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Complications of Temporomandibular Joint Surgery
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Complications of Temporomandibular Joint Surgery
Failure to Make the Correct Diagnosis Part I - A Neurologist's Perspective
Introduction
Epidemiology
Pathophysiology
Migraine
Tension-Type Headache (TTH)
Chronic Daily Headache
Trigeminal Neuralgia
Persistent Idiopathic Facial Pain
Cluster Headache
Trigeminal Autonomic Cephalalgia
Giant Cell Arteritis
Neoplasm
Cervicogenic Headache
Temporomandibular Disorder Headache
Case Scenarios
Case Explanations
Summary
References
Failure to Make the Correct Diagnosis: Part II - A Physical Therapist's Perspective
Introduction
Diagnosing Headache and Facial Pain
Diagnostic Tests
Treatment
Biopsychosocial Issues
Neck Pain
Summary
References
Failure to Make the Correct Diagnosis Part III - A Surgeon's Perspective
Introduction
Making the Correct Diagnosis
The Diagnostic Challenge
Arthralgia
Enlarged Condyle
Small Condyle
Clinical Conditions Mimicking TMJ Closed Lock
Increased or Normal Mouth Opening with Locked Jaw
References
Perforation of the External Auditory Canal or Middle Cranial Fossa
Introduction
Perforation of the External Auditory Canal (EAC)
Pathophysiology
Potential Sequelae of Puncture into the EAC
Prevention of the Complication
Open TMJ Surgery
Arthroscopic TMJ Surgery
Puncture Site
Puncture Direction
Puncture Depth
Puncture Force
Recognition and Diagnosis of the Complication
Management of the Complication
Injury Isolated to EAC Wall
Puncture and Perforation of the Tympanic Membrane
Initial Medical Management
Perforation of the Glenoid Fossa into the Middle Cranial Cavity
Pathophysiology of the Complication
Sequelae of Perforating into the Middle Cranial Fossa
Prevention of the Complication
Open TMJ Surgery
Arthroscopic TMJ Surgery
Puncture Site
Puncture Direction
Puncture Depth
Puncture Force
Recognition and Diagnosis of the Complication
Management of the Complication
Bone Perforation Only
Bleeding and Extradural/Subdural Hematoma
Dural Tear and CSF Leak
References
Facial Nerve Injury
Introduction
Pathophysiology
TMJ Procedures and Risk for Facial Nerve Injury
Arthrocentesis and Arthroscopy
Open TMJ Procedures
Prevention of the Facial Nerve Injury
Facial Nerve Monitoring
Surgical Approaches to the TMJ to Avoid Facial Nerve Injury
Recognition and Diagnosis
Management of Facial Nerve Injury
Nonsurgical Techniques
Medical management
Physical therapy
Botulinum toxin
Corrective makeup techniques
Surgical Techniques
Gold weight implantation - upper eyelid paralysis
Browlift/blepharoplasty
Static facial sling
Lower eyelid procedures
Neural procedures
A. Extratemporal neurorrhaphy
B. Cross-face grafting
C. Cable grafting
D. Hypoglossal nerve transfer
Muscle transposition
Free muscle flaps
Conclusion
References
Frey Syndrome
Introduction
Pathophysiology
Frey Syndrome and the Temporomandibular Joint
Diagnostic Testing
Treatment
Conclusion
References
Neuropathic Pain and Chronic Opioid Use
Introduction
Pathophysiology
Stimulus-Evoked Pain
Stimulus-Independent Pain
Prevention of Neuropathic Pain in Temporomandibular Joint Surgery
Recognition of Neuropathic Pain in Temporomandibular Joint Surgery
Diagnosis of Neuropathic Pain in Temporomandibular Joint Surgery
Management of Neuropathic Pain
Chronic Opioid Use
Opioid Tolerance
Pain Ladder
Is There an Opioid Benefit?
Opioid-Related Adverse Events
Adverse Drug-Related Behavior
Recommendations
References
Massive Hemorrhage
Introduction
Anatomy
Preoperative Evaluation
Surgical Techniques to Avoid Vessel Injury
Intraoperative Management of Massive Hemorrhage
References
Diagnosis and Management of TMJ Heterotopic Bone and Ankylosis
Introduction
Etiology
Diagnosis
Treatment Options
Nonsurgical Options
Gap Arthroplasty and Grafts
Fat Grafts
Ankylosis in Autogenous Reconstruction Versus Total Joint Prostheses (TJP)
Surgical Protocol for Managing Heterotopic Bone
Surgical Protocol for Managing TMJ Ankylosis
Pediatric Considerations
Case Presentation
References
Infection Following Total Joint Replacement
Introduction
Pathophysiology
Prevention
Preoperative Considerations
Nutrition
Systemic Disease Control
Smoking
Preexisting Remote Site Infections
Perioperative Considerations
Skin
Pre-incision Antibiotic Prophylaxis
Anesthesia
Eyes
Hair
Ear
Oral Cavity
Pre-incision Skin Preparation
Intraoperative Considerations
Incisions
Parotid Gland
TMJTJR Components
Hemostasis, Irrigation and Drains
Postoperative Considerations
Auditory Canal
Pressure Dressing
Postimplantation Antibiotics
Nosocomial Infections
Discharge Considerations and Information
Postoperative Infection
Diagnosis
Early TMJ TJR PJI
Delayed TMJ TJR PJI
References
Iatrogenic Degenerative Joint Disease
Arthrocentesis and Arthroscopy
Arthrocentesis
Arthroscopy
Open Procedures
Open Discopexy
Open Discectomy with and Without Interpositional Grafting
Total Joint Replacement (TJR)
References
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