Image-guided minimally invasive surgical access to the temporomandibular joint: A preliminary report

J Oral Maxillofac Surg. 2006 Oct;64(10):1546-52. doi: 10.1016/j.joms.2005.10.039.

Abstract

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.

MeSH terms

  • Adult
  • Facial Pain / etiology
  • Facial Pain / surgery*
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Imaging, Three-Dimensional
  • Injections, Intra-Articular
  • Magnetic Resonance Imaging
  • Minimally Invasive Surgical Procedures / methods*
  • Pilot Projects
  • Surgery, Computer-Assisted*
  • Temporomandibular Joint / surgery*
  • Temporomandibular Joint Disorders / complications
  • Temporomandibular Joint Disorders / surgery*

Substances

  • Hyaluronic Acid