Template-based temporomandibular joint puncturing and access in minimally invasive TMJ surgery (MITMJS) - A technical note and first clinical results

Head Face Med. 2019 Apr 2;15(1):10. doi: 10.1186/s13005-019-0194-8. Template-based temporomandibular joint puncturing and access in minimally invasive TMJ surgery (MITMJS) - a technical note and first clinical results. Krause M, Dörfler HM, Kruber D, Hümpfner-Hierl H, Hierl T(3).12, 04103, Leipzig, Germany. (2)Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl-Liebknecht Str. 145, 04277, Leipzig, Germany. (3)Department of Oral and Maxillofacial Plastic Surgery, Helios Vogtlandklinikum Plauen, Roentgenstr. 2, 08529, Plauen, Germany. Thomas.Hierl@helios-gesundheit.de. Erratum in Head Face Med. 2019 Jun 18;15(1):14. doi: 10.1186/s13005-019-0197-5. BACKGROUND: Minimally invasive temporomandibular joint surgery (MITMJS) is an option for patients suffering from severe internal derangement or adhesions. To improve TMJ access, a workflow to create surgical templates is introduced. METHODS: A workflow to generate a dividable patient specific template based on CBCT and optical scanning to access the joint is introduced. In a first clinical trial 3 patients (6 joints) were treated by way of template-guided endoscopically-assisted TMJ therapy (3 arthrocenteses and 3 arthroscopies). RESULTS: Generation and clinical use of the templates was as planned. All templates showed perfect fit and permitted instant access to the TMJ. All surgeries were performed without complications. CONCLUSIONS: Template-guidance could improve the feasibility of endoscopically-assisted TMJ therapy. An important issue is the capability to dis- and remount the template during surgery. Using in-house production, costs are affordable. TRIAL REGISTRATION: This study was registered at the Ethic Committee of the Berlin Medical Chamber ( Eth-30/17 , 12/06/2017). DOI: 10.1186/s13005-019-0194-8 PMCID: PMC6444874 PMID: 30940211 [Indexed for MEDLINE] Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This study was approved by the Ethics Committee of the Berlin Medical Chamber (Eth-30/17, 12/06/2017; https://www.aerztekammer-berlin.de/10arzt/50_Ethik-Kommission/index.html). This report followed the Declaration of Helsinki on medical protocol and ethics. CONSENT FOR PUBLICATION: Written informed consent was obtained from the patient for publication of the technical note. A copy of the written consent is available for review by the Editor-in-Chief of this journal. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.