顎関節病変に対する関節鏡視下レーザー手術

抄録

In order to approach a small lesion within the temporomandibular joint, the conventional therapeutic treatment is open surgery which has the possible disadvantage of surgical invasion including skin damage and exfoliation. Since 1985 we have applied a method of arthroscopic laser surgery to lesions within the temporomandibular joint because the method has the least surgical invasion. The outline of arthroscopic surgery by Nd-YAG laser is described in this report.
We investigated cases of recurrent dislocation, anterior disc displacement and fibrous adhesion of the temporomandibular joint where conservative therapy was ineffective and double contrasted CT scanning and arthrotomography showed the suspicion of organic changes within the temporomandibular joint cavity.
We examined the upper joint cavity by temporomandibular joint arthroscopy. In cases where results indicated the necessity of surgical operation, we practiced arthroscopic surgery after visualizing the lesion by arthroscopy. The new technique using the double-channel cannula by the needle scope which we recently invented visualized the lesion and we infused NdYAG laser fiber into the cavity for treatment of the area around the intra-articular wall
The separation, removal and vaporization of the adhesive area and cicatrix tissue were effective treatment against fibro-adhesion and fibrous ankylosis. We formed fresh injury by cauterization of the retrodiscal synovial membrane against hypermobility, recurrent dislocation and disc displacement, where we also practiced arthroscopic suturing when necessary. Observation after the operation revealed that we had obtained successful results, thus arthroscopic laser surgery was proven to be beneficial
We reported on arthroscopic laser surgery for temporomandibular joint disorders and the outline of the clinical results of these cases after operations.