Small incision arthroscopically assisted disc anchorage of the anterior disc displacement of temporomandibular joint: part I - technique introduction

Abstract

We describe a novel hybrid surgical technique, termed “small incision arthroscopically assisted disc anchorage” (SIAADA), for the treatment of anterior disc displacement (ADD) of the temporomandibular joint (TMJ). The aim of this study was to integrate the microinvasive benefits of arthroscopy with the procedural accessibility of open surgery. This technique combines arthroscopic intra-articular assessment and precise anterior attachment release with a minimal preauricular incision (~ 1.8 cm) for open disc repositioning and rigid bone anchor fixation. A preliminary case series of four female patients (mean age: 20.8 ± 3.0 years) with symptomatic unilateral ADD underwent the SIAADA procedure. Preoperative and 6-month postoperative clinical evaluations included maximum interincisal opening (MIO) and pain assessed by a 100-mm visual analog scale (VAS). All four patients completed the SIAADA procedure without major complications. At the 6-month follow-up, we observed clinically meaningful improvements. The mean MIO increased from 30.0 ± 5.7 mm preoperatively to 37.3 ± 1.3 mm postoperatively. The mean VAS pain score decreased from 79.3 ± 6.2 to 22.0 ± 10.8. The surgical scar was well-concealed within the auricular fold. The authors describe a new SIAADA technique for anterior disc displacement of the TMJ. This technique is proposed as a novel hybrid strategy that may offer a lower technical threshold compared to pure arthroscopic suturing while potentially providing improved cosmetic outcomes compared to traditional open disc anchorage. Long-term clinical outcomes, including relapse rate and condylar remodeling, will be investigated in future prospective studies with clinical and MRI follow-up.