Atlas of Temporomandibular Joint Surgery

Peter D. Quinn, Eric J. Granquist, Peter D. Quinn, Eric J. Granquist

• Editorial: Wiley-Blackwell
• Año: 2015
• ISBN:
  9781118825259
• Edición: 2
• Categoría: Medicine
• Categoría: Surgery & Surgical Medicine

This second edition of the Atlas of Temporomandibular Joint Surgery is a major revision of Dr. Quinn's classic work, taking into account new procedures, equipment, and evidence-based findings from the latest research in TMJ treatment. Assuming that readers are familiar with non-surgical therapies to correct temporomandibular pain and disorders, Drs. Quinn and Granquist focus on the surgical remedies for disorders that are beyond conservative treatment. This concise, how-to surgical atlas guides both the novice and experienced surgeon through the intra-articular and extra-articular procedures that have proven efficacious in the treatment of advanced craniomandibular dysfunction. Chapters take readers through decision making for TMJ surgery, diagnostic imaging methods, surgical approaches, surgery for internal derangements, trauma, osseous surgical procedures, total joint replacement, and pathologies.

CHAPTER 1
Surgical decision making for temporomandibular joint surgery

Correct diagnosis and surgical planning is the key to successful surgical outcomes. Many controversies exist in the management, indications for surgery, and the correct surgical procedure in temporomandibular joint disease. As a number of interventions and management schemes are currently accepted in the literature, these controversies only serve to complicate decision making in temporomandibular joint surgery for internal derangement, trauma, and management of benign and malignant disorders. Several excellent comprehensive textbooks on temporomandibular joint disorders explore the basis for these controversies and provide a historical and scientific overview of this problematic area of maxillofacial surgery.

The intent of this text is simply to illustrate the technical aspects of the various surgical procedures on the temporomandibular joint. No attempt was made to champion a single approach to temporomandibular joint surgery. Ultimately, only well-designed clinical studies can prove, or disprove, the safety and efficacy of the individual procedures. It is our hope that scientific evidence will one day provide the sine qua non that will dictate the proper role for all the potential surgical modalities, including arthroscopy, meniscal repair, and the use of both autogenous and alloplastic materials in joint reconstruction, and eventually, the use of tissue engineering in the management of temporomandibular joint reconstruction. Although serious mistakes have been made in the management of the temporomandibular joint, surgeons cannot allow the failures of the past to obscure the needs of the future.

This text is based on the assumption that primarily extra-articular conditions are most amenable to nonsurgical care. Patients with true internal derangements may benefit from nonsurgical care, and all these modalities should be exhausted before proceeding with any surgical option. The following algorithms are useful as guidelines but must always be modified according to the needs of the individual patient. These algorithms list only current acceptable surgical techniques for various conditions and make no attempt to advocate one surgical procedure over another one. Because several excellent comprehensive texts dealing with arthroscopic techniques are available, this book deals only with open-joint surgical procedures.

CHAPTER 2
Diagnostic imaging of the temporomandibular joint

Because of the anatomic complexity of the temporomandibular joint (TMJ) and its proximity to the base of the skull, temporal bone, mastoid air cells, and auditory structures, imaging of the joint structures can be problematic. Imaging studies should aid the clinician in diagnosis and surgical planning. The choice of imaging modality should be based on history and physical exam. Consideration should be given to the amount of radiation, invasiveness of the exam, ability to obtain the study, and cost. The study that is able to best answer the clinical question while maximizing cost effectiveness should be utilized.

Plain film, tomograms, and orthopantogram radiography

Plain films, tomograms, and orthopantogram (panoramic) studies provide good osseous detail of the TMJ, with minimal radiation, and are easily obtained. As such, they are often an excellent choice for initial evaluation of TMJ pathology.

Standard transcranial (lateral oblique) views provide a global view of bony architecture of the articular surfaces. If possible, a submental vertex film can be taken to allow the lateral oblique transcranial projection to b...