title: "Bat Wing Surgical Approach for the Temporomandibular Joint".
abstract: BACKGROUND
  The temporomandibular joint (TMJ) is anatomically complex; with its close proximity to neurovascular structures, including the facial nerve that gives a high degree of difficulty during surgical exposure. When the first description on TMJ surgery by Orlow in 1913 was published it gave an account describing the basic retroauricular, preauricular, endoaural and submandibular approaches, on treatment of articular pathologies as used today. The proposed study of the 'Bat Wing' approach, first described in 1993 by Garcia y Sanchez J.M. as a surgical alternative, offers great advantages is that it avoids the section of the ear canal and provides a wide surgical field. The management of the proposed technique has wide application with multiple joints addressed, achieving major objectives such as avoiding facial nerve damage, as well as avoiding the section of the external auditory canal with an optimum visibility of the operative field.
  
  
  METHODS
  The Department of Maxillofacial Surgery National Medical Center XXI Century records over a period of approximately 18 months have completed twenty TMJ surgeries using the 'Bat Wing', approach.
  
  
  CONCLUSIONS
  The bat wing approach is a surgical alternative that offers broad exposure of the surgical field in TMJ, it is effective and meets the goal of exposing the area to intervene safely, good visibility and access to the site to intervene. It perfectly fulfills the above described.
authors.affiliation: Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, "Instituto Mexicano del seguro Social" (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico.
authors.forename: J M
authors.initials: JM
authors.lastname: Garcia Y Sanchez
authors.affiliation: Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, "Instituto Mexicano del seguro Social" (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico.
authors.forename: J
authors.initials: J
authors.lastname: Davila Torres
authors.affiliation: Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, "Instituto Mexicano del seguro Social" (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico.
authors.forename: G
authors.initials: G
authors.lastname: Pacheco Rubio
authors.affiliation: Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, "Instituto Mexicano del seguro Social" (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico.
authors.forename: C L
authors.initials: CL
authors.lastname: Gómez Rodríguez
keywords: Approach; External auditory canal; Facial nerve; Temporomandibular joint