Success rates and complications of eminectomies: a retrospective case series

Abstract

Introduction: Eminectomy is the physical removal of the articular eminence to enable free movement of the condyle. The primary indication is to treat recurrent dislocation, although in the past it has been used for non-reducing disc displacement without reduction (NDDR). The established contraindication to the procedure is pneumatisation of the articular eminence or tubercle. Determining the success rates of eminectomies from previous papers are hampered by the lack of baseline objective measures needed to improve assessment of treatment outcomes. Methodology: A retrospective case series was conducted, in which written and computerised hospital records and images were analysed from 2007 to 2014, using a minimum data set developed by our unit to assess outcomes. These included indication for procedure, frequency of dislocation, interincisal distance, pre-operative imaging and objective pain scoring. Results: Twenty of twenty-eight (71%) patients receiving an eminectomy conformed to the minimum data set. Pain improvement was demonstrated in 60% of patients with both recurrent dislocation and NDDR. Complications occurred in 24% of eminectomies, all of which were temporary. Conclusions: Eminectomy is a safe and effective procedure for management of chronic temporomandibular joint dislocation in wellselected cases. However, the results were less predictable with NDDR. The recording of specific clinical information is required to improve comparing outcomes and we would recommend the use of a proforma such as one utilised in our study. There was no evidence that pneumatisation of the eminence was related to an adverse clinical outcome but further evidence is required to question this as a contraindication to eminectomy.

Is Eminectomy Effective in the Management of Chronic Closed Lock?

“…The contraindications for eminectomy are widely discussed in the literature [16]. There are a number of relative contraindications including chronic mandibular dislocations associated with a shallow articular eminence and radiographic evidence of a vascularised eminence [16].…”

“…The contraindications for eminectomy are widely discussed in the literature [16]. There are a number of relative contraindications including chronic mandibular dislocations associated with a shallow articular eminence and radiographic evidence of a vascularised eminence [16]. A single, absolute contraindication to eminectomy has been noted where, in the presence of pneumatisation of the articular eminence, there is an increased risk of intracranial spread of inflammation along with an increased risk of temporal bone fracture [17].…”