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5th yr- CMS2- TMJ Symposium > surgery of the tmj > Flashcards

surgery of the tmj Flashcards

1
Q

What are some symptoms of TMJ disorders

A
  1. Pain
  2. Click
  3. Limited opening
  4. Crepitus (crunching)
  5. Closed lock
  6. Dislocation
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2
Q

Name the muscles involved in jaw closure

A
  1. Temporalis
  2. Medial ptergoid
  3. Masseter
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3
Q

Name the muscles involved in jaw opening

A
  1. Lateral pterygoid
  2. Myelohyoid
  3. Suprahyoid muscles
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4
Q

Name the nerves that supply the TMJ

A
  1. Auriculotemporal nerve
  2. Masseteric nerve (branch of trigeminal nerve)
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5
Q

What can patients with jaw pain also present with

A

Ear ache

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6
Q

Do you need radiography to diagnose a solicited TMJ

A

No not to diagnose we may take it for more information

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7
Q

What will a pt who has dislocated their tmj present with

A

Won’t be able to close their mouth
Will dribble as they can’t close mouth

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8
Q

How do we relocate a dislocated joint

A

Push the jaw down and back using your body weight

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9
Q

Define internal derangement

A

Disruption within the internal aspects of the TMJ in which there is displacement of the disc from its normal functional relationship with the mandibular condyle and the articular portion the temporal bone

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10
Q

What can be a difficulty in treating internal derangement

A

1/3 of patients who have an MRI will present with internal derangement but will have no symptoms

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11
Q

How do we classify internal derangement

A

Using the Wilkes classification of internal derangement

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12
Q

What is a class 1 on the Wilkes internal derangement scale

A

Painless clicking- slight forward displacement of the dic

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13
Q

What is a class II on the Wilkes internal derangement scale

A

Occasional painless click, intermittent locking headaches suggesting the beginning of deformity and thickening of posterior edge

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14
Q

What is a class III on the Wilkes internal derangement scale

A

Frequent pain, joint tenderness, headaches, restricted motion suggestign anterior disc displacement and significant deformity

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15
Q

What is a class IV on the Wilkes internal derangement scale

A

Chronic pain, headaches and restricted motion suggestign degenerative changes flattening of eminence deformed condyle

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16
Q

What is a class V on the Wilkes internal derangement scale

A

Variable pain, crepitus, painful function suggesting disc perforation and goes anatomical deformity

17
Q

Give examples of minimally invasive surgical options for TMJ problems

A
  1. Joint injection
  2. Muscle injection
  3. Arthrocentesis
  4. Arthroscopy
18
Q

Give examples of open joint procedures

A
  1. Disc repair/repositioning (meniscopexy)
  2. Disc removal (meniscectomy)
  3. Articular eminence/ zygomatic arch procedures
  4. Joint reconstruction procedures”
19
Q

What is the indication for joint injections with steroids

A
  1. Failed conservative management
  2. Pain
  3. Degenerative joint disease (arthritis)
20
Q

What is Arthrocentesis

A

Joint wash out

21
Q

What are the indications for Arthrocentesis (joint wash out)

A
  1. Failed conservative management
  2. Pain
  3. Closed lock
22
Q

How does Arthrocentesis (joint wash out)

A
  1. Wash out debris
  2. Clear joint of inflammatory mediators
  3. Divide adhesions
  4. Remove restrictions of disk
23
Q

What are some indications for Arthroscopy

A
  1. Failed conservative management
  2. Pain
  3. Closed lock
24
Q

Name some Arthroscopic procedures

A
  1. Eminectomy
  2. Meniscopexy
25
Q

What are seen complications associated with Arthroscopy

A
  1. Swelling
  2. Bruising
  3. Bleeding
  4. Pain
  5. No improvement
  6. Facial nerve damage
  7. Damage to ear canal
  8. Damage to middle ear
26
Q

Give examples of invasive TMJ patients

A
  1. Open joint surgery
  2. “Meniscopexy (move disk back)
  3. Menisectomy (remove it)
  4. Smooth joint surfaces
  5. Gap arthroplasty (ankylosis)
26
Q

Give examples of invasive TMJ patients

A
  1. Open joint surgery
  2. Meniscopexy (move disk back)
  3. Menisectomy (remove it)
  4. Smooth joint surfaces
  5. Gap arthroplasty (ankylosis)
27
Q

What are seen complications associated with TMJ replacement

A
  1. Facial nerve damage
  2. Infection
  3. Damage to ear canal
  4. Hearing loss
  5. CSF leak
  6. Failure of implant
28
Q

What other procedures aside from surgery can we do to help manage TMJ disorders

A
  1. Physiotherapy
  2. Exercises
  3. Psychological input

5th yr- CMS2- TMJ Symposium (2 decks)

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