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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.
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.
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.
