Abstract
The present study aimed to trace the arterial blood supply of Tempromandibular joint after open joint procedures using CT volume rendering technique. To achieve this goal six operated joints with residual symptoms radiographed one year post-operatively. Computed tomographic scanning with intravenous contrast, were examined. The direct volume rendering technique of CT images was used, and a data set of images to demonstrate the vasculature of the human Tempromandibular joint in three dimensions. After elaboration of the data through post-processing, the arterial supply of the Tempromandibular joint was compared to reference anatomy. The most commonly injured arteries are anterior tympanic, masseteric, superficial temporal arteries (detection rate 33%, 33%, 50% respectively). Furthermore, osteoarthritic changes, synovial and articular cartilage calcifications with detached bony fragments were noticed that could be attributed to vascular injury. Open joint procedures are associated with significant decrease in arterial supply to TMJ, which could be correlated with osteoarthritic changes noticed later on. The three-dimensional volume rendering technique of computed tomography angiography is an effective non-invasive diagnostic tool; it allows simultaneous evaluation of boney changes and residual vascularity in previously operated joints.
Highlights
The Tempromandibular joint (TMJ) is a ginglymoarthrodial synovial joint consisting of the mandibular condyle, squamous temporal bone, fibrous capsule with accessory ligaments and the synovial membrane
Examining the temporomandibular region form poster lateral view, the External Carotid Artery (ECA) was seen cranially directed and after giving the posterior auricular artery, it curves laterally to run along the posterior ramus till space behind the neck of mandible, ending by dividing two major branches Internal Maxillary Artery (IMA) and Superficial Temporal Artery (STA)
Transverse facial artery (TFA), is seen arising from the STA passing anteriorly disappeared into the parotid gland
Summary
The Tempromandibular joint (TMJ) is a ginglymoarthrodial synovial joint consisting of the mandibular condyle, squamous temporal bone, fibrous capsule with accessory ligaments and the synovial membrane. What makes this joint unique is the articular surfaces are covered by fibrocartilage instead of hyaline cartilage [1]. The superficial MA is located laterally to the lateral pterygoid muscle and with a distance between zygomatic arch and maxillary artery of ≥20 mm. The deep MA is medial to the lateral pterygoid and with a distance between zygomatic arch and maxillary artery of >20mm [2, 3]
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