A Modified Approach For Temporomandibular Joint Disc Repositioning And Suturing

To introduce a modified posterior neurovascular bundle (superficial temporal vein) approach of temporomandibular joint (TMJ) disc repositioning and suturing for TMJ disc anterior displacement without reduction and evaluate its immediate clinical outcome. 132 patients (220 joints) were selected in affiliated stomatology hospital of Guangzhou medical University from August 2023 to April 2024. All patients in this investigation were diagnosed TMJ disc anterior displacement without reduction as stage IV-V of TMJ internal derangement according to Wilkes-Bronstein staging system. All patients underwent open surgery for TMJ disc sugical repositioning and suturing using, including 66 cases (116 sides) using the modified retrovascular approach, and 66 cases (104 sides) treated with traditional way (anterior vascular approach). Immediate post surgical evaluation was imaged by TMJ Magnetic Resonance (MR) and facial nerve test was performed. TMJ disc were well reductive in all operations by MR (219/220) and there was no significant difference between two groups at rate of TMJ disc reduction. 57 joints of 220 showed mild limited eyebrow raising after surgery. The rate of facial nerve dysfunction with new approach (16.38%) is lower than 36.54% with the traditional way (p<0.05). The function of facial nerve was well preserved in all patients by using the modified posterior neurovascular bundle approach. TMJ disc repositioning and suturing with posterior neurovascular bundle approach is one of the ideal methods for TMJ open surgery to treat anterior disc displacement.