Resident Massachusetts General Hospital Boston, Massachusetts, United States
Disclosure(s):
Mohammad Mousavian, MD, DMD, PhD: No financial relationships to disclose
Abstract:
Purpose: Temporomandibular joint (TMJ) arthroscopy is a noninvasive surgical diagnostic and often therapeutic treatment modality for certain patients with temporomandibular joint disease (TMD).1 In pediatric population, TMJ arthroscopy, though not commonly performed, serves as a noninvasive tool for diagnosis of inflammatory and mechanical disease processes.2 Outcomes and findings of TMJ arthroscopy is not widely described in current literature. In a study by Choi, et al, 23 pediatric patients were evaluated with a mean age of 14 after having undergone TMJ arthroscopy, with results notable for significant improvement in pain, just function, and mouth opening.3 The aim of this study is to further describe most common arthroscopic findings in pediatric patients undergoing TMJ arthroscopy. Materials and
Methods: In this retrospective observation study performed at Massachusetts General Hospital Oral and Maxillofacial Surgery, pediatric patients (maximum age of 18) who underwent TMJ arthroscopy between August 2019 and October 2024 were included. Operative reports were reviewed for the patients and data was consolidated into an aggregated database. Findings from each joint were summarized, and cumulative findings were combined and analyzed. Percentages of findings were calculated based on total number of joints instrumented, rather than total number of patients.
Results: 32 patients (54 joints), ages of 10 to 18 with a mean of 16 years were included in the study. Patient cohort consisted of 30 (93.8%) female, and 2 (6.2%) male individuals, with no patients identifying as non-binary. Synovitis was observed in 49 joints (90.7%), disc displacement in 34 joints (63.0%), chondromalacia in 16 joints (29.6%), disc perforation in 5 patients (9.3%), and stenosis in 3 joints (5.5%).
Conclusions: This study includes the largest sample size of pediatric patients undergoing TMJ arthroscopy, with 32 patients and 54 joints. The remarkable majority of patients identified as female. The most common arthroscopic findings were notable for synovitis, disc displacement, and chondromalacia. Disc perforation and joint fibrosis were observed in a small number of patients. Future studies are indicated to evaluate the outcomes of pediatric patients undergoing diagnostic and therapeutic TMJ arthroscopies.
References: 1. Connelly, S. T., Tartaglia, G. M., & Silva, R. G. (2019). Contemporary Management of Temporomandibular Disorders: Surgical Treatment (1st ed. 2019.). Springer International Publishing: Imprint: Springer. 2. Choi, D., Davis, C., Vandenberg, K., & McCain, J. P. (2017). Temporomandibular Joint Arthroscopy in the Pediatric Population. Journal of Oral and Maxillofacial Surgery, 75(10), e408–e409. https://doi.org/10.1016/j.joms.2017.07.138 3. Choi, D. D., Vandenberg, K., Smith, D., Davis, C., & McCain, J. P. (2020). Is Temporomandibular Joint Arthroscopy Effective in Managing Pediatric Temporomandibular Joint Disorders in the Short- and Long-Term? Journal of Oral and Maxillofacial Surgery, 78(1), 44–51. https://doi.org/10.1016/j.joms.2019.07.011
