目的:评估颞下颌关节(TMJ)单侧开放椎间盘复位手术(ODRS)对对侧关节内部紊乱(ID)的影响。
方法:选择双侧TMJ患者行单侧ODRS,随访1年。根据对侧疾病将其分为两组:前椎间盘移位复位(ADDWR)和不复位(ADDWR)。术后评估包括临床和MRI评估。测量的指标为单侧颌间距离(UID),视觉模拟量表(VAS),圆盘长度(DL),髁突高度(CH),和盘髁角(DCA)。配对t检验用于比较不同时间点之间的临床和MRI指标。
结果:纳入96例患者,其中ADDWR组47个,ADDWWoR组49个。手术后一年,ODRS导致MMO显着增加,DL,CH,手术侧VAS和DCA降低(P<0.05)。在ADDWR组中,UID,DL,CH显著增加,VAS降低(P<0.05),DCA无明显变化(P>0.05)。在ADDWoR组,临床和MRI变量略有恶化,除了UID,无明显变化(P>0.05)。
结论:ODRS是纠正TMJID的一种有前途的方法,可以改善对侧关节ADDWR的状况并减少ADDWR的进展。术前评估双侧TMJ对于更好的结果至关重要。
结论:ODRS可以有效治疗TMJID,并在对侧ID中产生适应性变化,为此,对侧关节的连续监测是必不可少的。
OBJECTIVE: To assess the influence of unilateral open disc repositioning surgery (ODRS) of the temporomandibular joint (TMJ) on the internal derangement (ID) of the contralateral joint.
METHODS: Patients with bilateral ID of TMJ who underwent unilateral ODRS were enrolled and followed-up for one year. They were divided into two groups based on the contralateral disease: the anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Postoperative evaluation included clinical and MRI evaluation. Indices measured were unilateral intermaxillary distance (UID), visual analogue scale (VAS), disc length (DL), condylar height (CH), and disc-condyle angle (DCA). Paired t tests were used to compare the clinical and MRI indices between different time points.
RESULTS: Ninety-six patients were enrolled, including 47 in the ADDWR group and 49 in the ADDWoR group. One-year post-surgery, ODRS led to significant increases in MMO, DL, and CH, and decrease in VAS and DCA on the operated side (P < 0.05). In ADDWR group, UID, DL, and CH increased significantly, and VAS decreased (P < 0.05), with no significant change in DCA (P > 0.05). In ADDWoR group, clinical and MRI variables worsened slightly, except for UID, which remained unchanged (P > 0.05).
CONCLUSIONS: ODRS is a promising method for correcting TMJ ID and may improve condition of ADDWR and decrease progress of ADDWoR at the contralateral joint. Preoperative bilateral TMJ evaluation is essential for better outcomes.
CONCLUSIONS: ODRS can effectively treat TMJ ID and produce adaptive changes in the contralateral ID, for which continuous monitoring of the contralateral joint is essential.