What is Arthroscopic TMJ Surgery?
The temporomandibular joint (TMJ) is a joint between the jaw bone (mandible) and the skull. It is a hinge joint that is present on either side of the head and enables movement of the jaw allowing you to talk, chew, etc. Arthroscopic TMJ surgery is a minimally invasive procedure in which a thin, illuminated tube called an arthroscope is inserted into the TMJ to view and treat its structures.
Indications for Arthroscopic TMJ Surgery
Arthroscopic surgery may be recommended for the treatment of TMJ disorders due to rheumatoid arthritis or degenerative joint disease causing pain and stiffness of the TMJ. Other disorders include abnormal loosening of the TMJ, and problems with the disc of the joint. Surgery is indicated when symptoms are severe or worsening and conservative treatments fail to provide adequate relief.
Symptoms of TMJ disease that may necessitate surgical intervention include:
- Intense, continuous pain and tenderness while opening or closing the mouth
- Limited jaw movement
- Difficulty with eating
- Structural abnormalities that affect jaw function
Contraindications of TMJ Surgery
TMJ surgery is avoided if there is
- Swelling or infection in the joint
- A tumor in the region
- Fusion of the TMJ
- Only one functioning ear on the same side
- Obesity that can make access to the TMJ difficult
Benefits of Arthroscopic TMJ Surgery
TMJ arthroscopy is a minimally invasive procedure associated with:
- Less postoperative pain
- Faster recovery
- Lower rate of complications
Procedure for Arthroscopic TMJ Surgery
TMJ arthroscopy is performed under general anesthesia. A small incision is made over the TMJ and the arthroscope is inserted into the joint. Special instruments are then introduced along with the arthroscope. The arthroscope is connected to a camera and an enlarged view of the joint is displayed on a monitor. Your doctor views the inside of the joint and maneuvers the instruments while looking at the monitor. TMJ surgery may involve:
- Lavage (flushing) of the joint
- Injection of an anti-inflammatory medication
- Removing scar tissue
- Repositioning or replacing the disc of the joint
- Correcting the shape of the jaw bone
- Tightening the joint to improve stability
Following the procedure, the instruments are removed and the incision is closed. A bandage is placed over the wound. The entire procedure may take 30 minutes or longer depending on the operation performed and you can return home the same day.
Postoperative Care for TMJ Surgery
Following surgery, physical therapy will be recommended to promote movement of the jaw and prevent the formation of scar tissue. You will be placed on a soft diet and may experience some pain and limitation of jaw movement for a while. Application of an ice pack can help relieve the discomfort and your doctor will also prescribe medications for pain control.
Risks Associated with Arthroscopic TMJ Surgery
As with any procedure, TMJ arthroscopy may be associated with certain risks and complications including:
- Infection of the joint
- Damage to the external or internal ear
- Hearing loss
- Nerve damage
- Injury to the parotid gland