Advancements in Temporomandibular Joint Arthroscopy: Refinements in Surgical Techniques for Treating the Superior Joint Spaces

This study introduces a novel technique for arthroscopic surgery of the temporomandibular joint (TMJ), developed by the first author. Traditional TMJ arthroscopy techniques typically utilize a reference plane extending from the lateral canthus to the tragus, which may misalign with the zygomatic arch and create technical challenges during percutaneous joint access. The proposed method addresses these limitations by leveraging coronal and sagittal tomographic measurements alongside 3-dimensional reconstructions to determine precise and anatomically appropriate entry points. The inclusion of a 3-port video arthroscopy system enhances intraoperative visualization and access to the superior joint spaces. Compared with conventional techniques, this refined method demonstrates increased procedural efficiency, improved safety, simplified technical execution, and enhanced reproducibility. Detailed procedural steps are presented, supplemented with illustrative diagrams to ensure clarity and replicability. This innovative approach significantly advances surgical maneuverability, allowing for a comprehensive assessment and treatment of the glenoid fossa, condyle, and articular disc while minimizing the risk of iatrogenic complications often associated with traditional techniques.