Arthroscopy and arthroscopic surgery of the temporomandibular joint (T.M.J.).

Arthroscopy consist of the insertion of a rigid endoscope into a joint compartment for observation and therapeutic purposes. Since the joint space of TMJ is small, the Indications for arthroscopy in the TMJ were very limited, but with the development of a needle type rigid arthroscope in 1974 in Japan, we began applying this instrument clinically. When arthroscopy is performed, decisions should naturally be made with careful consideration given to the indications. The reason for this is that, in cases where arthroscopy is performed for the purpose of diagnosis, the invasion required for arthroscope perforation might cause more damage than the lesion in the joint. In such cases, consideration must also be given to the after-effects of the damage resulting from the arthroscopy. Therefore, preoperative tests for arthroscopy should be carefully performed and thorough consideration should be given to the indications for arthroscopy based on an understanding of the degree of the lesion in the joint. The indications for arthroscopy should again be carefully considered in cases where diagnosis is made by arthroscopy but it is assumed that the lesion cannot be treated. We first perform arthroscopy on cases considered to be indicated for operations under arthroscopy from preoperative diagnosis, and then perform the operation under arthroscopy once the lesion has been confirmed. Care must be taken that the joint is not damaged uselessly when arthroscopic diagnosis is performed without treatment. Before performing arthroscopy of the TMJ it is extremely important to perform arthrography, especially double contrast arthrotomography and contrast CT, in order to evaluate the condition of the joint space.(ABSTRACT TRUNCATED AT 250 WORDS)