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Arthroscopy for Temporomandibular Joint Disorders

Arthroscopy is a word derived fro the Greek words for "joint" and "examine." It is a type of surgery in which a tiny fiber optic camera and is inserted through a small incision directly into the joint. Because it provides a clearer image of the actual joint space than any other imaging technology, arthroscopy was originally used to diagnose problems in a joint. However, the technique has been refined over the last few years, and surgeons are now able to insert very small surgical instruments through nearby incisions, and to actually perform the surgery by looking at a video image of the joint space on a screen.

While some TMD surgery must still be done using open joint surgery, many or most surgical procedures can now be conducted arthroscopically. For example, arthroscopy can be used to correct many disc displacements, to remove torn or frayed pieces of the cartilage, to repair discs, to perform some menisectomies, or to rinse out the joint space (a procedure called arthrocentesis, or lavage).

Arthroscopy has multiple benefits over open surgery to the joint, because it is much less invasive. Arthroscopic surgery has a lower chance of infection and other post-operative complications, and less post-operative scarring. It also can usually be done as a day procedure. Patients feel less post-operative pain and recover full use of their jaw much more quickly than after open surgery.

Treatment

The surgery takes approximately 3 hours and patients generally go home the same day after a short recovery from the anesthesia. Small (around 3mm) incisions are made over the jaw, through which a tiny fiber optic camera and instruments are inserted directly into the joint. The camera projects an extremely accurate image of the joint onto a screen, and the surgeon uses this image to guide the surgery.

Patients generally experience minimal post-operative pain, and are able to eat and drink right after the surgery. Full recovery may take one to three weeks, during which patients may have to limit their diet to soft foods and to work with a physical therapist.

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