OPERATIVE METHOD BY NEWLY DEVELOPED ARTHROSCOPE WITH A CHANNEL FOR ENDOSCOPIC SURGERY OF TEMPOROMANDIBULAR JOINT

一种具有颞下颌关节（TMJ）内窥镜通道的新型关节镜及其手术所需的器械已被开发出来。在最近开发出高像素（15000像素）的直径非常小的纤维镜之后，我们最近又开发了一种新的关节镜，旨在解决之前的问题。该关节镜结合了纤维镜和手术通道（φ1.1mm）。该纤维镜套管的长度和直径（φ2.9mm）与最常用的Striker关节镜套管相同。与此同时，我们已经开发了用于手术的器械，可以通过关节镜的手术通道（探针，钳，刀，烧灼刀等）。目的：从组织学和影像学角度评价绵羊颞下颌关节镜下电灼松解术后的组织反应。试验用13只成年美利奴羊，体重约60公斤。本研究中使用的更多器械是一种新开发的带通道的关节镜。电灼器插入内通道，针尖直接贴在后眼袋滑膜上，电灼器功率125瓦，从内侧壁到外侧壁对其表面进行损伤。然后将尖端用电枢从内侧到外侧放置在结节的关节表面上，直到露出底层骨。首次手术后第2、4、8、12周，用过量麻醉剂处死羊。标本脱钙，矢状面从外侧到内侧进行组织学研究。初次手术后第4周，所有椎间盘穿孔。初次手术后第12周，髁突关节表面部分脱落，部分表面出现纤维修复，椎间盘前移。这些变化在影像学和组织学上与晚期骨关节炎相似。提示关节镜下电刺激后囊滑膜松解可引起羊TMJ骨性关节炎的改变。少

A new arthroscope, which has a channel for endscopic surgery of the temporomandibular joint (TMJ), and the instruments needed for this surgery have been recently developed. Following the recent development of a very small diameter fiberscope with a high pixel number (15,000 pixel), we have recently developed a new arthroscope, designed to resolve the previous problems. This arthroscope combines a fiberscope with a surgical channel (φ1.1mm). The length and diameter (φ2.9mm) of this fiberscope cannula are identical to those of the most frequently used Striker's arthroscope cannula. At the same time, we have developed the instruments for use in surgery that would fit through the surgical channel of this arthroscope (probe, forceps, knives, cautery knives, etc.). To evaluate the tissue response after arthroscopic lysis with electrocautery in the temporomandibular joint (TMJ) of sheep histologically and radiologically. Thirteen adult merino sheep, weighting about 60 kg, were used. The instr … More uments used in this study were a newly developed arthroscope with a channel. Electrocautery was inserted into the inner channel and the tip placed directly against the synovial membrane of the posterior pouch and the surface was injured from medial to lateral walls by electrocautery with a power of 125 watts. The tip is then placed against the articular surface of the tuber which was damaged from medial to lateral part with electrocortery until the underlining bone was exposed. At the 2nd, 4th, 8th, 12th week after the initial operation, the sheep were sacrificed by an anesthetic overdose. The specimens were decalcified and sagitally sectioned from lateral to medial for histologic study.At the 4th week after the initial operation, all discs were perforated. At the 12th week after the initial operation, the condylar articular surface was partly denuded in some areas, and part of the surface showed fibrous repair, and the disc was displaced to the anterior portion. These changes were radiographically and histologically similar to advanced osteoarthritis. Is was suggested that an arthroscopic lysis with electrocautery against the synovial membrane of the posterior pouch was induced the osteoarthritic change of sheep TMJ. Less