Surgery Overview
For arthroscopic jaw surgery, the surgeon inserts a pencil-thin,
lighted tube (arthroscope) into the jaw joint through a small incision in the
skin. The arthroscope is connected to a small camera outside the body that
transmits a close-up image of the joint to a TV monitor.
The surgeon can insert surgical instruments through the arthroscope
to do surgery on the joint, preventing the need for more surgical
incisions. This technique is used to diagnose and treat
temporomandibular disorders (TMD).
During arthroscopic surgery, the surgeon may:
- Remove scar tissue and thickened
cartilage.
- Reshape parts of the jawbone.
- Reposition the
disc.
- Tighten the joint to limit movement.
- Flush (lavage) the joint.
- Insert an anti-inflammatory
medicine.
Procedures are done under
general anesthesia and usually take 30 minutes or
longer depending upon the type of procedure.
What To Expect After Surgery
After surgery, you may start physical therapy within 48 hours in
order to maintain movement and prevent scar tissue from forming. You may also
use a mechanical device that gently moves your jaw joint (continuous passive
motion).
Your jaw movement may be limited for at least a month. And you may
need to follow a diet of liquid and soft foods.
Why It Is Done
Arthroscopy can also be used to flush out the joint (lavage) or to
inject an anti-inflammatory medicine. This can be especially helpful to
people who have TMDs caused by
rheumatoid arthritis.
Arthroscopy can be used to treat TMDs involving:
- Joint disease that causes tissue and bone to
break down.
- Scar tissue (adhesions).
- Cartilage that is
too thick.
- Severe disc problems in the joint.
- A jaw joint that has
loosened over time or after an injury.
This procedure may also be used to diagnose a TMD (diagnostic arthroscopy).
Arthroscopy is not done when there is:
- Swelling in the jaw that has not been
diagnosed.
- Infection (surgery could cause infection to
spread).
- A tumor near the jaw joint. A procedure such as
arthroscopy could cause the tumor to spread
(metastasize).
- Stiffening or fusion of the jawbones (bony
ankylosis).
- An affected joint next to the only ear with which the
person can hear (surgery could accidentally damage the
ear).
- Obesity, making the jaw joint difficult to access under the
skin and fat.
How Well It Works
Arthroscopy is a minimally invasive surgery that can effectively treat TMDs. An arthroscopic surgery can effectively treat a TMD with fewer and less severe complications compared with an open-joint surgery.footnote 1
Risks
Complications of arthroscopic temporomandibular surgery are
uncommon but include:
- Outer, middle, or inner ear damage.
- Temporary
or permanent hearing loss.
- Temporary nerve
damage.
- Joint infection.
Any surgical changes to the bone and soft tissue are irreversible
and can create new problems in the joint's delicate balance. Scar tissue
results from surgery that involves muscles, tendons, and ligaments and is
likely to restrict jaw movement to some extent.
What To Think About
When possible, a nonsurgical approach is preferred over surgery,
because the treatment is cheaper, safer, noninvasive, and involves less risk of
permanent damage.
Current practice trends are to avoid altering disc position or
structure. After disc replacement, an adverse reaction to an artificial disc
is possible.
If your doctor recommends surgery, experts agree that
it is best to get a second opinion.
- Temporomandibular Disorder: Should I Have Surgery for Jaw Pain?
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Tucker MR, et al. (2008). Management of temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp. 629-649. St. Louis: Mosby Elsevier.
Credits
ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Tucker MR, et al. (2008). Management of temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp. 629-649. St. Louis: Mosby Elsevier.