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辅助进行颞下颌关节关节镜手术的导向装置——一项初步研究

Guide device to assist in performing arthroscopic surgery of the temporomandibular joint-a preliminary study.

作者信息

Abboud Waseem, Reiter Shoshana, Friedman-Rubin Pessia, Shamir Dror, Peleg Oren

机构信息

Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel.

Unit of Oral and Maxillofacial Surgery Bnei Zion Medical Center, Affiliated to Technion Faculty of Medicine, 3339419 Haifa, Israel.

出版信息

J Oral Facial Pain Headache. 2025 Mar;39(1):128-133. doi: 10.22514/jofph.2025.012. Epub 2025 Mar 12.

Abstract

BACKGROUND

Arthroscopic surgery of the temporomandibular joint (TMJ) requires inserting an arthroscope and a working cannula into the joint cavity. Working cannula introduction and positioning require high levels of expertise.

METHODS

A randomized controlled trial was performed on patients with closed lock of the TMJ who underwent arthroscopic lysis and lavage. A total of 15 subjects participated in this study, with 6 in the study group using the Locator-Positioner guide device (LOPO) and 9 in the control group using triangulation. The main outcomes included: (1) Number of attempts necessary for successful cannula insertion. (2) The time between arthroscope insertion and the appearance of the working cannula on the monitor, and (3) Overall surgery duration.

RESULTS

A successful cannula insertion took an average of 2.1 attempts in the study group compared with 3 attempts in the control group ( = 0.045). Study group arthroscope insertion to monitor appearance of cannula took 2.3 minutes, whereas control group took 4 minutes ( = 0.039). A total of 14 minutes was spent on surgery in the study group compared to 16.5 minutes in the control group ( = 0.009).

CONCLUSIONS

LOPO device improved both the insertion of the working cannula into the TMJ and its positioning relative to the arthroscope throughout surgery. It reduced insertion attempts and shortened the surgery duration.

CLINICAL TRIAL REGISTRATION

the study was registered at clinicaltrials.gov, identifier: NCT06520917.

摘要

背景

颞下颌关节(TMJ)的关节镜手术需要将关节镜和工作套管插入关节腔。工作套管的插入和定位需要高水平的专业技能。

方法

对接受关节镜下松解和灌洗的TMJ闭锁患者进行了一项随机对照试验。共有15名受试者参与了本研究,其中6名在研究组中使用定位导向装置(LOPO),9名在对照组中使用三角测量法。主要结果包括:(1)成功插入套管所需的尝试次数。(2)关节镜插入与工作套管在监视器上出现之间的时间,以及(3)总体手术持续时间。

结果

研究组成功插入套管平均需要2.1次尝试,而对照组为3次尝试(P = 0.045)。研究组从关节镜插入到监视器上出现套管的时间为2.3分钟,而对照组为4分钟(P = 0.039)。研究组手术总共用时14分钟,而对照组为16.5分钟(P = 0.009)。

结论

LOPO装置在整个手术过程中改善了工作套管插入TMJ的情况及其相对于关节镜的定位。它减少了插入尝试次数并缩短了手术持续时间。

临床试验注册

该研究已在clinicaltrials.gov上注册,标识符:NCT06520917。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13df/11934736/62eeb8b961e6/fig1.jpg

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