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TMJ Arthroscopy

TMJ Arthroscopy. Brielle Bowyer. Anatomy. Temporalmandibular Joint The articulation between the mandible and the temporal bone. Located just anterior to each ear. Equipment. A video tower Monitor VCR Color Printer Camera Light sourch Bipolar and Regular ESU

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TMJ Arthroscopy

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  1. TMJ Arthroscopy Brielle Bowyer

  2. Anatomy • Temporalmandibular Joint • The articulation between the mandible and the temporal bone. Located just anterior to each ear.

  3. Equipment • A video tower • Monitor • VCR • Color Printer • Camera • Light sourch • Bipolar and Regular ESU • Arthroscopic shaver control unit • Fluid infusion system • Suction

  4. Instrumentation • TMJ instrument set • Small joint shaver • Light Cord • Camera • 0, 30, and 70 degree lenses.

  5. Supplies • Basic pack • Basin • #11 blade • suture • Adhesive bandages • Suction • Head and neck drapes with fluid collection pouch. • Gauze Sponges • Assorted Syringes and 18 gauge needle • Lactated Ringer’s solution.

  6. Operative Prep • Anesthesia • General • Oral or nasal intubation • Position • Supine • Head turned to expose operative side. • Arms tucked at sides to protect ulnar nerves. • Prep • Hair • Removed or restrained. • Skin • Face, chin, and neck are prepped with mild antiseptic. • Draping • Bar drape and U-drapes

  7. Procedure • Time-out • Irrigation solution is injected into the joint space to distend the capsule. • Small stab wound incision is made. • Trochar is inserted and arthroscope inserted. • Irrigation is infused into the joint, which is then examined. • If functional surgery is required, a second stab wound is made. • Final visual inspection performed. • Trochar cannulas are removed and excess fluid is removed. • Wound is closed and dressing is placed. • Procedure may be repeated on contralateral side. • 2 Counts

  8. Post-Op considerations • Post-op care • Range of motion of jaw may be limited. • Extubation may be difficult. • Suction and emergency airway supplies should be available. • Application of ice may help prevent pain and swelling. • Patient may be placed on a soft food, or liquid diet for several days post-op. • Prognosis • Good outcome is expected. • Recurrence is possible if contributing behavior is not resolved. • Complications • Hemorrhage • Infection • recurrence

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