악관절경수술로 치험한 악관절내장증환자의 분석

Analysis on the therapeutic success on TMJ arthroscopic surgery

The therapeutic use of TMJ arthroscopy is discussed in many articles, but few address the therapeutic success of this surgical procedure. This study evaluated the therapeutic success of TMJ arthroscopies performed over a year period at Yonsei University Youndong Severance Hospital. Sixty-five TMJ arthroscopic lysis and lavage procedures of the superior compartment of fifty-one patients were reviewed. Seven males and Forty-four females underwent the procedure. Several different factors were used to access therapeutic success. These factors included: pain, noise, mobility, duration of symptoms, clinical diagnosis, and symptoms at longest follow up. Success was determined by minimal or no post-operative pain and increased or normal mobility. No pain of minimal pain was found in 75%(27/36) of the joints that underwent arthroscopic surgery. 16.7%(6/36) of the painful joint did not improved and 8.3%(3/36) developed a disease. The success of mobility was based on maximal incisal opening. 95.2%(20/21) of patients who suffered their hypomobility, achieved an increase in their maximum opening, and 4.8%(1/21) remained unchanged. 40%(8/20) with previous joint noise had no post operative noise, 55%(11/20) decreased significantly, and 5%(1/20) continued noise. The duration of symptoms prior to surgery were analyzed and compared with the post-operative result. Of significance was the 86.4% success rate in those patients treated in 3 years of onset of symptoms, on the other hand the 58.1% success rate over 3 years. In case of anterior disc displacement with reduction had better results(93.8%) compared to anterior disc displacement without reduction(68.8%). Arthroscopic surgery was shown to be an accepted therapeutic method for improving TMJ pain, mobility and decreasing joint noise. It was also found that the success of an arthroscopic procedure remained stable. Some post-operative complaints occurred, post-operative edema, ear bleeding, slight paresthsia of facial nerve. All these complaints resolved. This study shows arthroscopy to be a low risk very successful surgical procedure in improving TMJ pain, mobility and decreasing in joint noise.