A modified approach for eminectomy for temporomandibular joint dislocation under local anaesthesia: report on a series of 50 patients

Abstract

Conventional eminectomy for habitual dislocation of the temporomandibular joint is usually performed under general anaesthesia. This technique was modified for use under local anaesthesia to treat medically compromised patients. Fifty elderly patients (90 joints) were treated, for whom general anaesthesia was considered a serious risk due to systemic diseases; the dislocation was habitual in 39 and long-standing in 11. Following intravenous sedation and local anaesthesia, a 2-cm superficial vertical skin incision was made directly above the articular eminence. Careful and gentle dissection of the subcutaneous tissue was performed until the lateral joint capsule was exposed. The superior compartment was entered, followed by shaving of the articular eminence in a conventional manner. The surgery was successful in all patients, with a mean operative time of 47±12minutes. Intraoperative events occurred in 10 patients (20%). Postoperative complications affected 25 patients (50%), varying from severe (two deaths, due to cardiopulmonary arrest and accidental fall) to mild (local infection, etc.). Eleven patients (22%) had facial nerve palsy limited to the temporal branch; all recovered after 6 months. This approach is useful when general anaesthesia is contraindicated due to existing medical conditions. However, prudent consideration may be required to avoid serious complications when local anaesthesia is used.

Inferior repositioning of coronoid process for the treatment of temporomandibular joint subluxation/dislocation

“…The other disadvantages are placement of extraoral incisions resulting in a scar and risk of injury to facial nerve. Segami[5] proposed a modified preauricular approach under local anesthesia which also demonstrated facial palsy in 22% of patients. [5] GTO requires graft which is associated with donor-site morbidity and violates the TMJ architecture.…”

“…Segami[5] proposed a modified preauricular approach under local anesthesia which also demonstrated facial palsy in 22% of patients. [5] GTO requires graft which is associated with donor-site morbidity and violates the TMJ architecture. [5] Modified Leclerc[6] and Wolford's procedures require use of hardwares such as miniplate and screws which are prone for infection and loosening.…”

Efeito Da Terapia Periodontal Sobre Níveis De Glicemia E Perfil Lipídico Em Pacientes Com Periodontite

“…A figura 5 demonstra a manutenção da motricidade dos músculos faciais da paciente, indicando que não houve lesão ao nervo facial em decorrência do acesso cirúrgico. em consonância com dados presentes na literatura, onde a eminectomia se mostrou uma técnica segura, simples, e mais econômica para os pacientes que apresentam recidiva da luxação articular após procedimentos menos invasivos (SEGAMI, 2018;ABRAHAMSSON et al, 2020). Ademais, não houve comprometimento estético relacionado ao acesso cirúrgico e, de igual modo, não se constatou comprometimento da motricidade muscular associada a lesões nervosas.…”

Eminectomy versus eminoplasty for treatment of recurrent temporomandibular dislocation: Randomized controlled clinical trial

“…Since then, eminectomy has been successfully used alone or with other procedure for treatment of recurrent TMJ dislocation. 10,12,13,[16][17][18][19] Partial eminectomy (reduction eminoplasty) has been introduced as a modification of complete eminectomy. In this procedure, the eminence is partially reduced instead of complete removal.…”