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Inviscision: A Futuristic Alternative to Endaural Incision for TMJ Surgeries.

Ankita Sahal1, Sonal Anchlia1, Jigar Dhuvad1

  • 1Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Ahmedabad, Gujarat India.

Journal of Maxillofacial and Oral Surgery
|August 9, 2024
PubMed
Summary

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The Inviscision technique for temporomandibular joint (TMJ) surgery offers superior aesthetic results and patient satisfaction compared to the endaural incision. While both approaches provide adequate surgical access, Inviscision significantly reduces visible scarring, making it a preferred alternative for TMJ procedures.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Traditional TMJ surgery incisions like preauricular and endaural can result in noticeable scarring.
  • Advancements in surgical techniques aim to minimize facial deformity and improve surgical access.
  • The Inviscision technique offers a potentially scarless alternative for TMJ surgeries.

Purpose of the Study:

  • To compare the Inviscision and endaural incision techniques for TMJ surgery.
  • To evaluate surgical exposure, risk of VII nerve injury, and postoperative aesthetic outcomes.
  • To assess patient satisfaction and scar visibility between the two surgical approaches.

Main Methods:

  • A randomized study of 60 TMJ surgery patients divided into Inviscision (n=30) and endaural incision (n=30) groups.
Keywords:
Endaural incisionInviscisionNerve injuryScarringTMJ surgeries

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  • Assessment of surgical exposure time, nerve injury, scarring, cartilage integrity, and ear deformity.
  • Follow-up for an average of six months, including Likert's patient satisfaction and POSAS scar assessment scores.

    • Main Results:

    • Inviscision scars became invisible within 40 days, while endaural scars remained visible for 35 days.
    • Transient VII nerve weakness occurred in 33% of Inviscision cases and 40% of endaural cases, with full recovery.
    • Inviscision yielded higher patient satisfaction (average 4 vs. 2) and better scar scores (1.5 vs. 3).

    Conclusions:

    • Inviscision provides adequate surgical exposure and avoids critical anatomical structures.
    • The Inviscision technique results in outstanding aesthetic outcomes due to scar concealment within ear folds.
    • Despite slightly longer surgical time, Inviscision is a superior alternative for TMJ surgery based on aesthetic and patient satisfaction parameters.