The author analyzed the outcome in 91 patients undertaken with surgical treatment and proposed the concept and strategy for temporomandibular joint (TMJ) dislocation in especially elderly subjects. The patients composed of 20 long-standing and 80 recurrent TMJ dislocation, in which the majority were medically compromised characteristics and dementia. Applied procedures were as follows; arthroscopic eminoplasty (AE), open arthrotomy with eminectomy (E), eminectomy with additional procedures (E+α), tethering procedure employing screws and wire, and zygomatic arch down fracture procedure.
The overall outcome revealed 82% of success rate and the results indicated that, 1. Eminectomy and zygomatic down-fracture operation were both excellent procedures, 2. Elderly patients have trend to associate dyskinesia which may contribute lower surgical outcomes, 3. Documented complication with facial nerve paresis would be slight degree, 4. Different approach should be considered in different types with recurrent and long-standing styles, 5. The modified approach under local anesthesia needs to be performed with a high care managements.
