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Navigation-based access to the temporomandibular joint using a flexible needle: a cadaver study.
M L Linderkamp1, F Tavassol2, P Jehn1
1Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
International Journal of Oral and Maxillofacial Surgery
|March 18, 2026
Summary
Optical navigation for temporomandibular joint (TMJ) punctures is accurate, with a mean deviation of 2.83 mm. This technique successfully punctured the joint space in all cases, proving its validity for TMJ procedures.
Area of Science:
- Medical Imaging
- Surgical Navigation
- Orthopedics
Background:
- Optical navigation is an underutilized technique for temporomandibular joint (TMJ) punctures.
- Flexible cannulas can reduce accuracy in navigated TMJ punctures.
Purpose of the Study:
- To evaluate the accuracy of navigation-guided TMJ punctures using a flexible cannula.
- To assess the feasibility of optical navigation for TMJ interventions.
Main Methods:
- A navigation cone-beam computed tomography (CBCT) scan was used to plan the puncture trajectory.
- Thirty punctures were performed on six human TMJs from three donors.
- Post-puncture CBCT scans determined the deviation of the cannula tip from the planned trajectory.
Main Results:
- The mean deviation of the cannula tip from the planned position was 2.83 mm.
- 100% of the joint spaces were successfully punctured.
- Navigation-assisted puncture demonstrated high accuracy and success rates.
Conclusions:
- Navigation-assisted puncture is a valid and practical method for TMJ punctures.
- Optical navigation is suitable for complex TMJ cases or training due to technical demands and cost.
- Further adoption may be limited by higher costs and technical complexity compared to traditional methods.
