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Deveropmental study on the clinical technic of arthroscopic suture and fixation of temporomandibular joint disc.

关节镜下颞下颌关节盘缝合固定临床技术的研究进展

基本信息

批准号：
03454460
负责人：
OHNISHI Masatoshi
金额：
$ 3.14万
依托单位：
Yamanashi Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1991
资助国家：
日本
起止时间：
1991 至 1992
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03454460/
关键词：
arthroscopy temporomandibular joint arthroscopic surgery arthroscopic disc suturing & fixation arthroscopic suture needle arthroscopic suture technic arthroscopic laser surgery habitual dislocation of TMJ closed lock of TMJ 鏡視下レ-ザ-手術

项目摘要

We have developed, through the use of a Nd-YAG laser and suturing of the lesion through the arthroscope, a new method for dealing with temporomandibular joint lesions.1) Cadaver study on the technic: This arthroscopic suturing procedure, aimed mainly at the superior area of the articular cavity was performed primarily on the oblique protuberance in the synovial area extending from the posterior wall to the posterior aspect of the anterior disc. For recurrent dislocation and hypermobility, the procedure was performed deep within the area. In cases of disc displacement, a fresh wound was created by using the Nd-YAG laser to evaporate the surface, and then arthroscopic suturing was performed on the freshened free edge of the articular disc.2) Development of the arthroscopic suture needle A newly devised, experimental arthroscopic suture needle made of stainless steel was used in the procedure. It consists of two parts: a needle and its holder.The full length is 21 cm, approximately half of which is the needle itself. The eye of the needle is 1.0 mm in diameter at the tip. Depending on the operative case, either 1/2 circle or 1/3 circle needle tips were used.3) Clinical application: Eighty patients (138 temporomandibular joints) were treated by arthroscopic laser surgery including arthroscopic suturing and were postoperatively evaluated by combinations of physical examination, arthrography, and arthroscopy. There ware 30 patients with habitual dislocation and 24 patients with closed-lock condition who were treated with the Nd-YAG laser to reduce the range of motion to normal. Overall, 92% of the 54 patients treated with combinations of arthroscopic laser and/or suture techniques were relieved of their symptoms.

我们已经开发了一种新的方法，通过使用Nd-YAG激光和病变通过关节镜，处理颞下颌关节病变。1）尸体研究的技术：这个关节镜手术主要针对关节腔的上级区域，主要在滑膜区域中从前壁的后壁延伸到后面的斜隆凸上进行disc.对于复发性脱位和过度活动，手术在该区域深处进行。在椎间盘移位的情况下，通过使用Nd-YAG激光蒸发表面来创建新鲜伤口，然后在关节盘的新鲜游离边缘上进行关节镜缝合。2）关节镜缝合针的开发在该过程中使用了新设计的实验性关节镜缝合针，该缝合针由不锈钢制成。它由针头和保持器两部分组成，全长21厘米，其中约一半是针头本身。针尖的针眼直径为1.0 mm。根据手术情况，使用1/2圈或1/3圈针尖。3）临床应用：80例患者（138个颞下颌关节）接受关节镜下激光手术治疗，包括关节镜下切除术，术后通过体格检查、关节造影和关节镜检查进行评估。其中30例为习惯性脱位，24例为闭锁性脱位，采用Nd-YAG激光治疗，使关节活动度恢复正常。总体而言，在54名接受关节镜激光和/或缝合技术联合治疗的患者中，92%的患者症状缓解。