Use of reciprocating rasp in articular eminectomy

Abstract

We use a modified Al-Kayat and Bramley incision with extension through the temporalis fascia to allow adequate minectomy was first described by Myrhaug1 in 1951 for he treatment of habitual dislocation of the mandible. It s now a well established technique for recurrent disloation or subluxation and has been described for internal erangement.2 Baumstark et al. suggested that eminoplasty lone is sufficient for hypermobility cases,3 but if the disc equires decompression then eminectomy is better to reduce mpingement.4 Traditionally eminectomy is done using drills and chisels. ccess to the medial aspect of the eminence can be hazrdous because of the close proximity of the great vessels s they enter the base of the skull. For this reason we use micro reciprocator rasp (ConMed Linvatec, Largo, USA) s a saw attachment (Fig. 1). The smooth, rounded edge can e safely used deep in the infratemporal fossa to remove the uperomedial bone and achieve a good reduction of the entire minence without the risk of damaging vital structures. The elatively broad and flat working surface also prevents the isk of intracranial perforation. We have used this technique or a number of years and surgeons now familiar with the otal Biomet Microfixation TMJ replacement system (Biomet icrofixation—Europe, Dordrecht, The Netherlands) will be ware of a similar procedure they advise for preparation of he fossa.5