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A Minimally Invasive Approach for Temporomandibular Joint Replacement: A Pilot Study.

Daniel E Perez¹, Adam Wandell², Jason P Jones²

¹Associate Professor and Program Director, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons

|August 28, 2021

Summary

A novel endaural incision technique for temporomandibular joint replacement (TJR) shows promise. This minimally invasive approach resulted in quicker recovery and reduced operating time, though with longer-lasting facial nerve weakness in a pilot study.

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Area of Science:

Oral and Maxillofacial Surgery
Orthopedic Surgery
Biomedical Engineering

Background:

Temporomandibular joint replacement (TJR) using alloplastic devices is established.
Traditional TJR typically involves two incisions.
Minimally invasive techniques aim to reduce surgical morbidity.

Purpose of the Study:

To describe and evaluate a novel technique for TJR using only an endaural incision.
To compare the outcomes of this novel technique with traditional TJR.

Main Methods:

A pilot study involving 4 patients (8 temporomandibular joints) undergoing TJR with an endaural incision alone.
Assessment of maximal interincisal opening and subjective pain/disability at multiple time points.
Comparison of operative time and complications with a matched control group using traditional TJR.

Main Results:

No major complications in either group; all patients discharged on postoperative day 1.
Endaural incision group showed increased maximal interincisal opening and faster subjective pain relief.
Endaural incision group experienced less operative time but longer-lasting CN VII weakness.

Conclusions:

The endaural incision alone technique for TJR is a successful minimally invasive approach for select patients.
This technique may decrease morbidity associated with additional incisions.
Further investigation is warranted for this promising TJR approach.