Endoscopic Transcanal Repair of Temporomandibular Joint Herniation: A Preliminary Report.

Abstract

<h4>Objective</h4>To evaluate the feasibility and describe the surgical outcomes of an exclusively endoscopic transcanal approach for reconstructing the external auditory canal (EAC) in patients with temporomandibular joint (TMJ) herniation.<h4>Patients</h4>This study included 3 consecutive patients with symptomatic, spontaneous TMJ herniation. The primary indication for surgery was discomfort from the herniation that persisted for more than 3 months.<h4>Intervention</h4>All patients underwent reconstruction of the anterior EAC wall using a titanium mesh through an exclusively endoscopic transcanal approach.<h4>Main outcome measures</h4>The primary outcomes were technical feasibility of the procedure, operative time, and postoperative results, including any complications.<h4>Results</h4>The endoscopic procedure was successfully completed in all 3 patients without conversion to an open approach. The mean operative time was 75.3 minutes (range: 65 to 85 min). During a mean follow-up of 23.3 months, 2 patients had a complete resolution of symptoms without complications. One patient experienced mesh extrusion 8 months after surgery, which required removal of the mesh. The feasibility of most surgical steps was rated as 'adequate'.<h4>Conclusions</h4>An exclusively endoscopic transcanal approach is a feasible technique for repairing TMJ herniation into the EAC. This method provides excellent visualization of the surgical field and avoids external incisions. Although these preliminary results are promising, larger studies are necessary to confirm the long-term efficacy and safety of this technique.