Advantages of ultrasound guidance for TMJ arthrocentesis and intra-articular injection: A narrative review

Nordenflycht, Diego De; Tesch, Ricardo de Souza

doi:10.17219/dmp/146820

Cited by 10 publications

(6 citation statements)

References 42 publications

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“…Ultrasonography is a minimally invasive diagnostic tool known for its effectiveness in diagnosing soft tissue structures. Additionally, it can enhance the precision of invasive treatments like muscle injections or arthrocentesis [ 44 ]. Compared to MRI or enhanced CT, ultrasonography is slightly inferior in detecting the extent of fascial space infections, and it cannot detect deep space abscesses such as parapharyngeal abscesses [ 4 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Orofacial fascial space abscess disguised as temporomandibular disorder: a report of 3 cases and literature review

Kim,

Lee

2024

BMC Oral Health

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Fascial space abscess is a condition in which infections spread into fascial spaces. It is a severe and life-threatening disease unless treated at an early stage. Due to the similarity of clinical symptoms, fascial space abscesses in the orofacial area are often disguised as other diseases, such as temporomandibular disorder (TMD). In this case series, we report three cases of fascial space abscesses disguised as TMD. In all cases, patients complained of severely limited mouth opening and pain in the temporomandibular joint (TMJ) and masseter muscles, which led clinicians to diagnose them with TMD. After two patients showed facial swelling and the third complained of dyspnea, clinicians realized the possibility of an orofacial fascial space abscess. On further evaluation, all patients showed increased C-reactive protein in blood tests, and the location of the fascial space abscess was confirmed by enhanced computed tomography images. Moreover, all patients had suspicious sources of odontogenic infections in panoramic images, periapical abscess on maxillary molars and periodontal disease on maxillary and mandibular molars, which were not appropriately evaluated at the first visit. This case series emphasizes the need for clinicians to realize the possibility of orofacial fascial space abscesses based on: clinical symptoms of severely limited mouth opening (< 15 mm) with pain in the facial area, including TMJ or masseter muscle, and possible sources of infection such as odontogenic infection, other infectious lesions, trauma, or invasive treatments. These clinical insights will enable the early detection of fascial space abscesses.

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Section: Discussionmentioning

confidence: 99%

Orofacial fascial space abscess disguised as temporomandibular disorder: a report of 3 cases and literature review

Kim,

Lee

2024

BMC Oral Health

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“…In order to solve this difficulty, image guide or assistance seem promising, specifically with US. US‐guided procedures on the TMJ have not reported to be superior than conventional techniques in terms of pain relief or MMO improvement, 40,41 but instead it allows reduced needle manipulations and reduced operating time, 42 minimises trauma, improves the accuracy and efficiency of injections, provides easier access to both joint spaces and has a significantly higher success rate when lower joint space injection is attempted 17 . Non‐patient‐based studies on IJS injection guided 29,32 or checked 34 with US have well established the technique but clinical trials that demonstrate its efficacy are still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the aforementioned review reports on studies that used an anatomical (or blind) technique of injection, whose effectiveness for locating the needle in the IJS has not been completely proven in cadaveric or imaging studies without any image guidance. Nevertheless, recent evidence suggests that real‐time imaging guidance (such as ultrasound) may improve the outcome of minimally invasive procedures, especially when targeting the IJS 17 . It is noteworthy that positioning the needle in the IJS during intra‐articular injections appears to have a greater surgical complexity because of the smaller volume and ‘hidden’ location of the IJS, 15 and the lack of bone support to limit needle penetration may increase the probability of perforating the articular disc.…”

