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How invasive is TMJ double-contrast arthrography in combination with cinematography? Patient discomfort versus known
1Department of Maxillo-Facial Surgery, University of Zürich/Switzerland.
Abstract:
There is no doubt that double-contrast TMJ fluoroscopic tomography enables a differential diagnosis and treatment in internal derangement pathosis. Its indication is, apart from the expected diagnostic gain, also determined by the degree of its invasiveness, and other alternative diagnostics being available (nuclear magnetic resonance). Data on patient discomfort and complications were gathered in 63 arthrotomographies; pain sensations and mandibular mobility, during and after the procedure in particular, were studied. We consider, along with Westesson, the procedure to be less invasive than commonly considered, once the surgeon-radiologist has gained enough experience.
Insights
Double-contrast temporomandibular joint (TMJ) fluoroscopic tomography is effective for diagnosing internal derangements. Patient discomfort is minimal, especially with experienced practitioners, making it a viable diagnostic tool.
Area of Science:
- Radiology
- Orthodontics
- Maxillofacial Surgery
Background:
- Internal derangement of the temporomandibular joint (TMJ) requires accurate diagnosis.
- Diagnostic imaging plays a crucial role in evaluating TMJ pathosis.
- Alternative imaging modalities like nuclear magnetic resonance exist.
Purpose of the Study:
- To evaluate the efficacy of double-contrast TMJ fluoroscopic tomography for differential diagnosis of internal derangement.
- To assess patient discomfort and complications associated with the procedure.
- To compare the invasiveness of the procedure with alternative diagnostic methods.
Main Methods:
- A study involving 63 arthrotomographies was conducted.
- Data on patient discomfort, pain sensations, and mandibular mobility were collected.
- Fluoroscopic tomography with double contrast was the primary imaging technique used.
Main Results:
- Double-contrast TMJ fluoroscopic tomography facilitates differential diagnosis and treatment planning for internal derangements.
- Patient discomfort and complications were evaluated, with findings suggesting the procedure is less invasive than often perceived.
- Experienced surgeon-radiologists contribute to a less invasive procedure.
Conclusions:
- Double-contrast TMJ fluoroscopic tomography is a valuable tool for diagnosing TMJ internal derangements.
- The procedure's invasiveness is manageable, particularly with experienced operators.
- The diagnostic benefits should be weighed against invasiveness and availability of alternatives like MRI.