Template-based temporomandibular joint puncturing and access in minimally invasive TMJ surgery (MITMJS) - a technical note and first clinical results

Head Face Med. 2019 Apr 2;15(1):10. doi: 10.1186/s13005-019-0194-8.

Abstract

Background: Minimally invasive temporomandibular joint surgery (MITMJS) is an option for patients suffering from severe internal derangement or adhesions. To improve TMJ access, a workflow to create surgical templates is introduced.

Methods: A workflow to generate a dividable patient specific template based on CBCT and optical scanning to access the joint is introduced. In a first clinical trial 3 patients (6 joints) were treated by way of template-guided endoscopically-assisted TMJ therapy (3 arthrocenteses and 3 arthroscopies).

Results: Generation and clinical use of the templates was as planned. All templates showed perfect fit and permitted instant access to the TMJ. All surgeries were performed without complications.

Conclusions: Template-guidance could improve the feasibility of endoscopically-assisted TMJ therapy. An important issue is the capability to dis- and remount the template during surgery. Using in-house production, costs are affordable.

Trial registration: This study was registered at the Ethic Committee of the Berlin Medical Chamber ( Eth-30/17 , 12/06/2017).

Keywords: Computer-guided surgery minimally invasive temporomandibular joint surgery; Surgical template.

MeSH terms

  • Humans
  • Joint Dislocations*
  • Temporomandibular Joint
  • Temporomandibular Joint Disorders*