颞下颌关节镜手术少见并发症的防治

Prevention and treatment for the complications of arthroscopic surgery in the temporomandibular joint

目的:总结颞下颌关节镜手术的并发症,探讨其防治措施。方法:回顾1997年5月—2009年9月在我院进行关节镜手术治疗的2034例(2431侧)患者的临床资料,分析其少见的并发症,包括知名血管出血、咬肌神经损伤、器械折断、排异反应、外耳道穿孔等,探讨其发生的原因及其防治措施。结果:2034例(2431侧)患者中,知名血管出血5侧,咬肌神经损伤5侧,器械折断3侧,排异反应2侧,外耳道穿孔2侧。结论:关节镜手术是一种安全有效的治疗方法,其并发症发生率较低,但此项技术需由有经验的医师进行操作。

PURPOSE：To analyze the complications of arthroscopic surgeries in the temporomandibular joint（TMJ）,and investigate the preventive and treating methods.METHODS：In this study,Consecutive 2034 patients（2431joints） diagnosed as TMJ internal derangement（ID） were treated by arthroscopic surgeries from May 1997 to Sept.2009 in our department.The clinical complications were analyzed for investigating its cause,prevention and control measures.RESULTS：Of all 2034 cases,the complications were shown as follows.5 joints hemorrhage of lateral pterygoid muscle vascular,injuries of lateral pterygoid muscle nerve in 5 joints,3 joints with broken instruments,rejection reaction in 2 joints,perforation of tympanic membrane in 2 joints.CONCLUSION：Arthroscopic surgery was a safe and effective method to treat TMJ ID,its complications were limited and acceptable,but experienced operator was required for this surgical technique.