Альманах клинической медицины. 2017; 45: 460-465
Артроскопическая репозиция диска височно-нижнечелюстного сустава: часть III – подробное описание методики
https://doi.org/10.18786/2072-0505-2017-45-6-460-465Аннотация
Вывих диска – одна из самых частых патологий височно-нижнечелюстного сустава (ВНЧС). В наших предыдущих публикациях мы описали основные технические элементы артроскопического вмешательства для передней репозиции диска и показатели его эффективности в ближайшем послеоперационном периоде. Однако эта хирургическая методика очень сложна, овладеть ей трудно, и в предыдущих наших публикациях она не была представлена подробно. В настоящей статье эта артроскопическая операция описана настолько детально, чтобы обеспечить ее безопасное и эффективное выполнение. Мы рассматриваем предоперационную подготовку, необходимые инструменты и материалы, технику пунктирования с выбором точек для проколов, технику передней мобилизации диска и его поэтапного прошивания, а также обсуждаем ряд ключевых моментов, которые помогают избежать возможных ошибок и погрешностей в ходе операции. Все этапы методики исчерпывающим образом проиллюстрированы оригинальными фотографиями и чертежами, а результаты вмешательства подтверждаются данными магнитно-резонансной томографии. С 2015 г. авторы этого исследования выполнили артроскопические операции такого типа на 760 суставах, при этом хорошие ближайшие результаты были получены в 99,08% случаев.
Список литературы
1. Qiu WL, Zhang ZK. The textbook of oral and maxillofacial surgery. Peking: People's Medical Publishing House (PMPH); 2004. 304 p. Chinese.
2. Emshoff R, Innerhofer K, Rudisch A, Bertram S. Relationship between temporomandibular joint pain and magnetic resonance imaging findings of internal derangement. Int J Oral Maxillofac Surg. 2001;30(2): 118–22. doi: 10.1054/ijom.2000.0028.
3. McCain JP, Podrasky AE, Zabiegalski NA. Arthroscopic disc repositioning and suturing: a preliminary report. J Oral Maxillofac Surg. 1992;50(6): 568–79.
4. Murakami K, Moriya Y, Goto K, Segami N. Fouryear follow-up study of temporomandibular joint arthroscopic surgery for advanced stage internal derangements. J Oral Maxillofac Surg. 1996;54(3): 285–90. doi: https://doi.org/10.1016/S0278-2391(96)90742-9.
5. Ohnishi M. Arthroscopic laser surgery and suturing for temporomandibular joint disorders: technique and clinical results. Arthroscopy. 1991;7(2): 212–20. doi: https://doi.org/10.1016/0749-8063(91)90110-J.
6. Yang C, Cai XY, Chen MJ, Zhang SY. New arthroscopic disc repositioning and suturing technique for treating an anteriorly displaced disc of the temporomandibular joint: part I – technique introduction. Int J Oral Maxillofac Surg. 2012;41(9): 1058–63. doi: 10.1016/j.ijom.2012.05.025.
7. Zhang SY, Liu XM, Yang C, Cai XY, Chen MJ, Haddad MS, Yun B, Chen ZZ. New arthroscopic disc repositioning and suturing technique for treating internal derangement of the temporomandibular joint: part II – magnetic resonance imaging evaluation. J Oral Maxillofac Surg. 2010;68(8): 1813–7. doi: 10.1016/j.joms.2009.08.012.
8. McCarty WL, Farrar WB. Surgery for internal derangements of the temporomandibular joint. J Prosthet Dent. 1979;42(2): 191–6. doi: http://dx.doi.org/10.1016/0022-3913(79)90174-4.
9. Dolwick MF, Nitzan DW. The role of disc-repositioning surgery for internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1994;6:271–5.
10. Xie Q, Yang C, He D, Cai X, Ma Z. Is mandibular asymmetry more frequent and severe with unilateral disc displacement? J Craniomaxillofac Surg. 2015;43(1): 81–6. doi: 10.1016/j.jcms.2014.10.013.
11. Cai XY, Jin JM, Yang C. Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study. J Oral Maxillofac Surg. 2011;69(11):e340–6. doi: 10.1016/j.joms.2011.02.038.
12. Israel HA. Technique for placement of a discal traction suture during temporomandibular joint arthroscopy. J Oral Maxillofac Surg. 1989;47(3): 311–3. doi: https://doi.org/10.1016/0278-2391(89)90240-1.
