29804 Arthroscopy, temporomandibular joint, surgical

Name of the Procedure:

Arthroscopy, temporomandibular joint, surgical
(Common name: TMJ Arthroscopy)

Summary

TMJ arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems in the temporomandibular joint, the joint that connects your jaw to your skull. The procedure involves inserting a small camera, known as an arthroscope, into the joint space to visualize, diagnose, and treat various conditions affecting the TMJ.

Purpose

The procedure addresses conditions such as TMJ disorders, which can cause pain, clicking, and limited movement of the jaw. The goals are to reduce pain, improve jaw function, and diagnose the underlying issues within the joint.

Indications

• Chronic TMJ pain unresponsive to conservative treatments
• Suspected internal derangement or structural damage of the joint
• Limited mouth opening
• Inflammatory or degenerative disease of the TMJ
• Persistent jaw locking or clicking

Preparation

• Fasting for at least 6-8 hours prior to the procedure if general anesthesia is used
• Discontinuation of certain medications as advised by the doctor
• Pre-operative diagnostic imaging (such as X-rays or MRIs) to assess the joint
• A thorough medical evaluation and consultation with the surgeon and anesthesiologist

Procedure Description

1. Anesthesia: The procedure is typically performed under general anesthesia.
2. Incision: The surgeon makes a small incision near the ear to insert the arthroscope.
3. Arthroscope Insertion: A small camera is inserted into the joint space to visualize the inside of the TMJ.
4. Diagnosis and Treatment: The surgeon may perform diagnostic evaluations and can also use specialized instruments to remove inflamed tissue, realign the disc, or smooth out irregular surfaces within the joint.
5. Closure: The incisions are closed with sutures, and a sterile dressing is applied.

The procedure might involve additional steps based on the specific needs identified during the surgery.

Duration

Typically takes about 30 minutes to an hour, depending on the complexity of the condition being treated.

Setting

Usually performed in a hospital or an outpatient surgical center.

Personnel

• Oral and Maxillofacial Surgeon or Orthopedic Surgeon specializing in TMJ
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding and swelling
• Nerve damage or numbness
• Scarring
• Anesthesia-related risks
• Pain or stiffness in the jaw that persists

Benefits

• Relief from jaw pain
• Improved jaw function and movement
• Better diagnosis and understanding of the underlying joint issues
• Minimally invasive with quicker recovery compared to open surgery

Recovery

• Post-procedure care includes managing swelling and pain with prescribed medications.
• Soft diet recommended for a few days.
• Avoid strenuous jaw activities.
• Follow-up appointments to monitor healing and remove sutures.
• Expected recovery time is approximately 1-2 weeks, with a gradual return to normal activities.

Alternatives

• Non-surgical treatments such as medications, physical therapy, splints, or mouth guards.
• Open TMJ surgery for more severe cases.
• Pros of alternatives include avoiding surgical risks; cons include possible lesser effectiveness for severe conditions.

Patient Experience

Patients can expect mild discomfort following the procedure, managed with pain relief medications. Some swelling and bruising are normal and should subside within a few days. Detailed post-op instructions are given to ensure a smooth recovery with priority on comfort and safety.