Template-based temporomandibular joint puncturing and access in minimally invasive TMJ surgery (MITMJS) – a technical note and first clinical results

Abstract

Abstract Background Minimally invasive temporomandibular joint surgery (MITMJS) is an option for patients suffering from severe internal derangement or adhesions. To improve TMJ access, a workflow to create surgical templates is introduced. Methods A workflow to generate a dividable patient specific template based on CBCT and optical scanning to access the joint is introduced. In a first clinical trial 3 patients (6 joints) were treated by way of template-guided endoscopically-assisted TMJ therapy (3 arthrocenteses and 3 arthroscopies). Results Generation and clinical use of the templates was as planned. All templates showed perfect fit and permitted instant access to the TMJ. All surgeries were performed without complications. Conclusions Template-guidance could improve the feasibility of endoscopically-assisted TMJ therapy. An important issue is the capability to dis- and remount the template during surgery. Using in-house production, costs are affordable. Trial registration This study was registered at the Ethic Committee of the Berlin Medical Chamber (Eth-30/17, 12/06/2017).

Keywords

• Surgical template
• Computer-guided surgery minimally invasive temporomandibular joint surgery