial embolization (TAE) for the treatment of temporomandibular joint osteoarthritis (TMJ-OA)-related symptoms.
Three female patients were referred to our center for TAE after conservative and surgical TMJ treatments failed. Six TAE procedures were performed with bilateral treatments spaced four weeks apart. Following CBCT with maximal magnification and narrow collimation to confirm correct positioning of the microcatheter, superselective TAE was performed using Imipenem/Cilastatin mixed with contrast medium. Technical success was defined by successful embolization of the target vessel. Outcome measures included Oral Health Impact Profile-Temporomandibular Joint (OHIP-TMD) and Numeric Rating Scale (NRS) at baseline, 4 weeks and at 3 months intervals.
TAE was technically successful in all six procedures. No adverse events were recorded. Clinical follow-up data after 3 months are available for all three patients, one patient reached the 6-months follow-up. OHIP-TMD scores decreased from 38 to 31, 45 to 39, and 45 to 28, respectively. NRS pain scores improved from 9 to 6, 10 to 7, and 9 to 5, respectively.
TAE appears to be a feasible and safe minimally-invasive option for selected TMJ-OA patients with symptoms refractory to standard treatments. Further studies with larger cohorts and extended follow-up are warranted to confirm these preliminary findings.
评估经动脉栓塞术（TAE）治疗颞下颌关节骨关节炎（TMJ - OA）相关症状的疗效和安全性。
3例女性患者在保守治疗和手术治疗颞下颌关节失败后转诊至本中心接受TAE治疗。共进行了6次TAE手术，双侧治疗间隔4周。在使用最大放大倍数和窄准直的CBCT确认微导管正确定位后，使用亚胺培南/西司他丁与造影剂混合进行超选择性TAE。技术成功定义为目标血管成功栓塞。观察指标包括基线、4周和3个月间隔时的口腔健康影响量表 - 颞下颌关节（OHIP - TMD）和数字评定量表（NRS）。
6次手术在技术上均成功。未记录到不良事件。所有3例患者均有3个月后的临床随访数据，1例患者进行了6个月随访。OHIP - TMD评分分别从38降至31、45降至39和45降至28。NRS疼痛评分分别从9改善至6、10改善至7和9改善至5。
对于选定的经标准治疗症状难治的TMJ - OA患者，TAE似乎是一种可行且安全的微创选择。有必要进行更大样本量和更长随访期的进一步研究以证实这些初步发现。
