By Peter D. Quinn DMD MD
Univ. of Pennsylvania, Philadelphia. Surgical atlas meant to steer the beginner and skilled general practitioner during the intraand extra-articular techniques which have been confirmed powerful within the therapy of complex craniomandibular disorder. complete colour pictures. 2 U.S. members.
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Additional info for Color Atlas Of Temporomandibular Joint Surgery
16 Endaural incisions 1 year after arthroplasty. Note the ability to camouflage temporal extension in hairline. 41 Chapter Three Surgical Approaches to the Temporomandibular Joint Postauricular Approach Walters and Geist ( 1 9 8 3 ) popularized a modified postauricular approach to the temporomandibular joint. Although rarely used, the approach does have the following advantages: • Excellent exposure of the entire joint • Ability to camouflage the scar in patients who have a tendency to form keloids The main disadvantage is auricular stenosis, and the approach should not be used in the presence of joint infection or chronic otitis externa.
A small freer elevator can also be used to explore the inferior surface of the disk to diagnose any perforations that may not have been visible from the superior joint space. A decision must be made at this point regarding the type of procedure that will be performed on the disk. T h e surgical options are as follows: (1) disk plication—surgical repositioning of the disk by suturing it to retrodiskal and lateral capsular tissues, (2) diskopexey—a disk "tie-down" that anchors the disk to a condylar or fossa purchase point, and (3) lysis of adhesions in both superior and inferior joint spaces without any disk repositioning.
0 cm). The most variable measurement was the point at which the upper trunk crosses the zygomatic arch. It ranged from 8 mm to 35 mm anterior to the most anterior portion of the bony external auditory canal (mean, 2 . 0 cm). By incising the superficial layer of the temporalis fascia and the periosteum over the arch inside the 8 mm bound30 Chapter Three Surgical Approaches to the Temporomandibular joint 31 ary, surgeons can prevent damage to the branches of the upper trunk. The temporal branch of the facial nerve emerges from the parotid gland and crosses the zygoma under the temporoparietal fascia to innervate the frontalis muscle ("corrugaror muscle") in the forehead.