13. Tarro AW. Arthroscopic treatment of anterior disc displacement: a preliminary report. J Oral Maxillofac Surg. 1989;47(4): 353–8. doi: https://doi.org/10.1016/0278-2391(89)90336-4.
Almanac of Clinical Medicine. 2017; 45: 460-465
Temporomandibular joint disc repositioning with arthroscopy: part III – detailed introduction of the technique
https://doi.org/10.18786/2072-0505-2017-45-6-460-465Abstract
Disc displacement is one of the most common conditions affecting the temporomandibular joint (TMJ). In our previous publications we described the basic technical elements of the anterior disc repositioning surgery with arthroscopy and the success rates immediately after surgery. However, the surgical procedure is very complicated and difficult to study, and the technique has not been introduced in details in the previous papers. The present article presents the detailed introduction of the arthroscopic surgery to demonstrate the safe and successful performance of this procedure. It describes preparation for the surgery, the instruments and materials used, the puncture procedure with the choice of the puncture points, the technique of anterior release of the disc, stepwise disc suturing, and discusses some key points to avoid potential pitfalls and mistakes during the surgery. All steps of the technique are comprehensively illustrated by original photographs and diagrams and the intervention results are supported by magnetic resonance imaging scans. Since 2015, the arthroscopic procedure of this type has been performed by the study authors in 760 joints with a short-term success rate of up to 99.08%.
References
1. Qiu WL, Zhang ZK. The textbook of oral and maxillofacial surgery. Peking: People's Medical Publishing House (PMPH); 2004. 304 p. Chinese.
2. Emshoff R, Innerhofer K, Rudisch A, Bertram S. Relationship between temporomandibular joint pain and magnetic resonance imaging findings of internal derangement. Int J Oral Maxillofac Surg. 2001;30(2): 118–22. doi: 10.1054/ijom.2000.0028.
3. McCain JP, Podrasky AE, Zabiegalski NA. Arthroscopic disc repositioning and suturing: a preliminary report. J Oral Maxillofac Surg. 1992;50(6): 568–79.
4. Murakami K, Moriya Y, Goto K, Segami N. Fouryear follow-up study of temporomandibular joint arthroscopic surgery for advanced stage internal derangements. J Oral Maxillofac Surg. 1996;54(3): 285–90. doi: https://doi.org/10.1016/S0278-2391(96)90742-9.
5. Ohnishi M. Arthroscopic laser surgery and suturing for temporomandibular joint disorders: technique and clinical results. Arthroscopy. 1991;7(2): 212–20. doi: https://doi.org/10.1016/0749-8063(91)90110-J.
6. Yang C, Cai XY, Chen MJ, Zhang SY. New arthroscopic disc repositioning and suturing technique for treating an anteriorly displaced disc of the temporomandibular joint: part I – technique introduction. Int J Oral Maxillofac Surg. 2012;41(9): 1058–63. doi: 10.1016/j.ijom.2012.05.025.
7. Zhang SY, Liu XM, Yang C, Cai XY, Chen MJ, Haddad MS, Yun B, Chen ZZ. New arthroscopic disc repositioning and suturing technique for treating internal derangement of the temporomandibular joint: part II – magnetic resonance imaging evaluation. J Oral Maxillofac Surg. 2010;68(8): 1813–7. doi: 10.1016/j.joms.2009.08.012.
8. McCarty WL, Farrar WB. Surgery for internal derangements of the temporomandibular joint. J Prosthet Dent. 1979;42(2): 191–6. doi: http://dx.doi.org/10.1016/0022-3913(79)90174-4.
9. Dolwick MF, Nitzan DW. The role of disc-repositioning surgery for internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1994;6:271–5.
10. Xie Q, Yang C, He D, Cai X, Ma Z. Is mandibular asymmetry more frequent and severe with unilateral disc displacement? J Craniomaxillofac Surg. 2015;43(1): 81–6. doi: 10.1016/j.jcms.2014.10.013.
11. Cai XY, Jin JM, Yang C. Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study. J Oral Maxillofac Surg. 2011;69(11):e340–6. doi: 10.1016/j.joms.2011.02.038.
12. Israel HA. Technique for placement of a discal traction suture during temporomandibular joint arthroscopy. J Oral Maxillofac Surg. 1989;47(3): 311–3. doi: https://doi.org/10.1016/0278-2391(89)90240-1.
13. Tarro AW. Arthroscopic treatment of anterior disc displacement: a preliminary report. J Oral Maxillofac Surg. 1989;47(4): 353–8. doi: https://doi.org/10.1016/0278-2391(89)90336-4.
