TMJ surgery

Question 1

what does the external carotid branch into?

Answer 1

maxillary artery, superical temporal a.

Question 2

what branches off the Maxillary a?

Answer 2

Middle meningeal a.
Accessory meningeal a.
Masseteric a.

Question 3

what are the facial nerve branches?

Answer 3

Temporal branch
Zygomatic branch
Buccal branch
Marginal mandibular branch
Cervical branch

Question 4

__________ fascia looks like cobwebs (nerve located here), while _________ faca is tougher and leather-like

Answer 4

Tempoparietal
Deep temporal

Question 5

______ is a very dynamic joint with complex movement patterns (rotates and translates)

Answer 5

TMJ

Question 6

Ramus can be anywhere _______ anterior to EAC, but the mean is _______

Answer 6

8-35mm, 20mm

Question 7

what can get displaced in the TMJ joint and cause pain?

Answer 7

Articular disk

Question 8

when the articular disk gets displaced, its usually in which direction?

Answer 8

anteriorly

Question 9

what is advanced displacement of the disk?

Answer 9

clicking sound goes away and disk stays displaced all the time, limitation in jaw opening

Question 10

why does TMJ dislocation happen? is it common?

Answer 10

Happens because weakening of ligaments → they can get stretched out and eventually allows condyle to travel too far

Question 11

what are the different reasons you might do TMJ surgery?

Answer 11

reposition/repair disk
Joint replacement
Condylectomy
Eminectomy (dislocation)
Removal of pathological lesion

Question 12

what are the steps of surgical approach for TMJ surgery?

Answer 12

-Incision done in preauricular skin fold
-Get down to temporalis fascia and make an incision parallel to the nerve
-You can get down to bone through the pocket you created (deep to the nerve)
-Dissect down to arch and do a releasing incision that’s very posterior, now you can see TMJ capsule
-Once you get into capsule, you have to cut some lateral attachments to see into the inferior bone space
-Next move depends on surgery
-Be mindful of closing all components that are protective in function!
-Close capsule over that, surgery is finished now!

Question 13

why would the fossa also need to be replaced when replacing
TMJ?

Answer 13

if not metal ball will press against the base of your skull, ramus component could start to reabsorb into skull

Question 14

what happens to the physiology of the TMJ when you replace it?

Answer 14

you change its physiology from a translating joint to rotating joint