颞下颌关节盘前移位和穿孔的关节内窥镜研究

目的 :探讨颞下颌关节内窥镜下颞下颌关节盘移位和关节盘穿孔的病理改变特征。方法 :76例 84侧临床诊断为颞下颌关节盘前移位以及关节盘穿孔的病例进行颞下颌关节内窥镜检查。结果 :可复性关节盘前移位的病例出现滑膜炎 ,关节腔内有絮状物 ,关节结节表面有纤维形成。不可复性关节结节表面纤维形成 ,关节软骨软化 ,软骨剥脱 ,同时伴有纤维粘连。关节盘穿孔大多数位于双板区与后带。关节盘穿孔出现滑膜增生 ,关节窝及关节结节表面纤维形成 ,软骨剥脱甚至骨质暴露。结论 :关节内窥镜检查可诊断关节盘前移位与关节盘穿孔 ,并能发现病理性改变 ,如滑膜炎 ,滑膜增生 ,纤维变性 ,软骨软化 ,关节内粘连等。在不可复性盘前移位病例中发现关节退行性改变 ,关节盘穿孔为严重的骨关节病。

The arthroscopic study in the patients with disc displacement and perforation of TMJ

Objective: To evaluate the pathologic changes in the patients of anterior disc displacement (ADD) and perforation of temporomandibular joint (TMJ).Methods: Arthroscopic examination was performed in 76 patients (84 joints) with anterior disc displacement and perforation of temporomandibular joint.Results: Arthroscopic examination showed that there were synovitis, debris and fibrillation in the joints of ADD with reduction; synovitis, synovial hyperplasia, debris, fibrillation, chondromalacia,fibrocartilage rupture and adhision in the joints of ADD without reduction. Most perforated cases were located in the bilaminar and post band of disc and there were synovial hyperplasia, fibrillation, fibrocartilage rupture,and bone exposure.Conclusions:Arthroscopic examination is useful in diagnosing the anterior disc displacement and perforation of temporomandibular joint and in finding the pathologic changes including synovitis,synovial hyperplasia,fibrillation, chondromalacia and adhision. There were degenerative changes in the joints of ADD without reduction and osteoarthrosis th the joints of perforation.