- 期刊
Outcomes of Arthroscopic Arthroplasty for Treating Temporomandibular Disorders-A Case Report
關節鏡之關節成型術治療顳顎關節障礙的成果－病例報告
摘要
此報告為一位二十歲台灣女性病患罹患雙側變形之顳顎關節盤不可回復性前置位、右側顳顎關節骨關節病、及左側顳顎關節骨關節炎合併左側翼外肌痙攣。本文章描述了此病患的臨床特徵、臨床與影像診斷以及治療原則。我們也探討了關節開放手術及關節鏡手術的比較、關節鏡手術的優缺點以及關節成型術的步驟，包括電燒灼、理想的關節沖洗量及關節內用藥等等。在保守性治療之後，此病患接受雙側關節鏡之關節成型術的手術治療，術後得到總體的功能改善及症狀緩解。此病例報告的目的在於闡明關節鏡手術在適當的病人篩選之下已被證明是一種有效的治療及診斷工具，儘管手術的視野及空間受限，在與關節開放手術比較之下，病患的身體復原較為快速且傷口癒合時間較短，並且罕見有關節鏡手術的併發症發生。
並列摘要
This report presents a case of bilateral deformed discs of temporomandibular joint anterior displacement without reduction, osteoarthrosis of right TMJ, and osteoarthritis of left TMJ with left pterygoid muscle spasm in a 20 year-old Taiwanese female. The clinical features, clinical and imaging diagnosis, and the treatment protocols are described. The open versus arthroscopic surgery of TMJ, the advantages and disadvantages of TMJ arthroscopic surgery, and the arthroscopic arthroplastic procedures including electrocautery, ideal volume of lavage, and intra-articular medication are discussed. After conservative therapy, the patient received bilateral TMJ arthroscopic arthroplasty. The overall functional improvement and symptoms relief were achieved. The purpose of this report is to illustrate that TMJ arthroscopic surgery has been proven to be an effective treatment as well as a diagnostic tool on temporomandibular disorder patients with adequate patient selections. Despite the limited surgical view and excess, patient recovery is rapid with rare surgical complications and healing time is shorter than with open surgical procedures.
延伸閱讀
- Chang, C. H., & Liu, C. J. (2019). 顳顎關節之滑液囊軟骨瘤病－病例報告與文獻回顧. 臺灣口腔顎面外科學會雜誌, 30(2), 125-133. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201906-201907190009-201907190009-125-133
- 林彥宏、柯惠馨（2020）。以微創顳顎關節內視鏡復位縫合手術治療顳顎關節盤移位─病例報告。臺灣口腔顎面外科學會雜誌，31(3)，192-204。https://www.airitilibrary.com/Article/Detail?DocID=a0000494-202009-202011090005-202011090005-192-204
- Wang, Y. W., Lin, C. K., Shieh, Y. S., Wang, Y. B., & Chen, Y. W. (2016). 顳顎關節之不可復性盤後脫位的成功治療經驗－病例報告. 中華民國家庭牙醫學雜誌, 11(1), 11-17. https://doi.org/10.6566/JFD/2016.11(1).11
- 曾怡嘉、黃婷愉（2022）。中醫與口腔顎面外科合併治療之顳顎關節疾患病例報告。北台灣中醫醫學雜誌，14(2)，57-72。https://www.airitilibrary.com/Article/Detail?DocID=P20131218002-202209-202210130008-202210130008-57-72
- 陳柏錡、王東堯、陳畊仲、黃振勳、陳明正（2007）。使用顳肌瓣施行中置性關節成型術治療顳顎關節骨性粘連－病例報告。中華民國口腔顎面外科學會雜誌，18(2)，118-130。https://doi.org/10.7104/CJOMS.200709.0118