Darpan Bhargava1, Shaji Thomas1, Pratiksha Pawar2, Megha Jain3, Pankaj Pathak1. 1. Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Centre, People's University, Bhopal, Madhya Pradesh, 462037, India. 2. Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Centre, People's University, Bhopal, Madhya Pradesh, 462037, India. drpratikshapawar@gmail.com. 3. Department of Imaging and Radiodiagnosis, L.N. Medical College and Research Centre and J.K. Hospital, J.K. Town, Sarvdharm C-Sector, Kolar Road, Bhopal, Madhya Pradesh, 462042, India.
Abstract
PURPOSE: Temporomandibular joint (TMJ) disc derangement is defined as a malpositioning of the articular disc relative to the condyle and eminence. Arthrocentesis of the TMJ is considered by many as the first-line surgical treatment for patients who do not respond to conservative treatment. The aim of this study is to assist needle insertion for temporomandibular joint arthrocentesis using ultrasonography. MATERIALS AND METHOD: Twenty patients who required arthrocentesis of the TMJ were randomly assigned to two groups A and B undergoing single-puncture arthrocentesis with modified double-lumen single-barrel needle and ultrasound-guided single-puncture arthrocentesis using modified double-lumen single-barrel needle (n = 10 in each group). The number of attempts of needle manipulation, duration of the operative procedural time, and visual analog (VAS) scale score for pain to assess surgical discomfort were the main outcome variables. RESULTS: None of the patients in either group developed any complication with no significant difference in VAS score for pain between the two study groups. The number of attempts for needle manipulation (mean ± SD) for group A was 2.20 ± 0.789, and for group B, it was 1.10 ± 0.316 (p value, 0.0007); operative procedural time (mean ± SD) for group A was 18.5 ± 3.171 min, and for group B, it was 13.1 ± 1.663 (p value, 0.0002) which was significantly lesser in group A than in group B. The sentence signifies that the number of attempts that was required to re-insert the needle to enter the joint space in Ultrasound guided and conventional method of arthrocentesis. CONCLUSION: Ultrasound-guided single-puncture arthrocentesis using a customized needle is a promising method to perform joint lavage with minimal trauma and in a precise manner.
PURPOSE: Temporomandibular joint (TMJ) disc derangement is defined as a malpositioning of the articular disc relative to the condyle and eminence. Arthrocentesis of the TMJ is considered by many as the first-line surgical treatment for patients who do not respond to conservative treatment. The aim of this study is to assist needle insertion for temporomandibular joint arthrocentesis using ultrasonography. MATERIALS AND METHOD: Twenty patients who required arthrocentesis of the TMJ were randomly assigned to two groups A and B undergoing single-puncture arthrocentesis with modified double-lumen single-barrel needle and ultrasound-guided single-puncture arthrocentesis using modified double-lumen single-barrel needle (n = 10 in each group). The number of attempts of needle manipulation, duration of the operative procedural time, and visual analog (VAS) scale score for pain to assess surgical discomfort were the main outcome variables. RESULTS: None of the patients in either group developed any complication with no significant difference in VAS score for pain between the two study groups. The number of attempts for needle manipulation (mean ± SD) for group A was 2.20 ± 0.789, and for group B, it was 1.10 ± 0.316 (p value, 0.0007); operative procedural time (mean ± SD) for group A was 18.5 ± 3.171 min, and for group B, it was 13.1 ± 1.663 (p value, 0.0002) which was significantly lesser in group A than in group B. The sentence signifies that the number of attempts that was required to re-insert the needle to enter the joint space in Ultrasound guided and conventional method of arthrocentesis. CONCLUSION: Ultrasound-guided single-puncture arthrocentesis using a customized needle is a promising method to perform joint lavage with minimal trauma and in a precise manner.