Assessment of Discectomy and Eminectomy for Temporomandibular Joint Derangement: Manitoba Experience

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Manghera, Harmeet
Elgazzar, Reda
Shah, Adnan
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Temporomandibular joint disorder (TMD) is caused by the loss of function of the intra-articular tissues, leading to a failure in the biomechanics of the joint. Non-surgical modalities and less invasive surgical procedures such as arthroscopy are usually employed to manage patients with TMD in their earlier stages of the disease. Many patients respond well to such modalities while others fail to show satisfactory improvement. Hence, they qualify to be treated with more invasive open joint surgery such as arthroplasty. The aim of this study was to assess the surgical outcomes of temporomandibular joint (TMJ) arthroplasty, discectomy and eminectomy for the management of the refractory TMD cases. The retrospective chart review was conducted on TMD patients who were diagnosed and treated with arthroplasty, eminectomy and discectomy at the Health Sciences Centre (HSC) and the Seven Oaks General Hospital (SOGH) between the years of 2011 and 2017. The University of Manitoba Research Ethics Board (REB) provided approval for the project. A data capture sheet was created for data collection. Pre-operative, intra-operative and post-operative information was recorded. Eight (22%) males and 28 (78%) females incorporated the study group with ages ranging from 17 to 68 years with a mean of 40.4 years. The follow up period ranged from 1 to 29 months with a mean of 8.6 months. All patients had adequate recovery after receiving the arthroplasty supplemented with post-operative physiotherapy. Majority of these patients showed a noticeable increase in the range of jaw motion and a reduction in pain. No major complications were reported, a few minor complications were observed including numbness of the ear, transient weakness of the surrounding muscles due to impingement or stretching of the facial nerve and minor scar formation on the skin. The results show that TMJ arthroplasty is an effective and definitive surgery for the treatment of refractory TMD.
TMJ Internal Derangement, TMD, TMJ Arthroplasty, Discectomy, Eminectomy