Widmark G, Dahlström L, Kahnberg K E, Lindvall A M
Department of Oral and Maxillofacial Surgery, Mölndal Hospital, Sweden.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Mar;83(3):314-20. doi: 10.1016/s1079-2104(97)90235-3.
To follow up a series of patients treated consecutively who had undergone a diskectomy 2 years previously because of persistent pain and disk displacement in the temporomandibular joint.
Sixteen subjects rated their current symptoms during 1 week and were systematically examined for signs of temporomandibular disorders clinically and radiographically by independent observers.
Subjectively, all subjects were satisfied with the operation. Five rated their current pain as significant during masticatory function. Some signs of temporomandibular disorders, usually related to function, were registered in all subjects. Postoperative mandibular movements were improved but still below normal range. Signs and symptoms correlated significantly. Surgical complications were nonexistent, but radiographic changes were extensive. Erosion and flattening of the condyle were common.
It was verified that subjects with persistent pain and disk displacement benefit subjectively and clinically from diskectomy. The radiographic outcomes appear less encouraging. Only prospective, randomized, and controlled studies can eventually clarify the effectiveness of diskectomy in relieving pain caused by displacements in the temporomandibular joint.
对一系列因颞下颌关节持续性疼痛和椎间盘移位而在两年前接受椎间盘切除术的连续治疗患者进行随访。
16名受试者在1周内对其当前症状进行评分，独立观察者对其进行临床和影像学的颞下颌关节紊乱体征系统检查。
主观上，所有受试者对手术满意。5名受试者在咀嚼功能时将其当前疼痛评为严重。在所有受试者中均记录到一些通常与功能相关的颞下颌关节紊乱体征。术后下颌运动有所改善，但仍低于正常范围。体征和症状显著相关。无手术并发症，但影像学改变广泛。髁突侵蚀和平坦常见。
证实了患有持续性疼痛和椎间盘移位的受试者在主观和临床上可从椎间盘切除术中获益。影像学结果似乎不太乐观。只有前瞻性、随机和对照研究最终才能阐明椎间盘切除术在缓解颞下颌关节移位引起的疼痛方面的有效性。
