Evaluation Following Temporomandibular Joint Arthroscopy With Lysis and Lavagea Pilot Non-Randomised Study

Abstract

BACKGROUND Temporomandibular joint disorders are characterised by disturbance of mouth opening, TMJ pain and noise (clicking). The involvement of dislocation and deformation of the disc and the formation of adhesive lesions in the temporomandibular joint cavity are characteristic of this disease. With the development of the small endoscope, arthroscopy is now used for both examination and treatment of temporomandibular joint disorders. The objective of this study was primarily aimed at investigating the efficacy of arthroscopic lysis and lavage and examination of the temporomandibular joint in patients having pain and clicking sound in temporomandibular joint. MATERIALS AND METHODS In this pilot, non-randomised study patients with symptoms of TMJ disease were included. Preoperative evaluation including complete history with physical examination of patients along with relevant radiograph and/or CT scan/MRI was done. Routine investigations were done. The treatment plan was carried out through Arthroscopic examination and lysis and lavage of temporomandibular joint. Patients were operated either under general anaesthesia (nasotracheal intubations) or local anaesthesia. Proper medication, physical therapy and diet were advised to patients. Outcomes were measured using pain reduction in preauricular region, reduction in clicking/grating joint sound, maximal interincisal opening, deviation of mandible and disability improvement. Patients were followed at post-operative day-1, week-1, week-2, week-4, week-8 and week-12. RESULTS Out of a total of six patients, arthroscopic lysis and lavage reduced pain and increasing mandibular range of motion in approximately 83% of patients. Patients aged between 20-30 years were the predominant age group presenting with complaints of pain clicking sound in temporomandibular joint. Females (66.6%) were most commonly affected with pain clicking sound in temporomandibular joint. CONCLUSION Arthroscopic lysis and lavage is efficacious treatment modality for patients suffering and from pain clicking sound in temporomandibular joint. However, studies with larger sample size are necessary to corroborate the findings of the present study for their wider use in clinical practice.