Arthroscopy of the temporomandibular joint: an anatomic perspective.

Anatomic relationships in the temporomandibular joint (TMJ) region related to arthroscopic surgery were analyzed in cadaver dissections and dry skulls. The study showed that the maxillary artery and the main bifurcation of the facial nerve are located a safe distance from the usual arthroscopic approaches to the TMJ. The frontal branch of the facial nerve are located a safe distance from the usual arthroscopic approaches to the TMJ. The frontal branch of the facial nerve may be as close as 3 mm anterior to the midpoint of the lateral pole of the condyle. The neurovascular complex of the superficial temporal vessels and the auriculotemporal nerve may also be very close to puncture sites. The roof of the glenoid fossa had an average thickness of 0.9 mm. The external soft tissue auditory canal courses anteriorly to meet the bony external auditory canal. A skin puncture perpendicular to the bony canal was approximately 7 mm anterior to the posterior aspect of the tragus.