关节镜治疗颞下颌关节紊乱病的远期疗效观察

摘要

目的 评价应用颞下颌关节镜治疗颞下颌关节紊乱病的远期疗效.方法 对保守治疗无效的22例临床表现为张口受限合并关节疼痛的颞下颌关节紊乱病患者行颞下颌关节镜手术治疗,分析术前、术后6月、术后2年不同时期患者的疼痛值、张口度的变化.结果 治疗后张口度≥35 mm的患者占90.9％(20/22),不同时期的张口度均较治疗前有显著差异(P＜0.05),治疗后不同时期的疼痛直观模拟标尺(VAS)均较治疗前明显降低,有显著差异(P＜0.001),所有病例均无并发症发生.结论 颞下颌关节内镜手术能有效治疗颞下颌关节紊乱病,明显改善张口度和缓解疼痛.%[Objective] To estimate and analyze the long-term outcome of arthroscopy for the treatment of the temporomandibular joint (TMJ) disorders.[Methods] Twenty-two patients (25 joints) who had ineffective conservative treatment and then underwent TMJ arthroscopy under local anaesthesia between January 2009 and December 2009 were included in this study.The scores for preoperative maximal interincisal opening (MIO),and visual analogue scale (VAS) score for pain before arthroscopy,6 months and 2 years after arthroscopy were compared.[Results] Differences were significant between presurgical and postsurgical pain at months 6 and 24 (P ＜0.001).With regard to mandibular function,twenty of the twenty-two patients (90.9％) had the maximal interincisal opening ≥ 35 mm after operation which showed a statistically significant improvement (P ＜0.05) at 6-month and 2-year follow-up.There was no complication in any case.[Conclusions] Arthroscopic surgery is a reliable and effective procedure for temporomandibular joint dysfunction that improves pain and mouth opening,with the advantage of minimal invasion.