A Novel Technique for Surgical Reduction of Long-standing Temporomandibular Joint Dislocation

Abstract

Introduction: The dislocation of the temporomandibular joint (TMJ) typically occurs when the mandibular condyle becomes displaced out of the glenoid fossa. Long-standing TMJ dislocation may rarely be treated by conventional methods of closed reduction, thus needing surgical intervention ranging from various indirect traction techniques to direct exposure of the TMJ. Aim: This article aimed at bringing into attention of the scientific community a new surgical technique for the management of long-standing TMJ dislocation. Materials and methods: A surgical technique of reducing longstanding TMJ dislocation dubbed as the "Shabani maneuver" has been described. The technique utilizes an externally applied force by physician/surgeon at the mandibular notch which is accessed through a preauricular incision. After making the incision, the mandibular notch is accessed and a Warwick-James elevator is then directed at the notch. An inferiorly directed force is applied once the instrument is secured around the notch and with a combination of conventional method, the condylar head is reduced back to the glenoid fossa. Results: A total of 20 patients with long-standing TMJ dislocation were treated using the technique described. Out of those, 19 patients (95%) were successfully treated. The age range of the patient was between 19 and 81 years with a mean age of 37.75 ± 18.12 years. Yawning was the common cause for dislocation (65%). The mean duration of dislocation was 3.6 months, with the commonest reason for delay in treatment seeking being poverty. Conclusion: This invasive surgical technique is useful where conventional approaches have been tried and proved futile in multiple attempts to reduce long-standing cases of TMJ dislocation. Clinical significance: By describing a new and novel surgical technique for the reduction of long-standing TMJ dislocation, this study promotes its use in clinical practice, especially in settings of developing countries where due to low socioeconomic status, accessibility to operating theater is limited.

Chronic Protracted Dislocation of Temporomandibular Joint in a Trauma Patient - A Case Report

“…[ 8 ] Protracted TMJ dislocation may rarely be treated by conventional methods of closed reduction, but most need surgical intervention. [ 9 ] Surgical treatment including ones like the indirect traction and direct approach involved open-joint surgery. Additional procedures in unsuccessful cases may include extraarticular orthognathic techniques to correct malocclusion or TMJ replacement.…”