Endoscopic-Assisted Repair of Spontaneous Temporomandibular Joint Herniation Through a Transcanal Approach

Abstract

Objective: To report of the presentation, diagnosis, and management of a spontaneous temporomandibular joint (TMJ) herniation. Patients: A 69-year-old man with a spontaneous TMJ herniation. Interventions: Diagnostic evaluation and surgical approaches. Main Outcome Measures: Imaging, and medical and surgical treatment outcomes. Results: At 14 months follow-up, the patient reported improved tinnitus and on examination there was no evidence of a hypertrophic scar or canal stenosis, no recurrence of TMJ herniation, no signs of otorrhea, otalgia; and with normal TMJ function. Conclusions: The advantages of repairing spontaneous TMJ herniation through a transcanal approach using oto-endoscopy include a high definition video of surgical field, minimal invasiveness, and good postoperative cosmetic outcome.

Temporomandibular Joint Herniation as a Cause of Objective Tinnitus

“…Xie et al mentioned a new endoscopic-assisted approach, while the others performed preauricular or end-aural open approach. 7 The presented case did not accept any surgical procedure.…”

“…Twelve of them had objective tinnitus. 7 Twenty-seven of them were performed a surgical procedure, especially grafting with tragus cartilage. Additionally; fascia, polipropylen plate, au- tologous bone and titanium mesh were also used for repairing in the literature.…”

Temporomandibular joint herniation into the middle ear: A rare cause of mastication-induced tinnitus

“…A radiological study demonstrated that the incidence of persistent FT was estimated between 4.5% and 17.9% [4,14], and the average size of the foramen was 2.7 mm and 3.0 mm in the coronal and sagittal planes, respectively [5]. Although persistent FT is usually asymptomatic, necessitating no further treatment, surgical closure of bony defect may be required in symptomatic cases [3,7,8,15]. Spontaneous TMJ herniation as a complication of persistent FT has been reported only about 30 cases in the English literature [2], [3], [4], [5],[7], [8], [9], [10], [11], [12], [13], [14], [15], and the “herniation” occurred into the EAC in all of the cases.…”

“…Foramen tympanicum (FT), or foramen of Huschke results from a defect in normal ossification of the tympanic portion of the temporal bone, and serves as a communication route between the external auditory canal (EAC) and infratemporal fossa. Although closure of FT normally occurs during the first 5 years after birth, rarely persistent FT may lead to herniation of the temporomandibular joint (TMJ) tissue into the EAC, causing symptoms including tinnitus, conductive hearing loss and otalgia [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13].…”

Robotic and Microrobotic Tools for Dental Therapy

“…Dentists can also use robotic and microrobotic tools for nerve repair, which is challenging to operate without magnification [83]. Endoscopic surgery of the temporomandibular joint is becoming an important research direction in treating the temporomandibular joint [84,85].…”