Section: Introductionmentioning

confidence: 99%

Intra‐articular injections in the TMJ inferior joint space: A scoping review

Nordenflycht

Ayala

Orellana

et al. 2023

J of Oral Rehabilitation

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ObjectiveTo perform a scoping review to identify the available evidence regarding intra‐articular injections in the inferior joint space (IJS) of the temporomandibular joint (TMJ).MethodsAn electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: “Arthrocentesis”, “injection”, “joint injection”, “technique”, “Temporomandibular joint”, “Temporomandibular joint disorder”. Full‐text articles were obtained from the records after applying the inclusion/exclusion criteria. Only articles with full‐text access were included.ResultsThirteen articles were included for analysis—one technical note, three cadavers studies, one animal study, two case reports, five randomised clinical trials and one retrospective study; studies were classified as ‘patients‐based studies’ and ‘non‐patients‐based studies’. Most ‘patients‐based studies’ show moderate or high risk of bias. Techniques were categorised as ‘anatomical technique’ and ‘image‐guided technique’. Most ‘patients‐based studies’ show favourable outcomes such as pain reduction, increase in maximum mouth opening, improvement in quality of life and improvement in TMJ dysfunction indexes for the treatment of arthrogenic TMDs. Comparisons between superior and IJS injections are scarce. On the other hand, ‘non‐patients‐based’ studies show that image‐guided or ultrasound‐checked injection techniques achieved a higher effectiveness for needle location than anatomical (or blind) techniques.ConclusionThe amount of available evidence is scarce, heterogeneous in design, and most ‘patients‐based studies’ show moderate or high risk of bias, which demands the generation of new research to obtain definitive conclusions. The tendency observed suggests that intra‐articular injections for the IJS of the TMJ are able to relieve TMJ pain, increase mouth opening and improve TMJ dysfunction, and image‐guided injection techniques seem to be more effective than anatomical techniques to locate the needle in the IJS.

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“…Ultrasound is a non-invasive examination method. 4 After consulting relevant literature, we found some studies on observing the upper eyelid at all layers by ultrasound. [5][6][7] In order to objectively evaluate the effect of removing loose pretarsal fat fascia and orbital septum double eyelid blepharoplasty, we conducted preoperative and postoperative research on congenital single eyelid patients who underwent double eyelid blepharoplasty with the orbital septum method at the Plastic and cosmetic surgery department of Hunan provincial people's hospital from December 2019 to February 2022.…”

Section: Introductionmentioning

confidence: 99%

“…For this question, we got the answer by observing and comparing the differences between single eyelid and double eyelid at pretarsal fat layer. Ultrasound is a non‐invasive examination method 4 . After consulting relevant literature, we found some studies on observing the upper eyelid at all layers by ultrasound 5–7 .…”

Section: Introductionmentioning

confidence: 99%

Ultrasound‐based histological differences of pretarsal fat fascia before and after double eyelid blepharoplasty with the orbital septum method

Chen

Long

Luo

et al. 2023

J of Cosmetic Dermatology

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ObjectiveTo observe the changes of pretarsal fat fascia histological structure after double eyelid blepharoplasty with the orbital septum method.MethodsFrom December 2019 to February 2022, the patients with congenital single eyelid who underwent double eyelid blepharoplasty with the orbital septum method at the Plastic and cosmetic surgery department of Hunan provincial people's Hospital and the same number of congenital double eyelid volunteers. Then divided into three groups: preoperative eyelid ultrasound images in Group A, postoperative eyelid ultrasound images in Group B, and congenital double eyelid volunteers in Group C. To study the histological differences of pretarsal fat fascia before and after double eyelid blepharoplasty with the orbital septum method and congenital double eyelid by ultrasound.ResultsNinety‐eight patients who underwent double eyelid blepharoplasty with the orbital septum method met the inclusion criteria. All 98 patients aged 22.88 ± 3.00 years, including 7 males and 91 females, followed up for 6–12 months. Included 98 volunteers with congenital double eyelid, aged 23.58 ± 2.59 years, including 49 males and 49 females. Ultrasound showed that the pretarsal fat fascia was divided into two layers. The dense layer adhered closely to the surface of the tarsus with no statistically significant differences. There was a statistically significant difference in the thickness of the pretarsal loose fat fascia layer between Group A and B. The points a b c in Group A were significantly thicker than those in Group B and C, and there was no significant difference between Group B and C. Postoperative evaluation: 83 cases were satisfied, 11 cases were basically satisfied and 4 cases were unsatisfied.ConclusionAfter double eyelid blepharoplasty using orbital septum, the histological structure of pretarsal fat fascia is similar to that of congenital double eyelid, suggesting that double eyelid blepharoplasty with the orbital septum method can change the structure of pretarsal fat fascia and make it similar to congenital double eyelid, which is one of the anatomical bases for its good clinical effect.

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Advantages of ultrasound guidance for TMJ arthrocentesis and intra-articular injection: A narrative review

Cited by 10 publications

References 42 publications

Orofacial fascial space abscess disguised as temporomandibular disorder: a report of 3 cases and literature review

Orofacial fascial space abscess disguised as temporomandibular disorder: a report of 3 cases and literature review

Intra‐articular injections in the TMJ inferior joint space: A scoping review

Ultrasound‐based histological differences of pretarsal fat fascia before and after double eyelid blepharoplasty with the orbital septum method

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