O Hasson1, O Nahlieli. 1. Department of Oral and MaxilloFacial Surgery, Kaplan Medical Center, Rehovot, Israel. oshasson@yahoo.com
Abstract
OBJECTIVE: The purpose of this study was to reintroduce a rather simple, safe, minimally invasive, and rapid alternative procedure for the treatment of recurrent dislocation of the condyles. STUDY DESIGN: Subjects were 3 patients (5 joints) who suffered from recurrent condyle dislocation. The technique consisted of visually identifying a line from tragus to the eye angle. Then the articular fossa point was identified in this line, 10 mm anteriorly to tragus and 2 mm below the line. A 19-gauge needle was inserted at the articular fossa point. After injection of saline in the superior compartment, 5 cc of autologous blood drawn from the cubital fossa was injected (4 cc in the superior compartment and 1 cc in the pericapsular tissue). After this an elastic bandage was applied and left for the first 24 hours. Patients were advised to constrain their mandibular motion and to eat only soft foods for a week. They received cephalosporin antibiotics and nonsteroidal anti-inflammatory drugs for 7 days. A week after the procedure, supervised physiotherapy was started and the patients were encouraged to increase their mandibular opening to 40 mm. RESULTS: Postoperative recoveries were uneventful. Dislocation of condyles did not reoccur; however, patient no. 3 experienced an episode of unilateral subluxation. At follow-up all patients presented with normal mouth opening. CONCLUSION: Bleeding resulted from the introduction of a needle for injection in the pericapsular tissue. Blood coming from this wound, associated with autologous blood injected in the superior compartment, generates a bed for fibrous tissue formation in the region, creating a limitation of mandibular movement, thus ceasing dislocation of the condyles. Temporomandibular joint autologous blood injection is a simple procedure performed on an outpatient basis that we advise as an alternative treatment for patients with recurrent dislocation of the condyles.
OBJECTIVE: The purpose of this study was to reintroduce a rather simple, safe, minimally invasive, and rapid alternative procedure for the treatment of recurrent dislocation of the condyles. STUDY DESIGN: Subjects were 3 patients (5 joints) who suffered from recurrent condyle dislocation. The technique consisted of visually identifying a line from tragus to the eye angle. Then the articular fossa point was identified in this line, 10 mm anteriorly to tragus and 2 mm below the line. A 19-gauge needle was inserted at the articular fossa point. After injection of saline in the superior compartment, 5 cc of autologous blood drawn from the cubital fossa was injected (4 cc in the superior compartment and 1 cc in the pericapsular tissue). After this an elastic bandage was applied and left for the first 24 hours. Patients were advised to constrain their mandibular motion and to eat only soft foods for a week. They received cephalosporin antibiotics and nonsteroidal anti-inflammatory drugs for 7 days. A week after the procedure, supervised physiotherapy was started and the patients were encouraged to increase their mandibular opening to 40 mm. RESULTS: Postoperative recoveries were uneventful. Dislocation of condyles did not reoccur; however, patient no. 3 experienced an episode of unilateral subluxation. At follow-up all patients presented with normal mouth opening. CONCLUSION: Bleeding resulted from the introduction of a needle for injection in the pericapsular tissue. Blood coming from this wound, associated with autologous blood injected in the superior compartment, generates a bed for fibrous tissue formation in the region, creating a limitation of mandibular movement, thus ceasing dislocation of the condyles. Temporomandibular joint autologous blood injection is a simple procedure performed on an outpatient basis that we advise as an alternative treatment for patients with recurrent dislocation of the condyles.