The risk of damage to facial nerve, superficial temporal vessels, disk, and articular surfaces during arthroscopic examination of the temporomandibular joint

The risk of complications occurring during arthroscopic examination of the temporomandibular joint is not well documented. We therefore performed arthroscopic examinations of the upper compartment of the temporomandibular joint of fresh cadavers and during subsequent dissection studied possible damage to the facial nerve, superficial temporal vessels, disk, and articular surfaces. Damage to the facial nerve was not seen in any joint. The distance between the puncture site and any branch of this nerve was 3 mm or more in all but one of the specimens. The puncture site was repeatedly located immediately adjacent to the superficial temporal vessels, but damage to these vessels was not seen in any case. Scratch marks on the articular surfaces resulting from intra-articular manipulations with the instrument were seen in more than half of the joints. It was concluded that the risk of damage to the facial nerve or the superficial temporal vessels during arthroscopy of the temporomandibular joint is small. There is, however, a risk of damage to the articular surfaces. The frequency of this type of injury can probably be reduced in patients by sufficiently distending the joint before the instrument is inserted.