Abstract：
This study evaluated the feasibility of simultaneous temporomandibular joint (TMJ) arthroscopy and orthognathic surgery as a new treatment strategy for anterior disc displacement without reduction (ADDwoR) patients with severe jaw deformities. Twelve ADDwoR patients with facial deformities who underwent arthroscopy and orthognathic surgery between September 2015 and December 2019 were retrospectively evaluated. Pre- and postoperative maximum incisal opening (MIO) and joint pain were recorded. Computed tomography (CT) and three-dimensional cephalometric analysis were performed at 3 (T1) and ≥6 (T2) months postoperatively. Magnetic resonance imaging (MRI) of the TMJ was performed before, ≤7 days after and ≥6 months after surgery. The lateral profile radiological findings, the symmetry of the maxilla and mandible, and the MRI measurements were compared. Anterior disc displacement did not recur, and the maximum incisal opening (MIO) increased from 27.4 mm to 32.7 mm after surgery (p < 0.05). No significant differences were found in the lateral profile, symmetry indices or condylar height via MRI between T1 and T2. Joint morphology and the position of both the maxilla and mandible remained stable during postoperative follow-up, while joint symptoms were markedly relieved and facial appearance was noticeably improved. Combined arthroscopy and orthognathic surgery is effective and recommended for ADDwoR patients with jaw deformities.
摘要：
这项研究评估了同时进行颞下颌关节（TMJ）关节镜检查和正颌手术作为一种新的治疗策略的可行性。严重颌骨畸形的前椎间盘移位（ADDwoR）患者。回顾性评估2015年9月至2019年12月期间接受关节镜和正颌手术的12例ADDwoR面部畸形患者。记录术前、术后最大切口开口(MIO)及关节疼痛情况。术后3（T1）和≥6（T2）个月进行计算机断层扫描（CT）和三维头颅测量分析。之前进行了TMJ的磁共振成像（MRI），术后≤7天，术后≥6个月。侧向剖面放射学发现，上颌骨和下颌骨的对称性，和MRI测量结果进行了比较。前椎间盘移位没有复发，最大切缘开口（MIO）从术后的27.4mm增加到32.7mm（p<0.05）。横向剖面没有发现显著差异，T1和T2之间通过MRI的对称指数或髁突高度。术后随访期间关节形态及上颌骨和下颌骨位置均保持稳定,关节症状明显缓解，面部外观明显改善。联合关节镜和正颌手术是有效的，推荐用于颌骨畸形的ADDwoR患者。
