Image-Guided Minimally Invasive Surgical Access to the Temporomandibular Joint: A Preliminary Report
Purpose
To establish a protocol for image-guided minimally invasive surgical access to the temporomandibular joint (TMJ).
Materials and Methods
This study involved 2 patients with TMJ pain and mandibular motion dysfunction. Axial magnetic resonance imaging (MRI) of the TMJ was obtained and loaded into an intra-operative navigation system to guide joint space injection. With a navigated syringe, 1 mL synvisc Hylan G-F 20 was directly injected into the superior and inferior joint spaces under navigation guidance.
Results
With the assistance of an intraoperative navigational system, the TMJ MRI images were visualized in 3 dimensions and enabled guiding a needle into the superior and inferior joint spaces for therapeutic injection. The treatment outcome for both patients was satisfactory with improvement in pain score and mandibular motion.
Conclusions
A protocol for image-guided minimally invasive surgical access to the TMJ was established. This could provide the technical basis for evaluation of accurate joint space intervention as a form of treatment of appropriate TMJ disorders.
⁎Assistant Professor, Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
†Director, Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute; and Assistant Professor, Division of Pediatric Surgery, Department of Surgery, Medical School, The University of Texas Health Science Center at Houston, Houston, TX.
‡Professor, Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Address correspondence and reprint requests to Dr Yeung: Assistant Professor, Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
ABSTRACT