颞下颌关节灌洗术治疗不可复性关节盘前移位的临床研究

Arthrocentesis and lavage of TMJ for the treatment of anterior disc displacement without reduction

目的 评价颞下颌关节上腔灌洗术治疗不可复性关节盘前移位的临床疗效。方法 38例因不可复性关节盘前移位引起张口受限的患者行关节上腔灌洗治疗 ,分析治疗前后不同时期患者的疼痛值、下颌运动度变化 ,通过关节造影判定治疗前后关节盘位置的变化。结果 治疗后不同时期的下颌运动度均较治疗前有显著增加 (P <0 0 0 1 ) ,特别在治疗后 1个月内增加明显 ,疼痛亦有显著缓解 (P <0 0 1 )。关节造影显示仅有 2例患者的关节盘部分复位。结论 颞下颌关节上腔灌洗术能有效改善不可复性关节盘前移位患者的张口度 ,缓解疼痛 ,对病程短于 6个月的患者疗效尤为理想 ,该方法操作简单 ,有临床推广应用价值。

Objective To evaluate the clinical efficacy of the TMJ arthrocentesis and lavage as a treatment for anterior disc displacement without reduction of the TMJ Methods 38 patients with limited mouth opening caused by anterior disc displacement without reduction were treated by using TMJ arthrocentesis and lavage Clinical data including pain and mandibular motion were collected and then analyzed Arthrography was used to evaluate disc position Results The mandibular motion had increased significantly ( P <0 001) at different period of time, especially within 1 month Jaw pain had also significantly improved ( P <0 01) Arthrography revealed that most of the TMJs studied had persistent anterior disc displacement with only 2 patients demonstrating a “reduced disc” Conclusion Arthrocentesis and lavage is effective in reducing pain and increasing mandibular motion in patients with anterior disc displacement without reduction, especially in patients the duration of symptoms being less then 6 months It is recommended as a simple alternative to more invasive TMJ procedures