顎関節内障クローズドロック症例に対するパンピング療法，上関節腔洗浄療法および鏡視下剥離授動術の臨床評価

Abstract

We clinically studied 30 patients (34 joints) with closed lock who underwent arthroscopic surgery (lysis and lavage operations) of the superior joint compartment of the temporomandibular joint (TMJ). Arthroscopic surgery was studied as compared with arthrocenthesis and pumping manipulation by double-contrast arthrotomography and magnetic resonance imaging (MRI).The results were as follows:1. There was arthrographic evidence of marked narrowing of the anterior recess and lateral portion, of the upper joint compartment in patients who underwent arthrocenthesis and pumping, whereas narrowing of the posterior compartment and medial portion was found in patients who underwent arthroscopic surgery.2. In patients who underwent arthrocenthesis, MRI showed that anterior disk displacement and disk deformity were severer than after arthroscopic surgery.3. There was arthroscopic evidence of extensive synovitis, and osteoarthrosis and adhesionwere severe in the anterior recess.We found that upper joint arthroscopy of the TMJ was an important additional diagnostic method and that arthroscopy was effective in the diagnosis of synovitis and osteoarthrosis within the superior cavity and permitted the observation of adhesion.