Ultrasound-guided autologous blood injection in patients with chronic recurrent temporomandibular joint dislocation

摘要

Objective: To evaluate the accuracy and effectiveness of ultrasound (US) guided autologous blood injection (ABI) for the treatment of chronic recurrent TMJ dislocation. Design: Prospective cohort study. Setting: Centre for medical education and research. Participants (or Animals, Specimens, Cadavers): Ninteen patients with chronic recurrent TMJ dislocation (Fifteen bilateral and fourteen unilateral). Interventions: Autologous blood injected, 2ml in superior joint space (SJS) and 1 ml in peri-capsular tissue (PT) under ultra sound guidance. Main Outcome Measure(s): Reduction in number of dislocation episodes, maximal mouth opening, pain ( visual analogue scale) and TMJ sounds (present or absent) at the end of 2 weeks, 3 months, 6 months and 1 year. Results: At 2 weeks post operatively 18 patients (95%) were asymptomatic only one patient (5%) complained of Recurrence of dislocation and was treated successfully by a 2supnd/sup injection. At subsequent follow up visits none reported dislocation. Conclusion(s): US guided ABI for patients with chronic recurrent TMJ dislocations serves as an alternative, minimally invasive, highly effective and accurate modality of treatment since it includes exposure without radiation, real-time visualization of soft tissues, visualization of the needle tip advancement, local anesthetic spread relevant to the surrounding structures which can be performed on an outpatient basis.