关节灌洗和关节镜手术治疗颞下颌关节紊乱病的疗效比较

A Comparison Study of Arthrocentesis and Arthroscopic Surgery in the Treatment of Temporomandibular Disorders

【目的】比较关节灌洗和关节镜手术治疗颞下颌关节紊乱病的临床效果。【方法】应用关节灌洗术治疗 35例 (4 2侧关节 )颞下颌关节紊乱病 ;应用关节镜手术治疗 42例 (5 0侧关节 )颞下颌关节紊乱病 ,并对两种方法的疗效进行比较。【结果】关节灌洗组随访 12～ 45个月 ,术后张口度平均增加 (8± 4)mm ,86 %患者疼痛缓解 ,72 %杂音消失 ,总有效率为 83%。关节镜组随访 12～ 48个月 ,张口度平均增加 (8± 4)mm ,89%患者疼痛缓解 ,79%杂音消失 ,总有效率为 86 %。两组比较 ,张口度改善、杂音及疼痛缓解率均无显著差异。【结论】关节灌洗术和关节镜手术治疗颞下颌关节紊乱病均有效 ,但关节灌洗术方法简单、损伤小 。

Objective To compare clinical effects of arthrocentesis and arthroscopic surgery in the treatment of temporomandibular disorders (TMD). Methods 35 cases(42 joints) of TMD underwent arthrocentesis and 42 cases(50 joints) underwent arthroscopic surgery. The clinical effects of two treatment groups were compared. Results In arthrocentesis group, the follow up period was 12 to 45 months. Postoperative MIO(maximum interincisal opening) increased (8±4) mm in average. 86% of patients with pain had released of pain and 72% of patients with noises dismissed the symptom. The total success rate was 83%. In arthroscopic surgery group, the follow up period was 12 to 48 months. Postoperative MIO increased (8±4) mm in average. 89%of patients with pain and 79% of patients with noises reduced their symptoms. The total success rate was 86%. Concerning MIO, pain and noises, no significant differences were found between two groups. Conclusion Arthrocentesis and arthroscopic surgery are both effective procedures in the treatment of TMD. However, arthrocentesis is a simple and minimally invasive treatment method for TMD, and easy to be used widely.