The minimally invasive arthroscopic anterior myotomy in the treatment of internal derangement of the temporomandibular joint. A detailed description of the surgical technique - 13/05/20

Doi : 10.1016/j.jormas.2020.04.006

M.F. Muñoz-Guerra ^a,^b,⁎ , F.J. Rodríguez-Campo ^a, V. Escorial-Hernández ^a, P.J. Brabyn ^a, M. Fernández-Domínguez ^b, L. Naval-Gías ^a
^a Department of Oral & Maxillofacial Surgery, University Hospital La Princesa (Autónoma University), Madrid, Spain
^b Department of Oral & Maxillofacial Surgery, University Hospital Montepríncipe San Pablo CEU University, Madrid, Spain

^⁎Corresponding author at: Department of Maxillofacial Surgery, Hospital La Princesa, c/Diego de León, 62, 28006 Madrid, Spain.Department of Maxillofacial Surgery, Hospital La Princesac/Diego de León, 62Madrid28006Spain

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Abstract

Purpose

The aim of this report is to define a modification of the arthroscopic anterior myotomy that avoids disc suturing procedures for the treatment of advanced internal derangement (I D) of the temporomandibular joint (TMJ).

Surgical technique

The minimally invasive arthroscopic anterior myotomy (MIAAM) is based on a partial resection of the superior belly of the lateral pterygoid muscle performed through a small incision of the articular capsule associated with a scarification of the posterior ligament of the TMJ. The high-frequency wave system, called Coblation, is extremely useful to be able to complete the MIAAM.

Conclusion

This technique is indicated for patients with ID and Wilkes stages III–IV without response to conservative treatments, and the presence of an integral disc with an appropriate consistency is transcendent for the success of the procedure. Because of the unique characteristics of the MIAAM, it can be considered as an alternative to arthroscopic discopexy procedures.

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Keywords : Temporomandibular joint, Disc repositioning, Surgical arthroscopy