Arteriovenous fistula: an unusual complication associated with arthroscopic temporomandibular joint surgery.
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Biomedical subjects
Publications and source records attributed to J J Moses.
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The effect of arthroscopic release of temporomandibular joint (TMJ) discs was prospectively studied using a combination of preoperative tomograms, magnetic resonance imaging (MRI) scans and arthrograms, and postoperative MRI scans. Of 92 patients studied, 60 had bilateral and 32 had unilateral joint disease. All of the 152 joints studied had anterior disc displacement preoperatively. Postoperative MRI scans revealed that 92% of the patients had persistent anterior disc displacement, although 80% of the patients did have marked improvement of disc mobility. Ninety-two percent of the total patient sample had a significant reduction in pain and restoration of normal mandibular function.
Two hundred thirty-seven patients (419 temporomandibular joints) who had undergone arthroscopic surgery were retrospectively studied with a mean follow-up of 10.5 months (range 1 to 33 months). These results confirmed those of previous short-term studies on successful arthroscopic surgery.
The endaural approach to the temporomandibular joint overcomes some of the drawbacks associated with the commonly used superior posterolateral and anterolateral approaches. The technique allows improved visualization and access to instrumentation, especially to lateral and medial joint troughs, and the anterolateral region of the superior joint space. This has allowed for observations of the lateral impingement phenomenon occurring in the lateral superior joint space. Triangulation, and therefore the type of surgery performed have been greatly facilitated by the approach.