Skip to main content
2025 AAOMS 107th Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Ticketed <br><i>This session/event requires a ticket.</i>
Ticketed
This session/event requires a ticket.
In-person only<br><i>This session is offered in-person only.</i>
In-person only
This session is offered in-person only.
On-demand<br><i>On-demand session available beginning Sept. 15.</i>
On-demand
On-demand session available beginning Sept. 15.
Recorded<br><i>This session will be recorded and available beginning Oct. 6.</i>
Recorded
This session will be recorded and available beginning Oct. 6.
Sold Out<br><i>This ticketed session/event is sold out.</i>
Sold Out
This ticketed session/event is sold out.
Poster Icons
Poster Award
Poster Award

TMJ

OMS and Other Dental Specialists

Session: Oral Abstract Session Two

SA2 - Seldinger Technique for TMJ Arthroscopy: Bridging the Technical Gap in Arthroscopy

Friday, September 19, 2025
2:15 PM - 2:25 PM EDT
Location: Room 204C, Walter E. Washington Convention Center
2025 Oral Abstract Award
Abstract:
Background/

Introduction: The Seldinger technique is a guidewire-based entry method traditionally used for interventional radiology has been implemented successfully in various endovascular procedures. We propose adapting this technique into TMJ arthroscopy to reduce post-surgical complications and improve reproducibility in trainees compared to the traditional cannulated trocar puncture techniques.

Purpose: This study is the first to evaluate the safety and efficacy of the Seldinger technique compared to the traditional trocar technique in TMJ arthroscopy.
This innovation can minimize cartilage scuffing, excessive manipulation, and bleeding. Additionally, TMJ arthroscopy has a steep learning curve and is not commonly taught in residency, whereas arthrocentesis is commonly performed by surgeons worldwide. This method has potential to bridge the gap in education and technical expertise required to perform arthroscopy.
Materials and

Methods: Retrospective review of consecutive patients undergoing arthroscopy was performed. Exclusion criteria included patients with previous surgical intervention.
This technique uses a 17-gauge spinal needle, 18-gauge Nitinol wire, and sequential dilators to deliver the cannulas into the joint.
The traditional technique, described by McCain, utilizes a sharp trocar to insert the cannulas at the most concave portion of the glenoid fossa.
Primary outcome was major complication including ear or intracranial injury.
Secondary outcomes were minor complications including intraoperative bleeding, paresthesias of the auriculotemporal and trigeminal nerve, and masseteric or facial nerve weakness.

Results: 18 joints in 16 patients underwent traditional arthroscopy and 15 joints in 11 patients underwent Seldinger arthroscopy over a 6-month period.
There was one otologic complication in the traditional technique and none in the Seldinger technique.
Auriculotemporal nerve paresthesia was noted in 38.8% traditional and 20% in Seldinger. Trigeminal nerve paresthesia was noted in 11.1% traditional and none in Seldinger. Intraoperative bleeding, facial nerve and masseteric nerve injury were not noted in any of the groups.
This technique had the arthroscopic cannula successfully inserted in 14 of 15 joints, but one required the traditional technique due to significant joint stenosis.

Conclusion: This technique appears to be a safe and effective means of performing surgical arthroscopy when compared to traditional trocar technique. Further work on Seldinger technique adapted TMJ arthroscopy involves examining reproducibility in trainees and following up with patients for long term postoperative outcomes compared to traditional technique.

References
Taon, M. C. (2022). Seldinger technique. Essential Interventional Radiology Review: A Question and Answer Guide. Cham, Switzerland: Springer International Publishing, 47-48.
McCain, J. P. (1988). Arthroscopy of the human temporomandibular joint. Journal of Oral and Maxillofacial Surgery, 46(8), 648-655.