Image-guided minimally invasive surgical access to the temporomandibular joint: A preliminary report.
OBJECTIVE
To establish a protocol for image-guided minimally invasive surgical access to the temporomandibular joint (TMJ).


METHODS
This study involved 2 patients with TMJ pain and mandibular motion dysfunction. Axial magnetic resonance imaging (MRI) of the TMJ was obtained and loaded into an intra-operative navigation system to guide joint space injection. With a navigated syringe, 1 mL synvisc Hylan G-F 20 was directly injected into the superior and inferior joint spaces under navigation guidance.


RESULTS
With the assistance of an intraoperative navigational system, the TMJ MRI images were visualized in 3 dimensions and enabled guiding a needle into the superior and inferior joint spaces for therapeutic injection. The treatment outcome for both patients was satisfactory with improvement in pain score and mandibular motion.


CONCLUSIONS
A protocol for image-guided minimally invasive surgical access to the TMJ was established. This could provide the technical basis for evaluation of accurate joint space intervention as a form of treatment of appropriate TMJ disorders.
Yeung
Richie W K
RW
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China. rwkyeung@hkusua.hku.hk
Xia
James J
JJ
Samman
Nabil
N
D000328:Adult; D005157:Facial Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D021621:Imaging, Three-Dimensional; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010865:Pilot Projects; D025321:Surgery, Computer-Assisted; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000601:surgery*
D006820:Hyaluronic Acid