Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint
Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint
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DOI：
10.1016/j.bjoms.2011.02.004
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发表时间：
2012-03-01
影响因子：
1.8
通讯作者：
Wang, Yang
中科院分区：
文献类型：
--
作者：
Zhu, YaoMin;Zheng, CangShang;Wang, Yang
本研究的目的是探讨关节镜入路矫正椎间盘前移而不复位颞下颌关节 (TMJ) 且张口受限的临床结果和疗效。我们研究了 23 名患者的 28 个内部紊乱关节，所有患者均接受过关节镜手术（灌洗、松解上间室粘连、平行于上关节间室椎间盘滑膜折痕的切口，以及将位于前方的椎间盘拉回）。术前和术后 7、30、60 天和 6 个月或更长时间收集客观和主观数据（最大切口间开口的增加、磁共振成像和视觉模拟疼痛评分 (VAS)）。如前一行所示，术后 6 个月时最大切缝开口从术前测量值的平均 (SD) 20.4 (+/-4.5) mm 改善至 38.9 (+/-3.2) mm。 VAS 显示疼痛评分显着改善 (p = 0.0023)。术后 60 天，14 个颞下颌关节的椎间盘位置有了显着改善。其中 13 个颞下颌关节的位置略有改善。只有 1 个颞下颌关节完全没有改善。所有患者均未出现并发症。我们的关节镜手术对于治疗椎间盘前移且不需复位颞下颌关节的患者来说是安全、微创且有效的。 (C) 2011 年英国口腔颌面外科医师协会。由爱思唯尔有限公司出版。保留所有权利。
The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior compartment, incision parallel to the disc-synovial crease of the upper joint compartment, and pull back of the anteriorly located disc). Objective and subjective data (increase in maximal interincisal opening, magnetic resonance imaging, and visual analogue pain score, VAS) were collected preoperatively and at 7, 30, 60 days, and 6 months or more postoperatively. Maximal interincisal opening improved from a mean (SD) of 20.4 (+/-4.5) mm preoperative measurement to 38.9 (+/-3.2) mm by 6 months postoperatively where indicated in previous line. The VAS showed a significant improvement in pain score (p = 0.0023). Sixty days postoperatively the positions of the discs in 14 of the TMJs had improved considerably. In 13 of the TMJs the positions had improved slightly. Only 1 of the TMJs had not improved at all. There were no complications in any patient. Our arthroscopic procedure is safe, minimally invasive, and effective for the treatment of patients with displacement of the disc anteriorly without reduction of the TMJ. (C) 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.